Letters to the Editor

Wednesday, August 26, 2009 at 11:41pm

 

Lip service doesn’t heal

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) had to do with 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.

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 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.

Of course, these stories — like the authors' repeated claim that private employers opportunistically dropped their coverage and "forced" workers on to the TennCare rolls — are virtually unverifiable and unquantifiable because of the inadequate data collection and analysis from which TennCare historically suffered.

The people cast out by [TennCare] 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

 

 

299 Comments on this post:

By: MamaG on 8/27/09 at 1:33

brrrrk, you know he's not giving up, don't you? lol

By: Blanketnazi2 on 8/27/09 at 1:36

Mama, my grandma made it to 96. i loved her to death and i miss her so much. she was tough as nails but sweet as pie.

By: brrrrk on 8/27/09 at 1:37

Dragon said

"We're talking past each other. Private insurance providers do fund abortions, probably more than 90% of them. I am free to buy from them or not. That is my freedom."

You just made my point.... duh. Unless you've checked out your own provider, you're probably funding abortions right now as we speak. I'm just saying that for all your bitchin' and bellyachin' about the public option and abortion, the fact is that you're likely funding abortions now. Why don't you check with your provider and let us know when you're going to drop them... LOL

By: Kosh III on 8/27/09 at 1:37

"Weeding the bad doctors out of the system is the pervue of the AMA"

Yeah, let the foxes guard the hen house.

So it's capped at a certain amount. Suppose the person is young-ish and losing a lifetime of earnings? Are the just SOL? sounds like it.

By: chiefpayne568 on 8/27/09 at 1:38

brrrrk,

"And how many people suffer or die along the way? 10? 100? 1000? Is a million enough for you? And what if someone you cared about was one of that 10, 100, or 1000? Again it's all about Chief and screw everybody else...."

And how many do NOW that settling out of court does NOTHING to the reputation of the doctors and so they can continue to practise unimpeded until they finally DO go to court.

So my premise that tort reform is needed.

By: pandabear on 8/27/09 at 1:39

...yeah, and if you still believe them after they lie to you,
remember that the country waited 50 years to have the Warren Commission
documents "revealed".

It was a lying pile of fur :)

By: Captain Nemo on 8/27/09 at 1:39

MamG, your mother sound a lot like my grand mother. She slept with a 45 automatic under her pillow.

By: chiefpayne568 on 8/27/09 at 1:40

brrrrk,

"You just made my point.... duh. Unless you've checked out your own provider, you're probably funding abortions right now as we speak. I'm just saying that for all your bitchin' and bellyachin' about the public option and abortion, the fact is that you're likely funding abortions now. Why don't you check with your provider and let us know when you're going to drop them... LOL"

Yes and he would have the right to go to another PRIVATE insurance company for his healthcare if he doesn't like it...NOT so with a public plan. Whether he liked it or not, his money would go to fund abortions...Period.

By: pandabear on 8/27/09 at 1:40

Captain.
We don't want to hear about her relationships...

By: Dragon on 8/27/09 at 1:41

brrrrk, you just don't get it. I can donate money to Planned Parenthood if I want to. I can support and even donate to women's abortion clinics. That is great and wonderful.

I will continue to bit and bellyache when you tell me that the federal government will decide for me and my freedom of choice is taken away.

By: Blanketnazi2 on 8/27/09 at 1:41

i doubt he'd find a private insurance company that didn't pay for an abortion. like brrrk said, go find out and tell us who you dropped and who you got insurance from.

By: pandabear on 8/27/09 at 1:42

yeah,
you can go to another private insurer and they can lie
even better about not funding abortion...and you can sign with them....

By: Captain Nemo on 8/27/09 at 1:43

Great come back chief. Maybe you should go post someone else comeback. It might have more of a bit. LOL

By: Blanketnazi2 on 8/27/09 at 1:43

Dragon, the point is right now you don't have much of a choice anyway. Private insurance pays for necessary abortions. Find me a private insurance company that doesn't. Plus, if you are getting your insurance through your employer, it's not like you have a large array of providers to choose from. So really, where is that freedom of choice you're crowing about?

By: gdiafante on 8/27/09 at 1:44

"I will continue to bit and bellyache when you tell me that the federal government will decide for me and my freedom of choice is taken away."

Now apply that to the abortion debate and little Dragon can enlighten himself.

But I doubt it...

By: house_of_pain on 8/27/09 at 1:44

What's the big deal about funding abortions?
How much can a rat on a string possibly cost?

By: Blanketnazi2 on 8/27/09 at 1:45

good point, g.

By: brrrrk on 8/27/09 at 1:45

MamaG said

"brrrrk, you know he's not giving up, don't you? lol"

Well, as Ayn Rand; the Madonna of the Free Market thinkers and the author of The Virtue of Selfishness (now there's a good Christian title for ya) said,

"Reason is not automatic. Those who deny it cannot be conquered by it."

