Letters to the Editor

Wednesday, September 2, 2009 at 6:01pm

Nothing for what ills us

It is very difficult for me to understand what possible relevance the article by Reps. Marsha Blackburn and Phil Roe [TennCare Lessons for Health Care Reform, July 27] has to the pending national debate, except for allowing them to experience once again the joy of bashing TennCare.

There is not one positive or constructive suggestion in the entire article, and in fact the only subject that seems to interest them,  pro or con, is the possibility of a government-run health care option. The merits or demerits of this part of (some) health reform packages cannot be evaluated without an analysis of the need for reform, and for this particular component, in the context of the total package in which it is included.

Instead, the authors content themselves with a misleading and inaccurate summary of TennCare's sad history, on the apparent assumption that if TennCare was bad, then the new reform proposal (they do not say which one) must be worse even though the two have nothing to do with each other.

Blackburn and Roe characterize TennCare as "universal single payer care" and President Barack Obama's goal as "universal care," thus establishing (in their minds) that if two things sound alike they must be alike. But TennCare was not "universal," even within the small "universe" of Tennessee, and it certainly was not intended to be "single payer." Rather it was intended to lower costs and expand coverage through managed care exercised by various qualified provider organizations in competition with each other.  

But many of the providers were not qualified, there was little or no management of the care provided, and by the end any real semblance of competition had been  eliminated while virtually all risk was assumed by the State. So of course TennCare didn't work —because it was never properly implemented.

If it is true, as the authors charge, that patients with nothing more than a cold incurred high costs for doctor visits and medication when they should have just taken an over-the counter remedy, then true managed care was not occurring or these unnecessary expenditures would not have been authorized or reimbursed. 

On the other hand, of course, if people are really ill, then it is more economical (and patients are better off) if they do see a doctor instead of treating themselves and eventually winding up in an emergency room which is the most expensive option of all.

A final point:  TennCare alone simply cannot be blamed for "forcing" the then-Governor into proposing an income tax to bolster the State's chronically inadequate and unfair system for raising needed revenues.  I have read articles and papers dating back to at least the 1930s that say Tennessee's revenue structure needed to be revised so that it did not rely so heavily on an ever-increasing sales tax.  

Governor Phil Bredesen's unwillingness to acknowledge the obvious need for tax reform — along with his refusal to use the State's "rainy day" and reserve funds to help the poor and ailing — are the things that "forced" him to remove some 200,000 of our most vulnerable citizens from the protection of TennCare, thus eliminating the program in all but name. Tennessee being Tennessee, we will probably never know what happened to these people, but if we did the Governor's actions would forever stain his legacy and the reputation of the entire state.

As it is, the people cast out by Governor Bredesen are a large component of the the group which needs health care reform the most, whether through some sort of government-run plan or otherwise. People with no health coverage probably will not mind if a "government bureaucrat" is involved in the process that provides them with necessary care and treatment.  

The bugaboo that the new health care system will put another person "in the exam room" with the patient and his or her doctor should not frighten anyone anyway, since all but the most lavish current plans already place limits on costs and availability of certain procedures and require prior authorization for much if not all of the treatment provided.  

Like most opponents of reform, Blackburn and Roe give lip service to "affordable basic health care for all Americans," but they say that "creating a plan like TennCare is not the right answer." It would be more correct to say that creating a plan like TennCare is not the right question.  The question is how to meet the health care needs of all Americans, and on this subject Blackburn and Roe have nothing to offer.

Michael S. Lottman, 37082

Send comments via e-mail to letters@nashvillecitypaper.com

65 Comments on this post:

By: dargent7 on 9/3/09 at 7:18

Eureka! The server is up.
What's all this fuss about "health care"? You want real health? Get off your big lazy a@@es and walk, jog, run a couple of miles a day. Stay away from McDonald's, Burger King, Sonic, Wendy's. Avoid the canned and frozen food section in the grocery. Migrate towards the fresh produce. Get off the medications your local drug pusher, I mean Dr., prescribes. Learn to meditate. Listen to classical music. Pray.
Breathe deeply. Forgive grievances. And DO NOT enter any hospital at any time with the exception that you just got hit by a bus.

By: Kosh III on 9/3/09 at 8:15

Ya'll really need to fix your server problem pdq.

