Wednesday, July 07, 2004

Healthcare Watch: Tennessee Slashing Health Benefits and Costs

USA-Today reports that Tennessee is seeking permission to reduce and limit health care benefits in Medicaid. As more and more Americans rely on Medicaid at the State and Federal level for healthcare benefits as private employer healthcare benefits contract, this is surely a sign of things to come.

Experts say that what Tennessee proposes is unique. To avoid cutting people off the rolls, the state plans to seek federal approval to reduce medical benefits. The plan would limit the number of prescriptions and doctor visits for any patient and direct doctors to use the cheapest treatment alternative, such as an over-the-counter drug instead of a prescription. The Bush administration generally has encouraged states to seek cost savings.

While some health advocates laud Tennessee Gov. Phil Bredesen's attempt to avoid ending coverage for tens of thousands of people, they worry that his plan would create a second-class health system in which saving money, not healing the sick, is the primary concern.

"What you're moving toward is the appearance of health coverage without actually providing it," says Steve Hitov, managing attorney of the Washington office of the National Health Law Program, a public interest group that focuses on health issues for the poor.

Other states have experimented with benefit reductions. But experts say no state has gone as far as Tennessee's combination of doctor and drug limits and the elimination of entire classes of drugs. And they say Tennessee's emphasis on the least costly treatment would have broad implications for patients in Tennessee and other states seeking to cut costs.

The emphasis on cheapest treatments, critics warn, could threaten routine health screenings for at-risk poor children, such as for hearing and vision problems, developmental delays and diseases. They suggest that Tennessee's methods could even lead to the erosion of private health coverage for middle-class workers if managed-care health plans adopt similar standards of care.

What proponents of nationalized healthcare don't understand is that we are already moving toward a system of nationalized healthcare. It is a system where some people are covered by private employer healthcare, but more and more people either depend on Medicaid or go without until they have a catastrophic health crisis and the healthcosts are borne by local and State public hospital systems. There are already many uninsured and the costs being borne by Medicaid are steadily growing. The number of people uninsured or covered by Medicaid are now one in four (25%) roughly of the population. That's one in four. That's huge. If you add the number of people paying out of pocket for private health insurance (about 9%) the number reaches 34% or about one in three Americans either providing their own health insurance, on Medicaid, or going without standard care until some catastrophic health crisis forces them onto the county and State public hospital system which then bears tremendous costs.

We are already moving toward a system of nationalized healthcare. It's just that it sucks and it's called Medicaid.


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