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: gdiafante on 8/27/09 at 2:28

Chief, the Democrats aren't the ones making up death panels and telling old people that Obama wants them dead. I understand you're enthusiasm for your party, but reality is also a good thing.

By: chiefpayne568 on 8/27/09 at 2:30

brrrk,

"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."

Think so? So how about how congested it'll be waiting to see a doctor it if passes? And how many ERs are NOT going to see a heartattack victim? Come on, you know they use the triage system in emergency rooms.

BTW, I don't expect the ERs to close...no way. They may just stablize people and then ship them off...but they won't close.

By: Blanketnazi2 on 8/27/09 at 2:36

By: gdiafante on 8/27/09 at 3:27
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

well, at least my pocket protector is real! lol!

By: chiefpayne568 on 8/27/09 at 2:39

Gdia,

"The Democrats aren't the ones making up death panels and telling old people that Obama wants them dead. I understand you're enthusiasm for your party, but reality is also a good thing."

Well, isn't it true that there will be a panel that will decide whether or not certain procedures will be done, in particular to older folks? That's what's happening in England.

And there was that Section 1233 of the health-care bill that would pay doctors to give Medicare patients end-of-life counseling every five years -- or sooner if the patient gets a terminal diagnosis. That didn't sit well with the older folks. They don't want to be forced to deal that.

Bottom line is, if the Democrats want to stop all of the suppostion and whatever else they're gripping about, they need to make a permanent draft of the darn bill and let everyone READ it before voting on it. That way, we can all sit down and have a logical discussion about it.

By: brrrrk on 8/27/09 at 2:40

chief said

"Think so? So how about how congested it'll be waiting to see a doctor it if passes? And how many ERs are NOT going to see a heartattack victim? Come on, you know they use the triage system in emergency rooms."

More speculation.....

"BTW, I don't expect the ERs to close...no way. They may just stablize people and then ship them off...but they won't close."

While it is true that EMTALA requires treatment to be given, there is no law that prevents the hospitals from closing their emergency rooms, or requires them to have a traditional ER staff available to handle catastrophic events. By the time you get shipped off to Ritzy Hospital, Anywhere USA... you could be dead.

By: chiefpayne568 on 8/27/09 at 2:42

brrrrk,

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

Just as the DNC is ranting about something they haven't completed as yet, yes.

That's the point...the DNC says they have a working copy but when holes are mentioned they say they will fix them. I say then FINISH the blasted thing, then we ALL can read it and discuss it.

Recall, it's the DNC who wanted to rush thru this bill, as they did the stimulus bill. Only when people told them to slow down, not wanting to get another bill full of garbage not needed, did discussion of it suddenly come up. But since the DNC aren't sure what's going to be in it, it gives free reign for all to read into it.

By: chiefpayne568 on 8/27/09 at 2:44

brrrrk,

"More speculation....."

What do you expect...that's all we have to go on right now. There's nothing of substance other than promises to go on.

By: Blanketnazi2 on 8/27/09 at 2:45

wait, didn't bush push through a stimulus bill?

By: chiefpayne568 on 8/27/09 at 2:45

brrrrk,

And frankly, given this Congress record for breaking promises, not to mention this Adminstration, it's no wonder everyone is worried about it.

By: Blanketnazi2 on 8/27/09 at 2:46

hey, at least they're not leading us into an unnecessary war that costs $3 billion.

By: house_of_pain on 8/27/09 at 2:47

Blanket, can other people pray to your pocket protector?

By: chiefpayne568 on 8/27/09 at 2:47

Blanket,

Well, he signed it and pushed for it...but of course it was ultimately Congress that got it on his desk. BTW, Obama signed off on that one.

And frankly, I was truly disappointed in him for that. Really ticked me off, actually.

And Obama passing the second one didn't help matters either. And then his suggesting we might need another one really made things hit the fan.

By: Blanketnazi2 on 8/27/09 at 2:47

house, if my pocket protector starts "speaking" with others i'm going to be really offended. it's not said word one to me in all these years.

By: Blanketnazi2 on 8/27/09 at 2:48

but you'd just rather focus on Obama and the democratically controlled congress. i see how you side stepped bush.

By: house_of_pain on 8/27/09 at 2:48

Oh, you can speak to it, but it can't speak to you. That would be...crazy.

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

Blanket,

"hey, at least they're not leading us into an unnecessary war that costs $3 billion."

No, they're leading us to a healthcare reform that costs $1 trillion...at least.

By: Blanketnazi2 on 8/27/09 at 2:49

By: house_of_pain on 8/27/09 at 3:48
Oh, you can speak to it, but it can't speak to you. That would be...crazy.

LOL!

By: gdiafante on 8/27/09 at 2:51

"Well, isn't it true that there will be a panel that will decide whether or not certain procedures will be done, in particular to older folks?"