She apparently knows her peeps... :-)

By: Blanketnazi2 on 8/27/09 at 1:45

By: house_of_pain on 8/27/09 at 2:44
What's the big deal about funding abortions?
How much can a rat on a string possibly cost?

wow....lol! is that and upgrade or a downgrade from a coat hanger?

By: Captain Nemo on 8/27/09 at 1:46

house, are you talking about the GOP rats on a string?

By: house_of_pain on 8/27/09 at 1:46

Had to stop using coat hangers...tetanus.

By: Blanketnazi2 on 8/27/09 at 1:47

i love how much the free market christian right enjoys quoting one of the most famous of all atheists, Ayn Rand.

By: chiefpayne568 on 8/27/09 at 1:47

Blanket,

"Dragon, the point is right now you don't have much of a choice anyway. Private insurance pays for necessary abortions. Find me a private insurance company that doesn't. Plus, if you are getting your insurance through your employer, it's not like you have a large array of providers to choose from. So really, where is that freedom of choice you're crowing about?"

True enough Blanket...but we'll have even less freedom under a public option...and at least right now, if you don't like your plan, you can change it...under a public option you can't.

By: Blanketnazi2 on 8/27/09 at 1:48

technically you would think so but that doesn't work in the real world, chief. it's not like your employer gives you a wide array of providers to choose from or that you can simply afford to go out and buy your own private plan and it be worth a hill of beans.

By: chiefpayne568 on 8/27/09 at 1:49

Blanket,

No one said atheists are stupid mentally. I just think their faith is lacking. One can have a logical mind and a starving soul.

By: brrrrk on 8/27/09 at 1:49

gdiafante said

"Now apply that to the abortion debate and little Dragon can enlighten himself.

But I doubt it..."

I suspect it might cause a short circuit like the Austin Powers Fembots or all the Droids in "I, Mudd".... :0)

By: Blanketnazi2 on 8/27/09 at 1:49

besides, look at the flip side. what about others' freedom of choice in having the procedure done?

By: Blanketnazi2 on 8/27/09 at 1:50

By: chiefpayne568 on 8/27/09 at 2:49
Blanket,

No one said atheists are stupid mentally

No, but you have accused them of being amoral. but i guess that doesn't apply to the selfish free market, huh?

By: Dragon on 8/27/09 at 1:50

Right now, I can chose not to even buy health insurance. Soon, that will be illegal.

Freedom, look it up.

By: chiefpayne568 on 8/27/09 at 1:51

Blanket,

"besides, look at the flip side. what about others' freedom of choice in having the procedure done?"

Well what about that? What IF the public option DOESN'T cover that? Then their choice for having an abortion is gone, yes?

By: gdiafante on 8/27/09 at 1:51

"if you don't like your plan, you can change it"

Uh huh...you can change jobs in order to get better insurance. I did it, took a pay cut too. That's about the only choice, so stop kidding yourself.

And let's be honest here, this "reform" is going to fail and we're going to see bankruptcies and personal wealth decrease while the insurance companies and pharmaceuticals post record profits. That's the future folks, I hope you saved up some money because all your "retirement" will be lost the first extensive illness you contract.

God bless Amurka

By: Captain Nemo on 8/27/09 at 1:51

When the right wing says the word freedom, they somehow turn it into a whine.

By: Blanketnazi2 on 8/27/09 at 1:51

Dragon, do you have insurance now? If so, from which provider?

By: chiefpayne568 on 8/27/09 at 1:54

Blanket,

"No, but you have accused them of being amoral. but i guess that doesn't apply to the selfish free market, huh?"

One can be intelligent and not be moral at the same time.

BTW, the free market also allows for charitable contributions. Since abortion clinics are done by those methods, would they no longer be able to do so under the public option? Could be the only way they COULD get an abortion would be to make the public option to allow for abortions, which would not sit well with those who are against funding them.

Could be an issue, if this bill passes.

By: brrrrk on 8/27/09 at 1:57

Dragon said

"Freedom, look it up."

Drag, this is just for you........

It's a Free Country

A commonly heard mantra is, "Read your Constitution - it's a free country, you know!" Well, read your Constitution - it never says it is a free country. The implication of the aphorism is that in the United States, you can do whatever you want to do, and the Constitution is there to ensure that. It is certainly true that the Constitution protects many civil rights. The 1st Amendment ensures freedom of religious choice and freedom of speech, but those things are not without limit. You cannot create a religion that allows you to kill someone without civil punishment; you cannot use libelous or slanderous words without recourse. There are other things that restrict freedom - from the ability to suspend habeas corpus to the issuance of patents. Certainly the United States is a very free country, but it is not totally free - which is actually a good thing, unless you actually like anarchy. It is interesting to note that in his confirmation hearings in 2005, John Roberts said several times, "It's a free country." It will be interesting to see how this enters into his judicial philosophy on the Court.

http://www.usconstitution.net/constnot.html

By: gdiafante on 8/27/09 at 1:57

Seems to me that all the diatribes against reform always start with "If" or "Could"...lots of speculation going on here.

