The Washington Post
January 18, 2005
Tenn.’s Retreat On Medicaid Points to Struggle
By Ceci Connolly
On Jan. 10, Tennessee Gov. Phil Bredesen, a Democrat elected in 2002 on a promise to rescue TennCare, announced he is cutting 323,000 low-income adults from the program and limiting services for 400,000 others. Like many other governors, Bredesen said that Tennessee’s expanded Medicaid program is devouring the state budget and that he cannot afford what had been hailed as one of the most generous government health plans in the nation.
“It might not be the level of care we want to provide, but it’s the level of care we can afford without bankrupting our state,” said Bredesen, a former mayor who made millions as a managed-care executive.
Despite her joint pain, fatigue and muscle spasms from lupus and multiple sclerosis, Lori Smith was standing outside the War Memorial Auditorium here Wednesday, denouncing Bredesen as he held a black-tie dinner for state legislators two days after cutting TennCare.
“I can’t believe he is saying he tried everything he could when he knows that is not true,” Smith, 39, said in an interview later at the seven-person graphics design firm where she works. “This is not his last resort.”
As protests go, Wednesday’s event was unremarkable. Fewer than 75 people braved the harsh wind, and a handful stretched out “dead” on the concrete, only to discover the governor and guests had slipped in through an underground parking garage.
Although he avoided a confrontation, Bredesen is keenly aware of his detractors, even singling out some by name. Lori Smith is one.
Unprompted, in an interview in the Capitol, Bredesen identified her as a “poster child” for liberal advocates and the media. He denigrated Smith, and many of the 30,000 TennCare clients deemed “uninsurable,” for making “lifestyle choices” to work for small businesses that do not offer insurance rather than finding jobs with the state or large companies that do.
Told of Bredesen’s remarks, Smith teared up…
http://www.washingtonpost.com/wp-dyn/articles/A16471-2005Jan17.html
Comment: (Excuse me a moment… I need to wipe away my tears… Never mind, they just keep coming.)
A few points:
* Gov. Bredesen is a Democrat. This issue is not simply partisan; it’s political.
* Managed care executive Bredesen promised to use his skills to rescue TennCare. As the 90’s demonstrated, managed care cannot deliver on the promise of high quality, comprehensive health care for many of those with the greatest needs. Managed care was a blunt instrument used to reduce spending on health care, partly by avoiding those who needed care.
* Medicaid, a program for low income individuals perceived as a “welfare program,” will always suffer from a lack of adequate funding whenever the federal or state governments are controlled by political forces that limit budget decisions to the spending side of the ledger. Those times are now upon us.
* I repeat the point made by many others. We have the highest per capita wealth, and we have the lowest taxation rate of all industrialized nations. We do not lack the funds; we lack the will to ensure comprehensive health care for everyone.
* We have the health policy tools at our disposal that would provide us with the ability to provide comprehensive care, not only for all Medicaid patients, but for everyone, without spending more than we already do. We already have the funds.
* Gov. Bredesen, like so many others, has allowed the opponents of health care reform to define the arena in which we hold the debate. In his unprompted comments, Gov. Bredesen denigrates the “uninsurable” who make the “lifestyle choices” to work for small businesses that do not offer insurance…
(Excuse me… The tears are flowing again…)
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Subject: qotd: HHS nominee Leavitt’s position on low-income patients
The New York Times
January 19, 2005
Bush Nominee Wants States to Get Medicaid Flexibility
By Robert Pear
President Bush’s nominee for secretary of health and human services, Michael O. Leavitt, said Tuesday that states could provide health insurance to more people, at no additional cost, if they had “greater flexibility” to reshape the Medicaid program and trim benefits.
Mr. Leavitt repeated that view several times, suggesting that it would be a theme as the administration worked with Congress this year to slow the growth of Medicaid, the federal-state program for more than 50 million low-income people.
As governor of Utah, Mr. Leavitt said, he devised a program that offered a limited set of health care benefits to people who had no insurance, and he suggested that Utah’s experience could be a model for other states to study.
State officials said that Utah’s “limited benefit plan,” approved by the Bush administration under a Medicaid waiver in 2002, did not include hospitalization or specialty care.
Comment: So HHS nominee Leavitt is adamant that states should be granted the option to devise new programs for Medicaid such as his own program in Utah.
Do we really want to establish policies that would deny low-income individuals coverage for hospitalization and specialty care?
What kind of a nation have we become? Where is the outrage?