do we all agree that Bredesen is a failure on this program? This one he should have gotten right. This is his field of expertise, they say. He created an HMO at his and Andre Conte's kitchen table. Remember that?

No, Bredesen is doing what he can within the constraints of a seriously broken system, a failing federal Medicaid program, and a state that values low taxes over health care or anything else.

(If I recall correctly, it was a Republican governor who expanded TennCare until it collapsed under its own weight, and a Republican governor who called for a state income tax to fund trying to fix it.)

What is your solution, Brian? How would you fix it? What does your party propose? How would you get insurance to the 830,000 uninsured in Tennessee, nearly 150,000 of whom are children?

Hint: this is not something that can be fixed at the state level, by Bredesen or any other governor.

TennCare was created by Big Bubba aka Ned Ray McWherter. Mikey's daddy.

I would not create socialized medicine.

All the individuals that voted for the Democrat Prince Phillip of Nashville back in 2002 said that he could fix it. He had the expertise. In 2006, in Fentress County Bredesen stood up locked arms with Tommy Kilby and said I need Tommy Kilby to help me fix this. He hasn't. He failed. So Sad.

Does it not have a calendar year max of $25,000 for all covered service??? Yes it does...

Pre-existing waiting period of 12 months... yes it does

Prescription drugs are limited to $250 per quarter... $83.33 per month not much for prescrioption drugs...

here is the link to the coverage outline...

(link...)

Hate to have something really bad happen and think I have health insurance... but I guess something is better than nothing... and this is almost nothing once you really read the coverage forms...

Back in the 90's the insurance industry tried similar type plans for part-time workers, they called them mini-medical and they flopped because the folks buying them thought it was real health insurance and it is not...

I am sure we are going to hear the same stories as soon as someone has cancer, heart attack or some other major illness... then they are going to complain that it did not pay anything...

The legislature House and Senate was in the control of the Democrats. The last time I checked it was neccesary to have both House and Senate to approve something.

I would fix it with a Republican House, Republican Senate and a Republican Governor.

Help is on the way!

He tried. He failed. So Sad.

repeat the same mistakes of the HealthCare expert Prince Phillip of Nashville.

So, I've asked several times now, and you don't have a solution, or you won't articulate it. And you won't even explain what these 'mistakes' were.

I guess you've decided to be a part of the problem rather than a part of the solution, and you're not really interested in have a serious discussion about it.

Brian, don't you work for Blue Cross Blue Shield? Or is that just some rumor that has been passed around?

Does he not work for the cookie folks... Keebler...

What I will tell you is that when the Republican caucus unveils their plan. That will be my plan.

So, again I assure you. Help is on the way!

I am sorry for what you have endured. I wish the state had done more for your situation. The allegations you make of me not caring is simply not true. But again alot of rumors,gossip and lies have been thrown at me over the years and that is just the way it has been.

I had high hopes that Bredesen could or would be a man of his word. He hasn't, he can't. I will repeat what I said earlier and posted earlier, probably while you were composing your post. When the Republican caucus unveils their plan. That will be my plan.

Pam Strickland

"We are what we pretend to be, so we must be careful about what we pretend to be." ~Kurt Vonnegut

"No matter where you live in the United States, it's likely to be much easier to get a gun than to get help for mental problems." ~Ste

This year the Old Man and I have had a combined total of three surgeries. The total bill for these was just over 34 grand. Once the PPO discount was applied, the hospital, doctors and all the other associated agencies involved took as full payment about 30% of the grand total. That was the PPO discounted price. What a deal! All because we used an in-network provider.

It never fails to amaze me that we who are insured enjoy the luxury of discounted rates. I have to wonder if my discount then is made up for by those with either traditional insurance or worse yet- the un or under insured.

I think as long as we want to help EVERYONE, there will always be some sort of a problem. I'm not saying we shouldn't; I honestly don't know what the best solution is. And even as one who overwhelmingly votes Republican, I certainly don't trust as Brian says, "When the Republican caucus unveils their plan. That will be my plan."

Don't get me wrong. I don't think we just let someone die because they can't afford the healthcare. But as long as you want to service everyone, there will be a money shortage.

One thought I have would be for the people that can't afford healthcare, we should not be providing them with coverage for doctor visits, prescriptions, little things, etc. We should be providing them with INSURANCE against CATASTROPHIES. Just a thought.