You mean like how that decision is made by insurance companies right now? But that's ok. Gotcha.

"They don't want to be forced to deal that."

Right, they don't want to die, but if they're terminal...well guess what...

Let it play out Chief before declaring the sky's falling.

By: Blanketnazi2 on 8/27/09 at 2:52

g, don't you know that those free market insurance companies are so compassionate when it comes to elderly and the chronically ill?

By: chiefpayne568 on 8/27/09 at 2:54

Blanket,

"but you'd just rather focus on Obama and the democratically controlled congress. i see how you side stepped bush."

Last I looked, Bush is out of office...and Obama is President.

Remember --- he WON.

By: gdiafante on 8/27/09 at 2:54

"No, they're leading us to a healthcare reform that costs $1 trillion...at least."

Call me crazy, but health care reform that will save lives and benefit the future of our country is money well spent. Rather than an ill-advised, poorly managed and plain stupid war.

By: house_of_pain on 8/27/09 at 2:55

"stupid war"? Them's fightin' words...

By: chiefpayne568 on 8/27/09 at 2:55

Gdia,

"Call me crazy, but health care reform that will save lives and benefit the future of our country is money well spent. Rather than an ill-advised, poorly managed and plain stupid war."

Ok...you're crazy...because it could conceivably break the bank as it were...especially since we will be $9 trillion in debt in a few years.

By: gdiafante on 8/27/09 at 2:56

Don't make me turn the table, house...

By: Blanketnazi2 on 8/27/09 at 2:57

By: gdiafante on 8/27/09 at 3:56
Don't make me turn the table, house...

LMAO!

By: gdiafante on 8/27/09 at 2:57

"...because it could conceivably break the bank as it were..."

There you go again...sky is falling...sky is falling!!

By: brrrrk on 8/27/09 at 2:57

chief said

"And frankly, given this Congress record for breaking promises, not to mention this Adminstration, it's no wonder everyone is worried about it."

And the fact that the GOP is purposefully misrepresenting a few things that have been mentioned as a means of scaring the hell out of the most vulnerable in this society, the elderly, has nothing to do with it? You do know that lying is a sin, don't you? Or is that another part of your faith that's subjective?

By: chiefpayne568 on 8/27/09 at 2:58

Blanket,

Well let's just go with the public plan then...and encourage abortions so that our population can be regulated (MUCH more civilized than what the Chinese did with their baby girls).

Oh and we can euthanize the elderly...after all, they're taking up resources and aren't productive citizens. Heck, let's just set a age limit...you get to live to, say, 60 - then your done!

See, I can generalize too.

By: chiefpayne568 on 8/27/09 at 3:00

brrrrk,

"And the fact that the GOP is purposefully misrepresenting a few things that have been mentioned as a means of scaring the hell out of the most vulnerable in this society, the elderly, has nothing to do with it? You do know that lying is a sin, don't you? Or is that another part of your faith that's subjective?"

Well gee, seems to me the DNC have done the same thing for YEARS with the Social Security system.

Besides, we DON'T KNOW if they are misrepresenting a few things or not...that's the whole POINT of it. No final draft, no idea whether what is feared is in it or not.

By: gdiafante on 8/27/09 at 3:00

Oh yeah, forgot about the "euthanizing the elderly" BS the right has been espousing.

Talk about people who truly need to be medicated...

By: Blanketnazi2 on 8/27/09 at 3:01

you generalize a lot, chief. and you speculate a lot. abortions are not there to regulate the population and we won't be killing off anyone's granny. more ridiculous scare tactics.

By: house_of_pain on 8/27/09 at 3:02

If we don't cull the herd somehow, eventually nature will do it for us.

By: chiefpayne568 on 8/27/09 at 3:02

Gdia,

Well, it might not have been an issue if they didn't have that mandatory end-of-life counseling in the draft. It scared the elderly and gave the GOP the point they needed to bring up a worst-case scenario.

By: gdiafante on 8/27/09 at 3:02

I have news for you Chief, Social Security is a mess and needs serious reform. That's another thing our wonderful politicians like to raid and say it needs fixed, but never do. Wait until you see the bill for that...

But we should take Chief's advice and just put it off for when we can afford it...which is never.

By: Blanketnazi2 on 8/27/09 at 3:03

i just don't see how end of life counseling can be turned into a death squad scanario. talk about ridiculous! really!!!!

By: Blanketnazi2 on 8/27/09 at 3:04

house, i still support selective retro abortions.

By: gdiafante on 8/27/09 at 3:05

You're right Chief, the GOP only deals in worst-case scenarios...or fantasy-case scenarios...they are good at that and they know it scares the hell out of people. Pretty sorry ass tactic, if you ask me.

By: house_of_pain on 8/27/09 at 3:05

Judges will start sentencing the guilty to "End of Life Counseling",
in lieu of the "Death Penalty".