Paul? When did you join the John Birch Society?
A healthy lifestyle is good but no guarantee. I knew a woman, she was a fitness freak, eat organic, no meat. Did that stop her from dying from cancer?
If you are hit by a bus, what do you do? Just go bankrupt and be in debt for the rest of your life because you don't have coverage?

Single-payer for all citizens. It's the most cost effective solution.

By: Loner on 9/3/09 at 8:18

Server Up? This is getting to be a regular SNAFU.

Good grief, not another letter from Michael S. Lottman...this guy is a professional zealot - this is the second LTE from Lottman on the same subject; this LTE is longer winded, but the content is virtually the same as in his first letter.

I Googled Lottman's name and it seems that he is a local lawyer. One wonders what's in it for Mr. Lottman.

By: gdiafante on 9/3/09 at 8:24

I ran three miles a day, three times a week for 20 years...ended up with DJD of the knees and DDD of the lower back...listened to Wagner and Bach while running, ended up with severe hearing loss...Avoided McDonalds and was hit by a bus crossing the street to get to Whole Foods...bought some fresh produce that was tainted with E coli and had my entire digestive tract removed. Now I can only eat over toilets. Stopped taking all medications, went into the DT's and fell down the stairs. Took a deep breath and inhaled the second hand smoke of my neighbor and got COPD...

But, I did enter a hospital for a minor cut and won a million dollars for being the one billionth patient. Thanks American Healthcare System!! **Thumbs up**

By: house_of_pain on 9/3/09 at 8:24

I think he just added more to his original LTE, and re-submitted.
The server probably won't allow for much discussion today. Again.

By: Kosh III on 9/3/09 at 8:33

Woman in wheelchair heckled and booed for supporting health reform

http://guerillawomentn.blogspot.com/2009/09/new-low-at-new-jersey-town-hall-video.htm

By: Captain Nemo on 9/3/09 at 8:35

Good morning'

This is America. The Greatest country is History. Real Americans don't need Health Care. They can stand on their own two feet. -Rush Bimbo

By: Captain Nemo on 9/3/09 at 8:38

Great story gdia. I'm still laughting.

Kosh

Woman in wheelchair heckled and booed for supporting health reform.

NOW THIS IS JUST SAD

By: BenDover on 9/3/09 at 8:42

Tenncare was a total c_f_. It was polyannish 'care for the poor' plan of the same mold of Obamacare; and about bankrupted the state.

By: dargent7 on 9/3/09 at 8:58

GD: I think you exemplify "Cream's" song..."Born Under a Bad Sign".

By: sidneyames on 9/3/09 at 9:01

And Mass. is about bankrupt as well as CA. So one-pay gov'ment health care is a bust! I wan to be responsible for my own health care. And we have the best health care in the world. The hospitals and doctors have to write off a lot of UNPAID bills.

By: dargent7 on 9/3/09 at 9:02

d'pain: We don't "discuss" here. Normal discussion is sitting across from your ex-wife's attorney who want's "50% of everything", including right's to your pecker. Now, that's some real discussion.

By: Captain Nemo on 9/3/09 at 9:02

Verbal Cartoon

Iraq sometime in the near future, an army troops is about to go into a dangerious area. The leader of this brave men is a veteran of many missions. All of which have been flops. Fortunately previous mission had not been serious. However today's mission was different, they were going out into meet the people of Iraq.

The sholdiers are nervous because the leader is going to deviate from their orders of just distributing food and medical supplies. He is al so going to spread his version of Christianinty to the sinners of Islam. Has he gets out of his armor vehical and starts toward a group of Iraqis a shot is heard. Grabbing his butt, chiefpayne screams in pain. His men grab him and then rush him to the nearest medical facility.

Three days later chiefpayne is telling the people back home how his was wounded in a furious firefight. The offical report states that it was friendly fire and ruled an accident.

By: dargent7 on 9/3/09 at 9:03

gd: But, did you PRAY?

By: gdiafante on 9/3/09 at 9:04

"I want to be responsible for my own mental health care."

Fixed that for ya...don't thank me, it's my pleasure...

By: gdiafante on 9/3/09 at 9:07

Yes, I prayed to the lord that he would wash away my sins...and then fell in the shower and broke my hip...

