Dolemite wrote:
] Decius wrote:
] ] This is a post election article from Tennessee. The title
] was:
] ]
] ]
] ] ] Bredesen sees no significant effect of shift in power
] ] ]
] ] ] Tennesseans elected the first state senate majority in
] ] ] 140 years.
] ] ]
] ] ] On the issue of TennCare, Bredesen said, "We've always
] ] ] known there were two options for controlling TennCare
] ] ] costs so it doesn't take all the resources of state
] ] ] government."
] ]
] ] Five days later, he kills the program.
]
] Well, I'm trying to figure out where the link between
] Bredesen, a Democrat, and the Republicans is.

I wouldn't blame Bredesen for foul play here. He's very knowledgeable about the industry, has done almost everything he can do to save the system, and is historically socially conscientious. If anything, he's trying to reboot it because it had certain restrictions embedded in the charter that made it impossible to continue its existance. Even then, I don't think he wanted to scrap it.

] ] My mother is on Tenncare. She has a condition which in
] general
] ] does not contribute much to her healthcare costs. However,
] no
] ] insurance company will provide her with general health
] ] coverage because of it. Tenncare was really her only option.
]
] ] She pays more for Tenncare then most people do for their
] ] health insurance, and she doesn't get much out of it. She is
]
] ] often stuck going to ghetto Tenncare doctors who primary
] treat
] ] people who are too poor to pay. We have insurance so that in
]
] ] the event of something catastropic we're able to pay.

does your mother work? what about a catastropic policy coupled with a healthcare savings account?

] That's why he's been trying to save TennCare. Right now,
] 430,000 people in Tennessee are able to at least get some form
] of insurance that they normally wouldn't be able to. However,
] the system as it exists today is growing at such a rate that
] it will bankrupt the state in literally just a few years.
] When TennCare is dissolved, those 430,000 people will be left
] out in the cold and the remaining 900,000 on the rolls will
] have standard Medicaid coverag.
]
] ] My mother now joins the growing ranks of the uninsured in
] this
] ] country, not because she is a leech on the system, as rock
] ] stupid Republican fucking commentators consistantly claim
] ] everyone on Tenncare is, but because actuaries have decided
] ] that they will not cover her at any price.
]
] You think the commentators are rock stupid? How about those
] that are suing the State and therefore causing the governor to
] dissolve the program? Drug costs are the largest single
] expenditure and there are some scary statistics out there...
] the average number of prescription drugs in the nation is
] around 6, I believe. The average for people in TN is will
] over 10! Bredesen wanted to cap the number of drugs per month
] at 6, with an allowance under very special circumstances after
] a review. The main issue that people are suing the program
] over is the number of drugs covered - they want a preferred
] drug list with negotiated prices, but no cap on how many. The
] end result is that most people suing for the uncapped drug
] amount will end up off the rolls as it is. Oh, well.

the problem isn't the number of scripts per person. usually, the reason why someone is on 10 instead of 6 is because they need to be. Tenncare doctors don't necessarily have any more incentive to write scripts than any other doc does.

the problem is that the system doesn't align costs with performance, ie. are you getting that script because there's a standard of care that shows that taking it will improve your health outcome and therefore you should cost less (or at least not inflate your costs with ER visits or other expensive episodes)? Are the doctors doing things that will drive you to a more stable and healthier outcome? Is your drug regimen under compliance (are you taking your meds as prescribed?)? There's nothing in Tenncare that aligns these things or even collects the damn data, so costs will continue to spiral out of control no matter what your prescription policy is.

If you're going to reform the program, you need to align the stakeholders to performance and outcomes. Otherwise it's just a cost shifting/wealth distribution free-for-all.

] TennCare was and still is a good idea because people like your
] mother can't get insurance elsewhere. Sure, it's expensive,
] but it's better than nothing. As a die hard social liberal, I
] think we should just have socialized medicine with an option
] for privately funded doctors, much like the rest of Western
] Civilization...

You won't avoid the problems by socializing medicine in the US. In fact, all the evidence points to exacerbating the problems. The rest of the world with socialized medicine has substandard care, rationing, long waiting lists, and their costs are STILL out of control. The only difference is that their costs are lumped together in the government budget, instead of distributed and aligned around profit.

Any example of socialized medicine (ie Medicare/Medicaid) in the US shows that our culture does this worse than others. It's fraught with abuse, greed, and fraud. Until the system is aligned properly, to show that patterns of behavior are established, monitored, graded, and paid for based upon compliance, then it will continue to just be a shell game, usually with the little guy taking all the risk. This isn't necessarily a vote for privitization. It's not a privitization vs socialization argument. It's old acute system vs new outcomes system. You could have it private or public as long as it was aligned properly.

RE: YEAH FU@#$ING REPUBLICANS!!@!@!@!#$