Craig Thomas
blog.craigdthomas.com

is the plan that I will support. I have the right, as you do to talk with my legislator's to have input into the plan.

Bredesen was elected in 2002 as the healthcare guru. In 2006, he promised to fix it.

I am not an elected official, just as you are not an elected official. I can't introduce legislation on the floor of the House or Senate, just as you can not.

I will offer suggestions to my Republican elected officials, but it will be their job to cull all the ideas and create a comprehensive piece of legislation to fix what Prince Phillip was unable to do.

One thought I have would be for the people that can't afford healthcare, we should not be providing them with coverage for doctor visits, prescriptions, little things, etc. We should be providing them with INSURANCE against CATASTROPHIES. Just a thought.

Actually, that might be backwards if you think about it.

People with means are the ones who should have insurance against serious injury and catastrophic illness. They can afford the routine doctor's visits, prescriptions, etc.

People living in or near poverty don't go to the doctor, so their health problems go undetected and/or get worse and worse until they end up in the emergency room with a serious problem that ends up costing all of us a lot more than a little preventive care would have cost.

Sorry, I clicked the wrong button at the wrong time.

I've been reading KnoxViews for a while, and have considered posting before but have never been incensed enough to go ahead and register so that I could post.

Where to start? I moved back to East Tennessee three years ago, in part because of a desire to be closer to family because of a chronic health condition that is mostly managable but nonetheless requires regular health care, which means weekly/monthly visits with a health professional. My COBRA expired a couple of months after I moved.

My health condition is a red flag for insurers so getting a private, individual policy wasn't possible. I didn't qualify for TennCare because I had some retirement funds. Because the waiting list was so long, it took nearly a year to qualify as a patient at Interfaith Health Clinic. I am ever thankful that they exist, but they've had trouble getting the medications that I need because they depend on patient assistant programs with the drug companies. It took a year and a half before I felt that I was truly getting the medications that I needed, that made me feel close to 100 percent.

Cover Tennessee wouldn't do for me because of the limitations on doctor visits and perscriptions. I'm sure that it will help some, but mostly it's simply what can be done under the limitations that Bredeson must function.

I live in the world of adjunct teaching and freelance writing. It's got some great advantages, but health insurance isn't one and it's why I regularly look for leads for something that I would like and that would give health insurance. Unfortunately, I get a lot of "you have too much experience" in my job queries. But that's another topic.

Pam Strickland

"We are what we pretend to be, so we must be careful about what we pretend to be." ~Kurt Vonnegut

"No matter where you live in the United States, it's likely to be much easier to get a gun than to get help for mental problems." ~Steve Lopez

Brian: I will offer suggestions to my Republican elected officials

And again, what will those suggestions be? Everybody's interested in finding a solution. You might have some great ideas!

And seriously, if Republicans can put together a health care plan the guarantees every American affordable health care, that will be a winning ticket.

So tell us what it is?

Or just admit that you have no clue and you just want to argue and bash Democrats.

Which is pretty hilarious if you think about it, considering the "solutions" Republicans have given us so far on this issue.

They're about like your solutions -- not forthcoming.

I have and will continue to do so. Thanks for asking and for the encouragement.

I have ideas. I will communicate them to the proper authorities/officials and do not view you and KnoxViews as the proper authorities/officials.

You should feel free to forward your ideas to Rep. Joe McCord, Rep. Doug Overbey and Senator Dr. Raymond Fenney.

I will forward mine to Rep. Parkey Strader and Senator Jamie Woodson.

Thanks for your interest.

(link...)

for playing as well.

It was interesting to see you blast the Governor and then defend the Governor.

I guess you supported him, before you blasted him, before you supported him.

Sounds familiar. doesn't it.

you can ask. I have never derailed a discussion. I always respond to questions/comments.

Thanks.

Self-employed and own a business.

That might be a solution, but my guess is that those premiums would be astounding given my health history.

The thing I also want to add is that I don't know what the answer is, and before I found myself in this situation I thought doing something about health care/insurance costs was important, but I must admit that I paid more attention to other government and political matters. And, frankly, I don't know what the answer is at this point. I was for national universal medical care in the early 90s. The way the Iraq veterans have been treated has me reconsidering whether that's a good idea.

At the state level, I lived in a state for 20 years that had a state income tax. I remember being amazed when the riots against a state income tax broke out in Nashville. I honestly believe that when you refuse to put something like that on the table, that it chokes the hope out of the possibilities. And not just for health care, but also for education and the environment and many other good and necessary things.