By: dargent7 on 9/3/09 at 9:11

gd: You should of prayed to the CEO of Bank of America. I've received more "blessings" from that guy than God and Jesus, combined.

By: gdiafante on 9/3/09 at 9:15

I prayed to him once, and got $250 in insufficient funds charges. I then prayed to God to help me financially, was overheard by a doctor who thought I was talking to myself or an indivisible entity and promptly committed me to an institution.

That's where I met Sidney.

By: Captain Nemo on 9/3/09 at 9:19

g and d, I hope you two are covered for lightning strikes. lol

By: dargent7 on 9/3/09 at 9:20

gd: Forget praying to the "Almighty". False advertising. Pray to the "god" who manages your hedge funds and money markets, and CD's. Mo betta'.

By: gdiafante on 9/3/09 at 9:26

You're right Darg, I think I'll pray to the patron saint of lost causes...

By: Captain Nemo on 9/3/09 at 9:28

By: gdiafante on 9/3/09 at 9:26
You're right Darg, I think I'll pray to the patron saint of lost causes...
_________________________________________________________________

You are going to pray to chief? Why?

By: BenDover on 9/3/09 at 9:32

http://tinyurl.com/bredesensTakeOnIt

By: Funditto on 9/3/09 at 9:49

NCP has been moving from their present local so I'll give them a pass on the server issues!

By: brrrrk on 9/3/09 at 10:04

How sad it must be for Republicans to live a life where EVERYTHING revolves around money. Could it be that they're so concerned about the after life that they lose focus on "life". But then that doesn't make sense because of their genuine lack of concern for everyone but themselves. And according to the Bible, that's a no no.

The point is, I've rarely met a Republican who actually knew how to let lose and have fun just for the fun of it and without thinking of the religious ramifications of said fun. In fact, my uber religious office mate is so socially constipated that I couldn't even get her to take a chance on tasting an unusually flavored "crisp" (mozzarella and herb - and they were killer) from the U.K. God forbid!! You would think I was trying to shove Castor oil down her throat... not that I haven't thought about it.

By: gdiafante on 9/3/09 at 10:25

Not meaning to invoke Shakespeare, but some do protest too much, methinks.

By: Funditto on 9/3/09 at 10:46

I loved this letter in today's Tennessean. Pretty much sums it up for me!

*****

To the Editor:

Recent TV coverage of the effort to fight the “Station” fire in California has pushed me to write to try to stop this socialistic waste of taxpayers’ money.

In the United States, the land of rugged individualism and free enterprise, why can’t people manage to get off their butts and fight fires on their own property? Why do they expect the rest of us to pay for their misfortune?

If it weren’t for tax-supported fire-fighting entities, there would be for-profit private fire protection companies that people could pay to fight their fires for them (if they were unable or unwilling to fight their own fires). They used to exist before socialism drove them out of business.

If this state meddling in private affairs doesn’t stop soon, we will be surrounded by bleeding hearts shouting leftist slogans like “To each according to his need; from each according to his ability” and “Do unto others as you would have them do unto you!”

Dan Church, NASHVILLE 37215

By: brrrrk on 9/3/09 at 10:47

What?! No chief today?! There must be a local meeting of the Jack Bauer fan club in town....

By: Kosh III on 9/3/09 at 10:55

Nah, he's probably at a seminar led by Sen. Craig and Ted Haggard on "Tools for Success as a Heterosexual"

By: brrrrk on 9/3/09 at 10:57

Funditto,

That's a great letter. But what a lot of people don't realize is that there's a serious side to this. Some historians actually point to the Chicago fire as being a perfect example of what happens when there are nothing but private fire stations. As I understand it, prior to the great Chicago fire, there were no public fire houses in Chicago. Everyone subscribed to a fire service and for that subscription they received a medallion that they put on their front door. As a result, houses were left to burn out of control because they either had no medallion or the wrong medallion. After the fire, and during the rebuilding, there was a great deal of discussion as to how to prevent something like this from happening again.... the result, Chicago's public fire stations.

By: brrrrk on 9/3/09 at 11:07

Funditto,

I must correct myself, apparently Chicago did have a city fire department at the time, as well as there being private fire departments in the city.