By: house_of_pain on 8/27/09 at 3:06

Mandatory in some cases, Blanket.

By: gdiafante on 8/27/09 at 3:06

Every elderly person will be required to read "The Handbook for the Soon-to-be Deceased".

By: slacker on 8/27/09 at 3:07

pain, great idea. Tell they get an extra slice of pecan pie, if they hang themselves.

By: house_of_pain on 8/27/09 at 3:10

Great idea, gd. I'm going to start referring to Granny as
my "soon-to-be ex-grandmother".

By: Blanketnazi2 on 8/27/09 at 3:12

By: house_of_pain on 8/27/09 at 4:06
Mandatory in some cases, Blanket.

I can think of a few.

By: Blanketnazi2 on 8/27/09 at 3:13

i know, for every voluntary senior hanging, you get a free abortion for your granddaughter.

By: Blanketnazi2 on 8/27/09 at 3:14

or two 4 one Tuesdays.

By: slacker on 8/27/09 at 3:14

Gold plated drool cups.

By: house_of_pain on 8/27/09 at 3:15

You know, pregnancy is a pre-existence condition...

By: brrrrk on 8/27/09 at 3:24

chief said

"Well gee, seems to me the DNC have done the same thing for YEARS with the Social Security system."

Ok, let's talk the truth about the Social Security system. Social Security was designed as a pay as you go system... has always been that way. Now, to handle the additional strain on the system as a result of the Baby Boomers, a special Social Security trust fund was set (1983, I believe) up to handle the additional expense. In addition, the FICA tax was increased (and the increase is set to expire but I can't recall the year) on Baby Boomers so they could in essence pay part of the additional expense. The problem came when Saint Reagan (at the suggestion of Alan Greenspan) dumped that special fund into the general fund in order to buck up his budget numbers and to borrow against to support infrastructure expenditures. If there's someone to blame for the Social Security mess, it's Reagan. Prior to him, that fund was to be untouched.

By: EddieA on 8/27/09 at 7:59

November 6, 2040 Vote for Nick!

Sixteen year-Old Nick Jonas, of the Jonas Brothers band, has announced his plans to run for the office of the president of the United States in the year 2040. At Tuesday night’s Nashville concert, the tween members of the audience screamed when he told them of his plans. His campaign bumper stickers, $3.00, were quickly sold out.

While I commend his ambition, Nick Jonas does not understand politics. According to U.S. population projections, in the year 2040 people of Hispanic descent will have the largest voting population in America. In 2040, Nick will be campaigning against Juan, Magdalena and Luis not Ron, John and Hillary. For every screaming tween fan in the audience, there are seven Hispanic tweens who did not attend – their parents can not afford the $50 + ticket price. For every screaming fan that vowed to vote for him, there are seven who will not. The voting odds are stacked against Nick Jonas and any non-Hispanic candidate in the year 2040.

If trends continue, Nick will need to learn a minimum of four dialects in Spanish if he is to participate in the scheduled 2039 – 2040 Presidential debates. According to the 2007 novel ‘George’s Flag’, America will have evolved from English speaking to a Spanish speaking nation in the year 2040. The debates will be in Spanish with the questions asked in Spanish, not English. According to the novel there will be three political parties in the year 2040: Democratic, Republican and the newly formed Hispanic Peoples Party.

If Nick is to succeed he needs to change his image. Nick could marry a Hispanic woman. He has already made a major political mistake by recently breaking up with Selena Gomez (a severe mistake as she is an attractive, talented up and coming Hispanic star from the Wizards of Waverly Place). Selena could have brought him thirty – forty million Hispanic votes.

However, Nick Jonas does have a chance. People have short memories and the novel’s fictional political party had a unique campaign message of Hope! Hope for a better life for parents and their children! Hope for a better America! [Page 437]. The campaign message worked for the fictional character George Pilar in 2040 and Senator Obama in 2008. I see no reason why it would not work for Nick Jonas.

Nick would be wise to re-read the book and use the tactics of the fictional political party. He should pay attention to the chapters that deal with raising campaign donations; they are similar to what Senator Obama used in 2008.

In the novel, the fictional political party began their campaign to elect George Pilar president in the year 2006; that is thirty-four years before the election. Nick Jonas only has thirty-one years to prepare; he is already three years behind. However, Nick needs to realize that the fictional character George Pilar was not only Hispanic, but female. Her mother and father were illegal immigrants from Mexico whom many voters, in the year 2040, could identify with.

George Pilar, candidate for the newly formed Hispanic Peoples Party, won the presidential election in 2040 – in a landslide victory that completely destroyed the Democratic and Republican parties. The Democrats and the Republicans are forced to join forces and became the Unified American Party. George Pilar never held a public office and the days of the professional politician were over.