About | Portfolio | Backup | Archives | PayPal Tip Jar | Amazon Tip Jar | Shop@Amazon
Advertising


Search BillHobbs.com
Stats, Etc.


TTLB Ecosystem Stats
Powered by FeedBurner


« Nashville Government May Steal From Poor to Help Rich | Main | Arafat Dead. Let's Party! »

November 10, 2004

Would TennCare By Another Name Be Bredesen's Plan?

Is Tennessee Gov. Phil Bredesen really going to shut down TennCare, the state's Medicaid-plus program that serves one in four Tennesseans, as was announced earlier today? The answer is complex. In fact, it could be yes and no at the same time.

Bredesen announced this morning that he was going to shut TennCare down over the next six months and return the state to a traditional Medicaid program, cutting approximately 400,000 low-income and medically-uninsurable people from the rolls. Only people who are Medicaid-eligible would keep their coverage.

South Knox Bubba thinks Bredesen is bluffing, scoring political points with Republicans who think TennCare is a fiscal black hole (which, by the way, it is), and will score points again with Republicans when his bluff forces the lawyers to cave whose lawsuits helped destroy TennCare by preventing needed fiscal reforms.

But what if the lawyers don't cave? Bubba doesn't account for that - he fully expects they will. He might be right, but I suspect Bredesen has a plan to win even if they don't cave - by pulling the plug on TennCare and replacing it with a new program designed to do what TennCare did, only on a more fiscally sane and sound basis.

TennCare has been a fiscal disaster from almost the first day it was created a decade ago by then-Gov. Ned McWherter. Attempts to reform it have been stymied by the self-appointed holier-than-thou legal "advocates" who incessantly file lawsuits that demand the program pay for everything all the time, with no meaningful limits or effective controls against fraud and abuse, and no effective way of culling ineligible people from the rolls.

Left as-as, TennCare would soon have bankrupted the state or forced huge tax increases that would have wrecked the state's economy, harming tens of thousands of Tennesseans.

Bredesen got the legislature to pass a reform package last year, in a last-ditch attempt to save the program, but the advocates are now fighting even that. Some suspect the advocates' real motivation for incessantly suing the state over TennCare is less concern for TennCare members than it is concern for keeping up the flow of legal fees the lawyers get for their work. Who pays their legal fees? Ultimately, the Tennessee taxpayers do. TennCare, thus, is the cash cow that keeps on giving.

But the simple facts are that TennCare can not survive in its current state, and the "advocates" won't allow it to be reformed.

Bredesen has only threatened to pull the plug because TennCare is soon going to be fiscally unsustainable. Obviously, his announcement today - which included seven days for the advocates to change their minds - is a piece of political brinksmanship designed to force the advocates to back down. But if they don't - and lead "advocate" Gordon Bonnyman has shown no inclination to alter his course in 10 years - Bredesen will have to keep his word to the people of Tennessee and pull the plug.

The headlines warn that will mean 400,000 Tennesseans will lose their healthcare coverage. Don't believe it.

TennCare was created by executive order - that's why Bredesen can kill it by executive order. He also can replace TennCare by executive order.

I fully expect Bredesen will get his reformed TennCare one way or the other - either Bonnyman and his crowd will back down and let the reform package be implemented, or they will refuse, and Bredesen will pull the plug - and then, some time during the six-month wind-down of TennCare, he'll create a new program by executive order that will be better designed and more fiscally sound, and cover most of those 400,000 people. It will be a fully-reformed TennCare under a new name.

By "pulling the plug" and replacing TennCare, Bredesen gets a clean slate, legally speaking. Because it won't be TennCare, it will not be subject to and governed by the various lawsuits and court orders and "consent agreements" that currently hamstring TennCare reform efforts.

Bredesen is not just a former healthcare executive who knows how to make the numbers work in a very tricky industry. He's also a Democrat who believes in government healthcare for those who need but can't afford it. He's also a politician who wants to get re-elected governor and almost certainly has his eye on higher office - the U.S. Senate or higher. He doesn't want 400,000 citizens angered that he cut off their health coverage. He most certainly doesn't want an opponent in 2006 running ads featuring all sorts of low-income and medically uninsurable people "who lost their healthcare because of Gov. Bredesen."