By: BenDover on 9/3/09 at 11:11

"How sad it must be for Republicans to live a life where EVERYTHING revolves around money. Could it be that they're so concerned about the after life that they lose focus on "life". But then that doesn't make sense because of their genuine lack of concern for everyone but themselves. And according to the Bible, that's a no no."

What a raw distortion. Is that what you really think?

Brrrrk, without our market based society we would not have the luxury to consider the relationship with our fellow man. It is the surplus generated by our work-reward system that allows for charity, government services, mass education, the wide-spread availability and quality of health care... and all manner of altruism in society.

The republicans' stand is that society must be careful not to kill the golden goose that provides the excesses upon which the entire world relies. The impetus to work is hindered by a system that takes the rewards from the workers in a disproportionate manner to the extent that the workers become overburdened by the excesses of the political class and those who choose sloth over productivity.

In short, it is wrong to take the largess of society and flush it through an inefficient, often corrupt and politically motivated bureaucracy to the degree that it removes the producer's impetus to produce and creates plateaus among the working class where there is little benefit to working over not working.

Why anyone would choose to characterize this very reasonable position as mean spirited, racist or ungodly is logically bereft and truly without reason.

By: gdiafante on 9/3/09 at 11:14

Look, ten stones in row!!

By: Kosh III on 9/3/09 at 11:14

" overburdened by the excesses of the political class and those who choose sloth over productivity."

You mean like bankers, hedge fund managers and speculators? That's who got us in much of this current mess.

By: Loner on 9/3/09 at 11:24

LOL, GD.

Here's a link to a breaking story, seems a health care demonstrator bit off the finger of another demonstrator ...yeah, it happened in California. The biter was pro-health care reform, the bitee was against health care reform.

http://cbs2.com/local/Finger.Bite.Off.2.1161846.html

I'd want to start anti-rabies treatment...obviously, the biter was quite rabid.

By: Loner on 9/3/09 at 11:35

Ben sez: ".It is the surplus generated by our work-reward system that allows for charity, government services, mass education, the wide-spread availability and quality of health care... and all manner of altruism in society. "

That's true, but there would be no surplus for the workers to enjoy without the groundwork laid by organized labor, through collective bargaining. Captalism works best when the laborers are adequaely compensated and are fully vested in the system. The capitalists, historically speaking, share the wealth only when forced to do so.

By: brrrrk on 9/3/09 at 11:36

BenDover,

With all due respect, your long winded answer can be reduced to one sentence.

Money first, your fellow human second.

As for your golden goose analogy... you think the golden goose is then monied aristocracy whom you must cater to, while I think the golden goose is the American worker.

By: dargent7 on 9/3/09 at 12:06

Bend-O: Excuse me while I barf. Aren't you the one "and only" who says GW Bush was the "greatest President ever", and wants his face carved into Mt. Rushmore?
The guy and his cabal destroyed whatever was left of America, both home and abroad, and stated an illegal, immoral, unethical war in the Middle East. Almost 7 years later, we're being bled to death financially in this money pit, with no end in sight. You, and others' like you seem to think , "We won!" Won what?
Your opinion, while articule, is marginalzed. You sound off like those Senators on the Congressional floor talking for hours, but making no sense.
Bottom line: Bush Sr. and Bush Jr. ruined this country due to lies, deception, corruption, ties to oil, and malefesense.

By: gdiafante on 9/3/09 at 12:20

233 years later and we're still debating the aristocracy versus the working man.

Policies that systematically eliminate the middle class are not the answer.

I'd also like to know about these "excesses". Seems to me that disposable income keeps getting lower, while prices keep increasing. Is there any wonder why our economy is based on credit? Is there anyone who can really afford to purchase anything without financing? Why do you think no one can save and we're mired in debt?

By: slacker on 9/3/09 at 12:59

History Of Civilization

Humans originally existed as members of small bands of nomadic hunter/gatherers.
They lived on deer in the mountains during the summer, and would go to the coast and live on fish and lobster in the winter.

