Lean Left

« Previous | Next »

What Bredesen Hath Wrought
Posted by Kevin

Sharon Cobb points out that Bredesen’s cowardice on TennCare is going to kill real people:

People are going to Die. I’ve been saying that for months regarding the cuts to TennCare. Intellectually, I knew it was accurate, but it didn’t hit me emotionally until yesterday.

I was on the phone with a woman from Jackson, Tennessee yesterday, when breaking news came that the 6th Circuit in Ohio would allow Bredesen to cut 323 thousand people from TennCare. The woman I was talking with, M. Hall, had a heart transplant and she will not be able to obtain vital, immunosupressive medication without TennCare. She will die.

Ms. Hall is a mother of five, and grandmother of ten. Ms. Hall received a heart transplant on April 26, 2003. Her anti-rejection drugs that allow her to keep the heart she has received is not covered by Governor Phil Bredesen’s plan.

I have said this before, but it bears repeating: Bredesen is a deliberate coward. There were things that Bredesen could have done to save money before he tried to gut the program. He refused to join other states in a program to purchase drugs in bulk — a move that the former head of TennCare said would have saved the state about 500 million dollars. As I mentioned before, simply changing the way paperwork was done would save millions:

Bredesen’s failure is even worse than I thought. e is leaving many easy to implement things undone. Bredesen is literally leaving hundreds of millions of dollars of easy savings on the table. One egregious example is this:

This year TennCare will pay its managed care contractors $245 million, or nearly 5% of the $4.96 billion in health services which they administer. Those rates are relics of a past when the contractors were true HMOs that accepted financial risk. They are now only administrative services organizations (ASOs). They do not manage care. They pay claims and issue eligibility cards, which can be done for a fraction of present rates. In 1993, the last year before TennCare began, the Medicaid contractor that performed those functions received $8.5 million to administer $1.78 billion in claims, a rate of less than half of one percent. The state should not pay HMO prices for ASO service.

If TennCare would abandon its reliance on for profit HMOs to push paper around, and instead went back to the old system with the same percentages, the savings would be substantial. If the costs were one half of one percent, on 4.96 billion dollars of claims, then the state would be paying 24.8 million dollars — a savings of 220.2 million dollars a year. That is about 38% of the money Bredesen is going to save by kicking these people off TennCare:

South Knox Bubba highlights the fact that this kind of stupidity still goes on today:

Rehashing of old wingnut talking points in comments reminded me of something that was bugging me earlier this week.

The Tennessean reported that the state had problems with a company contracted to manage pharmacy benefits. The state’s response? To more than double the amount the state pays them from $15.2 million to $37.9 million. Sweet!

The company, First Health, was recently acquired by Coventry Health. Coventry Health’s earnings (i.e. profits) have increased by 300% since 2001. No wonder health care costs are skyrocketing.

Oh, and according to the transcript of this conference call about the acquisition (PDF format) they wouldn’t rule out eliminating First Health’s pharmacy benefit management business at some future date, assuming I correctly interpret the question by analyst Christine Arnold and the CFO’s (now CEO) response.

By the way, that conference call is an excellent look into the minds of senior management at health care “provider” outfits. People are their first priority. Not. It’s a perfect example of why profit needs to be removed from the health care equation.

TennCare is a good program that has made us all healthier (by getting people care and treatment that they needed before they transfered their problems to the rest of us), helped reign in health care costs (by getting people treatments before the problems escalated), helped the economy (by helping companies who did not have health insurance for their employees to miss less work and maintain their productivity), and provided a much needed safety net to people across this state to protect them form the harshness of the modern economy. TennCare’s problems weren’t structural, they weren’t caused by being too generous or by some inherent flaw in the concept of state provided health care. They were caused by poor management and the refusal to act in the best economic interest of the program. There were simple things that could have been done that would have saved the state about 720 million dollars — more than Bredesen claims his “reforms” will save.

And Bredesen didn’t even try to implement them. He simply adopted Republican talking points and turned his back on a program that was both the moral and practical thing to do. He refused to take on either the powerful pharmaceutical and HMO lobbies or the Republicans, and consigned 323,000 people to poor health care — and sometimes death. If I had wanted a governor afraid to stand up for Democratic principles, if I had wanted a governor more interested in the favor of pharmaceutical and HMO companies than the citizens of the state, if I had wanted a governor who spoke in RNC platitudes, then I would have voted for the Republican. It was political cowardice of the rankest kind, and Bredesen should never, ever be allowed to escape it. It should be tied around his neck like a millstone until it crushes his career under its weight.

Just like his cowardice is going to crush the life out of some of Tennessee’s citizens.

April 13th, 2005 Politics, Bloggin, Health | 12 comments