Mark it down: 400,000 low-income or medically uninsurable Tennesseans now covered by TennCare are not going to lose their coverage on Bredesen's watch, even if he pulls TennCare's plug.

Posted in Tennessee News | Linked By |
Please support HobbsOnline by doing your online shopping at Amazon.com
Comments

I read about this in an article today and came over to your blog to see what you had to say.

I'm sure you'll keep us posted on this development.

Posted by: Thomas Galvin at November 10, 2004 08:52 PM

I wasn't very impressed with your speculation until I read the ending and slapped my head, Doh! That made me realize that my victory dance may have been a little premature. However, one thing that I am sure will have to happen for Bredesen to enact any kind of state program would be Federal approval. Bredesen is playing his cards very tightly to his chest on this one.

Posted by: jody at November 10, 2004 09:31 PM

I wasn't very impressed with your speculation until I read the ending and slapped my head, Doh! That made me realize that my victory dance may have been a little premature. However, one thing that I am sure will have to happen for Bredesen to enact any kind of state program would be Federal approval. Bredesen is playing his cards very tightly to his chest on this one.

Posted by: jody at November 10, 2004 09:31 PM

I wasn't very impressed with your speculation until I read the ending and slapped my head, Doh! That made me realize that my victory dance may have been a little premature. However, one thing that I am sure will have to happen for Bredesen to enact any kind of state program would be Federal approval. Bredesen is playing his cards very tightly to his chest on this one.

Posted by: jody at November 10, 2004 09:34 PM

"The answer is complex. In fact, it could be yes and no at the same time."

Hmmm...sounds like a plan Mr. Kerry could get behind.

Posted by: lakergary at November 10, 2004 10:41 PM

I don't know. Bonnyman's fought every change tooth and nail since Day One. He's never been one to compromise. I can't see him accepting anything less than full coverage for everyone now on the program. I'd even expect him to go to court to reverse Bredesen's Executive Order on any number of grounds, just to fight it.

Bredesen was elected because a lot of folks expected his background in health care to enable him to "cure" TennCare. I suspect he gave it the ol' college try, saw what he was up against, and has now thrown up his hands in disgust. We can only hope.

Posted by: mike hollihan at November 10, 2004 11:00 PM

      You've overlooked a possibility: Bredesen will shut down TennCare, he'll put his replacement program into effect, and then the various "advocates" will sue to expand the program.  After all, they can claim that "it's really TennCare with the name changed," so it must be bound by all the previous court rulings.

      Whee!  Ain't it fun when democracy is abolished?

Posted by: Stephen M. St. Onge at November 10, 2004 11:53 PM

OMG. Now I remember his background in running a health provider. I'm starting to believe that he, better than anyone, could actually find that *better way* of leveraging public and private health care - effective health care reform.

I think his "new program" must include a major restructuring, but with limited disruption of functioning. Meanwhile, Bredesen will get the legislature to pass a bill protecting the this program from such litigation.

I have high hopes for Bredesen.

Posted by: equitus at November 11, 2004 03:48 AM

I just stumbled in here from Instapundit, so forgive me if I don't seem to know quite where I am.......it's only because I don't.

This is the first I learned about TN having this massively expensive government-provided healthcare boobdoggle. My husband and I are planning to move to TN in the early spring. We have our own healthcare.

What concerns me is the cost of this monstrosity and how to curb it. It seems like an uphill battle against the worst bureaucratic cancer imaginable all because of the usual suspects - lawyers.

We're staunch Republicans, and normally I'd say this governor is just scamming the public like most Democrat office-holders do, but this at least sounds like he is trying to resolve this in a fiscally healthy way. Is the governor a conservative Democrat, by any chance? I certainly hope so, because one of the reasons we're leaving the state we live in now is fiscal irresponsibility of a longstanding Democrat-controlled legislature.

Can anybody give me a little perspective on TN's governor? And how is that a full 1/4 of TN residents don't have private, self-pay healthcare?

I thank you in advance.

Posted by: KittyBurglar at November 11, 2004 05:59 AM

i've voted straight republican before, and this year i was happy to vote for bush and bredesen. sorry no caps; baby in arm.