The two most important events in all of history were the invention of beer and the invention of the wheel. The wheel was invented to get man to the beer. These were the foundation of modern civilization and together were the catalyst for the splitting of humanity into two distinct subgroups:

1. Liberals
2. Conservatives

Once beer was discovered, it required grain, and that was the beginning of agriculture. Neither the glass bottle nor aluminum can were invented yet, so while our early humans were sitting around waiting for them to be invented, they just stayed close to the brewery. That's how villages were formed.
Some men spent their days tracking and killing animals to Bar-BQ at night while they were drinking beer. This was the beginning of what is known as the Conservative movement.
Other men who were weaker and less skilled at hunting learned to live off the conservatives by showing up for the nightly Bar-BQ's and doing the sewing, fetching, and hair dressing. This was the beginning of the Liberal movement.

Some of these liberal men, eventually evolved into women. The rest became known as girlie-men. Some noteworthy liberal achievements include the domestication of cats, the invention of group therapy, group hugs, and the concept of Democratic voting to decide how to divide the meat and beer that conservatives provided.
Over the years conservatives came to be symbolized by the largest, most powerful land animal, the elephant. Liberals are sybolized by the jackass.
Modern liberals like imported beer (with lime added), but most prefer white wine or imported bottled water. They eat raw fish but like their beef well done. Sushi, tofu, and French food are standard liberal fare. Another interesting evolutionary side note about liberals: most of their women have higher testosterone levels than their men. Most social workers, personal injury lawyer's, journalists, dreamers in Hollywood and group therapists are liberals. Liberals invented the designated hitter rule because it wasn't fair to make the pitcher bat. Liberals also developed affirmative action because it was not fair that people who had average grades in college could not qualify for admission to medical school.
Conservatives drink domestic beer, mostly Bud. Thet eat red meat and still provide for their women. Conservatives are hunters, rodeo cowboys, lumberjacks, construction workers, firemen, medical doctors, engineers, police officers, corporate executives, athletes, members of the military, airline pilots, and generally anyone who works productively.
Conservatives who own companies hire other conservatives who want to work for a living.
Liberals produce little or nothing. They like to govern the producers and decide what to do with the production. Liberals believe Europeans are more enlightened than Americans. That is why most of the liberals remained in Europe when conservatives were coming to America.
They crept in after the Wild West was tamed and created a business of trying to get more for nothing.
That is the history of civilization.

By: brrrrk on 9/3/09 at 1:15

Loner said

"That's true, but there would be no surplus for the workers to enjoy without the groundwork laid by organized labor, through collective bargaining. Captalism works best when the laborers are adequaely compensated and are fully vested in the system. The capitalists, historically speaking, share the wealth only when forced to do so."

Couldn't agree more. The problem with the American version of Capitalism is that Corporations look at their workers as if they were a cost and not a partner in the system. Anyone who questions what Corporations would do without organized labor and collective bargaining should read Howard Zinn's A Peoples History Of The United States.

It was Republican President Teddy Roosevelt who said, "It is essential that there should be organization of labor. This is an era of organization. Capital organizes and therefore labor must organize."

By: dargent7 on 9/3/09 at 1:35

And NOTHING reduces life to it's lowest form than The President of the United States declaring war on a Nation,...weaker, smaller, unable to defend itself.

By: gdiafante on 9/3/09 at 1:44

What a crock of **** slacker. You must be drunk today.

By: Kosh III on 9/3/09 at 2:01

"And NOTHING reduces life to it's lowest form than The President of the United States declaring war on a Nation,...weaker, smaller, unable to defend itself."

But Granada was destined to become a Great Power.

By: Dragon on 9/3/09 at 2:04

Rats! Both of my Che T-shirts are in the laundry.

By: chiefpayne568 on 9/3/09 at 2:21

After reading this story, I really have to ask...which group of protesters are more civilized again?

Healthcare activist bites off finger of counter-demonstrator
http://latimesblogs.latimes.com/lanow/2009/09/health-care-activist-bites-off-the-finger-of-a-counter-demonstrator.html

By: chiefpayne568 on 9/3/09 at 2:25

Ok...now THIS is scary.

Sentenced to death on the NHS

Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors have warned.

http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html

By: MamaG on 9/3/09 at 2:48

So chief, do you think the sick and uninsured have it any better?

By: MamaG on 9/3/09 at 2:49

FYI, if you are looking for quality care here in Nashville, do not expect to get it from Baptist hospital. The dr's are great. The nursing staff is a joke.

By: gdiafante on 9/3/09 at 2:51

Chief, that story has already been posted. If you're going to bore us, at least bore us with something new.