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Fsck Phil Bredesen
Posted by Kevin

The coward that killed Tenncare seems to think he is an expert on making health care affordable:

We’ve felt the pinch in Tennessee, and we’re not alone. The skyrocketing cost of health care is a national problem that deserves a national solution. Unfortunately, that day - when America comes together to address the issue of health care costs from a national perspective - has not yet arrived.

But as Governor of Tennessee, I cannot in good conscience stand by and wait for the folks in Washington to act on a problem that today impacts the lives and livelihood of every hardworking man and woman in America. That’s why, last year, I presented to the General Assembly a plan for what we can do here in Tennessee to offer a helping hand to our citizens - folks who work for modest wages, for small businesses, for themselves.

Cover Tennessee, is a modern, fiscally cautious, down-to-earth approach. It’s not the “end-all, be-all” solution to our problem. It is not another big government entitlement program. It is not TennCare part 2. What it is instead is a starting point that, if we’re successful, will allow us to grow step-by-step in a fiscally responsible way.

Well, isn’t that lovely. Good ol’ Phil, doing everything he can to help the poor and middle class of Tennessee who are stuck without health care. Sounds like quite a guy. Except that Phil Bredesen didn’t do one thing to help save Tenncare when he had the chance. He ran from the fight like rabbit runs from a wolf. He rejected out of hand any steps that might have saved Tenncare:

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.

Bredesen didn’t even try to take on the established players. He didn’t try a single real reform, he didn’t try to take on the business interests that were costing Tenncare money, he didn’t even try to crack donw on fraud — enrollment or billing. He just wined about lawyers and said the words “government program” like they were a curse and gave up without even the appearance of a fight. After all, what are the health concerns of the poor and the unlucky, right?

The study found a mixed scene for those taken off TennCare rolls. Many with multiple chronic health conditions can’t get health insurance. Some found their way through the complicated safety net system, a low-cost option called CoverTN, while others did not.

Primary care was generally available to the unenrolled either through emergency room visits or CoverTN. However, hospitals absorbed much of that cost. Also, social services agencies, like the CHC, have made changes to programs to meet new needs.

The CHC was bursting at the seams prior to TennCare reforms, Morris says. Now it is scrambling to handle the volume, but also deliver quality care. TennCare patients were an easy target, he says, because of perception.

To quote myself, Bredesen 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.

July 31st, 2007 Politics, Health | 2 comments