Posted by: tadeusz at November 11, 2004 06:56 AM

let me revise that; i don't think bredesen ran this year. got carried away with alliteration. but i would have been.

Posted by: tadeusz at November 11, 2004 06:58 AM

Bredesen is a fiscal conservative who has balanced the state budget without tax increases, unlike his predecessor.

Posted by: Bill at November 11, 2004 07:03 AM

Kitty Burglar (love the name!), to answer your question a bit more than Bill did: Bredesen is a nominal Democrat who will campaign for his party friends and for those whose support he needs (Speaker of the House and the Lt. Gov.). He's said he became a Dem because they most resemble how he feels, but says it in a way that doesn't sound enthusiastic.

He is a fiscal conservative, but there are wrinkles. After years of being told that the only solution for TN's budget woes was to create an income tax, which is highly unpopular here, and an incredible display of public anger in weeks of sustained demonstrations at Capitol Hill, Dems were swept from office, with the exception of Bredesen, who beat the Republican who sounded a lot like him. Bredesen promptly cut the budget by 5 to 9% (estimates vary). Again, there were cries of woe from those who depend on government money. But the state has survived and prospered none the less.

But.... Bredesen has made it clear that he will restart public spending when the budget allows it. He balanced his budget by keeping state funds ($30 million or so) normally given to cities. In spite of increasing revenues (the state took in almost $700 million more than budgeted this fiscal year) he has neither restarted sending those funds to cities nor cut the 7.75% state sales tax. All this money is being kept in Nashville and being quietly dispensed.

So, as TN gets more and more prosperous, as we come out of the recession and pick up steam, Bredesen's beginning to slough off his fiscal luster. That doesn't portend well for the future at all. He bears continued watching.

You don't say what part of TN you're moving to, but I hope it's not Memphis, were I am. We are the majority of those 400,000 folks who will be cut from TennCare, and our local Regional Medical Center is already cash-strapped! Both the city and county have big budget hemorrhages that are promising increased property taxes. City government just tried to impose a "payroll" (ie "income") tax on non-Memphis residents who work in the city!

Posted by: mike hollihan at November 11, 2004 01:12 PM

Mike, thanks so much for such a full reply. I appreciate it very much.

We are moving to eastern TN. We will be looking for a rural property butting up to the Cherokee Nat'l Forest, most likely near (east of) Elizabethton, or perhaps a bit further south toward Greeneville. We will be renting briefly, probably in the tri-cities or Greeneville area, while we look for just the right property.

We presently live in CA, and the condition of keeping revenues at the state capitol rather than distributing them to the county municipal governments is what prompted us to wrest those monies away from the hands of our Democrat-controlled legislature via a ballot referendum last week. You may also be aware that we recalled former Governor Gray "The Corruptionator" Davis last year and replaced him with a moderate Republican, Arnold "The Governator" Schwarzenegger. We immensely enjoyed removing Davis, probably the most corrupt, tax-and-spend governor in our history. Davis managed to take a $16B (that's BILLION) surplus built up by sixteen years of sound management by Republican governors and transform it into a $38B (that's BILLION) deficit in four years, which, along with imposing even more draconian regulatory controls than we already had to contend with, devastated our economy. I won't bore you with the hundreds of stories of his corruptions and blunders that we suffered for over four years before we finally dumped his thieving, conniving butt into the unemployment lines. It was glorious.

I wish you success with managing your fiscal affairs until someone more trustworthy gets into office, although it sounds like things could be worse were you saddled with some other member of the Democrat panoply of fiscal mismanagers. Coming from CA, we certainly recognize and are wary of the signs of incremental acts of disregard for the fiscal will of the taxpayers.

My husband and I followed the stories of red-blooded Volunteers surrounding your state capitol over the legislative effort to impose an income tax, and read about the demonstrators' success with glee. In fact, that was one of the reasons we decided to give TN a look in terms of our pending relocation, and then fell in love with the gentle pastoral beauty of eastern TN, as well as the wamth and well-mannered civility of your people.