That's where Obama's dropped the ball. It's giving the chicken littles of the world their 15 minutes.

By: chiefpayne568 on 8/27/09 at 2:00

Gdia,

But you COULD change jobs and get it. Under this plan, you lose your job, you're on the public option and can't get off once on, from what I've read of it. Now they may have changed this but I haven't see it if they did.

"And let's be honest here, this "reform" is going to fail and we're going to see bankruptcies and personal wealth decrease while the insurance companies and pharmaceuticals post record profits. That's the future folks, I hope you saved up some money because all your "retirement" will be lost the first extensive illness you contract."

Well, I tend to agree with you on this one...at least in terms of the failure of the reform and the bankruptcies and personal wealth. But the insurance companies and pharmaceuticals will take the hit too...all businesses will. Everyone is going to be hurting!

By: Captain Nemo on 8/27/09 at 2:04

The liberals have Freedom Riders

The conservatives Have Freedcom Whiners.

See you tomorrow. Have a good day rest of gthe day.

By: chiefpayne568 on 8/27/09 at 2:05

brrrrk

I love it! AKA freedom isn't free!

That's true...everyone has responsibilites to go with that right of freedom.

By: gdiafante on 8/27/09 at 2:06

Health costs have been spiraling out of control for years, it's just magnified in a piss-poor economy. It seems to me that healthcare companies are doing pretty well despite both of those facts, huh?

By: gdiafante on 8/27/09 at 2:09

How about Freedom Fries...those damn French...how DARE they choose to not support the Iraq War...

You know they're Socialists...BOYCOTT FRENCH TOAST!!!

By: Blanketnazi2 on 8/27/09 at 2:10

chief, show me where once you're on the public option you can't get off. that's not correct.

By: chiefpayne568 on 8/27/09 at 2:12

Gdia,

Only if people use it. I suspect if enough people are unemployed, it will affect them too. It's inevitable.

By: Blanketnazi2 on 8/27/09 at 2:14

that's already happening. people cannot afford regular healthcare so they wait until they end up in the ER.

By: brrrrk on 8/27/09 at 2:16

gdiafante said,

"Seems to me that all the diatribes against reform always start with "If" or "Could"...lots of speculation going on here."

Ain't that the truth! Every GOP point against the public option is speculative. Not a one of them has backed up their statements with ANY imperical data.

If you want a real kick, look up Reagans speech that he gave warning of the impending doom that is Medicare. He predicted that Medicare (as is) would eventually drive private insurers out of business and would be the end of Democracy as we know it. Gee, I wonder how that turned out? squawk squawk squawk......

By: chiefpayne568 on 8/27/09 at 2:22

Blanketnazi2 on 8/27/09 at 3:10

"chief, show me where once you're on the public option you can't get off. that's not correct."

Sorry...I'm pretty sure I saw it but I'm digging thru the blasted thing again. BTW, if you are on the public option, there's very little chance an employer would take you off it anyway.

By: brrrrk on 8/27/09 at 2:24

Blanketnazi2 said

"that's already happening. people cannot afford regular healthcare so they wait until they end up in the ER."

Hey, according to Chief, that's an integral part of our health care system... but hey, did you know that hospitals are starting to close down ER's because they simply can't cope with the cost of dealing with all the uninsured? Or they're getting so congested that waits our increasing dangerously. That'll be a bitch for sure the next time you have a heart attack.

http://www.lhj.com/health/family/kids/danger-americas-ers-are-closing/
http://pnhp.org/blog/2008/07/21/our-ailing-emergency-rooms/

By: chiefpayne568 on 8/27/09 at 2:25

brrrrk,

"Ain't that the truth! Every GOP point against the public option is speculative. Not a one of them has backed up their statements with ANY imperical data. "

Rather difficult as the liberals haven't completed a final draft of the darn thing...of course that hasn't stopped them from claiming all kinds of good things too. Door swings both ways, you know.

By: gdiafante on 8/27/09 at 2:27

Next time you have a heart attack, cough and eat an aspirin...and pray...lots of praying...except for blanket, you just hold your pocket protector! lol

By: brrrrk on 8/27/09 at 2:28

chief said

"Rather difficult as the liberals haven't completed a final draft of the darn thing...of course that hasn't stopped them from claiming all kinds of good things too. Door swings both ways, you know."

So you admit then that the GOP is ranting about something that doesn't even exist yet.