From one who has seen the fiscal and economic havoc and devastation Democrats wreak at the state government level, I advise Tennesseans to purge as many of them from control of your state government as possible. Frankly, we were surprised and disappointed to learn TN elected a Democrat to the statehouse, but of course we are willing to withhold full judgment until we see him in action. Dumping the Tenncare program seems like a very good idea and if Bredesen can be reined in from stepping up spending and be forced to distribute revenues more fully to municipal governments, he may turn out to be not such a bad choice.

I wish you continuing success with your growing prosperity.

Volunteers rock!

Posted by: KittyBurglar at November 11, 2004 04:30 PM

KittyBurglar,

Did you see every posts you had at SKB was deleted? I think you will like it much better here at Bill's site. You had some great posts but free speech is hard to find at SKB.

Posted by: bob at November 13, 2004 01:02 PM

Yep, I sure did. Did you see any of my posts from today there before they were deleted? I'm assuming from what you just said that you did.

Posted by: KittyBurglar at November 13, 2004 02:26 PM

BTW, I wrote a LOT of posts there. It probably took some time to go through and delete all of them.

The only thing that motivates that kind of action is fear.

Now, what do you suppose SKB has to fear from me?

Posted by: at November 13, 2004 02:32 PM

I don't think he thought I was a wingnut. I think he was afraid the lefties on there would strike up too many rational, reasonable conversations with me. That's the threat, and that's why he had to delete all my posts, the vast majority of them being that lengthy civil exchange with Rochambeaux. He doesn't want them wandering off the reservation. He has to keep up the hatred.

I have a dynamic IP so he can only ban me temporarily. If I want in, all I have to do is logoff and then reconnect. But I'm not the type to hang out somewhere I'm not wanted, and he knows that.

Posted by: KittyBurglar at November 13, 2004 06:11 PM

Were your post today about TennCare? Did you have any post with SKB? I wish I could have seen your last post.

Posted by: bob at November 13, 2004 07:24 PM

http://www.knoxnews.com/kns/local_news/article/0,1406,KNS_347_3327525,00.html

The article above in the Knoxville News Sentinel may explain SKB's behavior. Tennessee was 62 % for Bush. That had to be difficult for SKB. I thought what made his site special was local issues.

Posted by: jim at November 13, 2004 11:36 PM

The above post is mine.

Also, here's a correction:

"Within about a half hour, all those posts were deleted. I didn't know ALL my previous posts had been deleted until you pointed it out to me."

It should read, ".......until Bob pointed it out...."

Posted by: KittyBurglar at November 14, 2004 02:35 AM

http://web.knoxnews.com/silence/archives/001885.html

Support free speech on blogs.

Posted by: bob at November 14, 2004 11:32 PM

I left a note over there.

Posted by: KittyBurglar at November 15, 2004 03:43 AM

lakegary said:

"Hmmm...sounds like a plan Mr. Kerry could get behind."

Yeah, before he got in front of it.


Posted by: KittyBurglar at November 15, 2004 03:48 AM

Bill, the 'Never Forget' video is terrific - very moving indeed. And no, I will never foregt.

Nicely done.

Thank you.

Posted by: KittyBurglar at November 17, 2004 04:24 AM

I don't know if readers here are interested in the shakeup at the CIA, but there's an excellent, informed discussion going on about it over at The Belmont Club: http://belmontclub.blogspot.com/2004/11/cia-shakeup-in-july-2004-marc-ruel.html

Posted by: KittyBurglar at November 18, 2004 03:02 AM

Bill, in view of your outstanding video and the themes represented on your site, I thought this piece from The Times of London would be of interest to you. Since I can't seem to find any more current blogs here to post comments to, I'm leaving it here:

http://www.timesonline.co.uk/article/0,,3-1359782_1,00.html

Posted by: KittyBurglar at November 18, 2004 04:44 AM
Post a comment
Comments Policy: Your comment is subject to deletion if it is off-topic or includes foul language or personal attack. Readers, please email me if you find comments that include egregious violations of this policy. Comments may not post immediately - do not post twice!









Remember personal info?






Email this entry to:


Your email address:


Message (optional):




back to top
Advertising

Lamar!

Find the Good
and Praise It
I Also Blog At...
button-fcs-blog.gif
Archives
Blogroll