And, saying that whatever the party caucus wants is what I want is childish. Just as calling someone "Senator Dr." is. He's a senator who happens to be a doctor. I once had a congressman (he's still in office, I just live here not there) who was a doctor, a lawyer, and a former Marine. Should he have been Rep. Dr. Esquire Sgt Snyder? He also mowed his own yard, so lawn boy would need to be in there somewhere too.

Pam Strickland

"We are what we pretend to be, so we must be careful about what we pretend to be." ~Kurt Vonnegut

Pam your point is well taken Dr. Fenney is in fact a Doctor. He also happens to be a citizen legislator, serving as a State Senator.

Which came first? Which is more important?

Certainly, being a Doctor and providing health to his patients would be more important. But if his constituents are contacting him about legislation then his appropriate title is Senator.

Does he have to give up his earned title of Doctor because he is currently serving his community as a Senator? Or does he have to give up his title as Senator because he is a Doctor?

Well, I don’t have the answers but I do have a few suggestions…
(that I will gladly forward on to the Parkey and Joe McCord)

Ned Ray created TN Care as a legacy with one foot out the door of the governor’s mansion. Sunquist put band aids on a system that run amuck and leaked money faster than it could account for it. With each band aid there were at least a half dozen lawsuits and the Sunquist administration simply appeared to be overwhelmed. Bredesen has done a credible job of at least understanding the issues; but, understanding the issue doesn’t fix the problems. It is better now than it’s ever been but, frankly, that isn’t saying much. Cover TN is a start and it is a much better start than what we had with TN Care. A couple of different administrations have failed in their attempts to save what in concept was a wonderful (albeit ambitious) plan. Unfortunately, you only get one chance to make a first impression, and the state blew it the first time around.

Here are some suggestions…

1) At the grassroots level, many physicians treating TN Care and/or indigent patients have little or no regard to cost. Many still insist on writing prescriptions for brand name pharmaceuticals, all the while increasing the costs of health care. A few small adjustments, without risking the health of the patient, would save a significant amount of money (but, to the chagrin of a select few drug companies).
2) Stop giving money to non-profits when the local government provides similar or identical services; or, conversely, stop funding government programs when there’s a solution provided in the private non-profit sector. (IE funding a grant for prenatal services – minority or otherwise – when an existing local governmental agency provides the same or similar service)
3) Do something to amend the Grier decision to put common sense back in patient care
4) Prosecute anyone caught on TN Care that also has private insurance
5) Actually review, monitor and enforce the state’s newly created drug database to catch patients doctor-shopping for controlled substance prescriptions.
6) Stop covering things on the state plan that aren't even covered under private insurance (example: testosterone gel)
7) Fix the flaws in the system that covers the state only mental health prescription plan

There… now you have some specific ideas on the current system. I got more but I’ve reached the self imposed word limit of my post (500). One thing is pretty straight forward, contain the cost without risk to existing patient care and you can cover more citizens in need.

If you NEEDED more than the maximum number of prescriptions in a month would you just have to do without?

There is a system in place to exceed the maximum number of prescriptions to a patient but the health care providers consider the paperwork too cumbersome. However, if it was easy to complete, it would probably be abused... There you have the essence of the entire public health care dilemma…

Did you know it is perfectly legal to have private insurance and be on CoverTN and TNcare...

CoverTN and TNCare act as secondary to your private insurance plan...

Look it up... thought I was wrong until someone pointed out to me...

I might try to find the link and post it later...

Yeah, I probably should have said "caught using TN Care as primary when they have private insurance"

Thanks for pointing that out...

The point is, folks should not be pulling out a private insurance card to pay for a prescription when they are told TN Care won't cover it.

To make your point...

In this day and time of low co-pays for doctors’ visit, prescription drug cards with low co-pays, emergency room co-pays etc... No one should be on two health insurance plans... be they both private plans or government type CoverTN or TNCare...

If an employer sponsored plan is set up correctly with manageable inpatient deductibles and out of pocket maximums... there is truly no need to have primary and secondary health insurance and it just creates huge duplication of effort...

This duplication of effort and money could be used to insure and spread the premium dollars to a greater number of covered lives... which is the basic principal of insurance... the law of large number and spreading risk

The solution can be found right here:

(link...)

They even have a plan for productive re-employment of the employees of the parasitic private health-insurance rackets, which must be demolished.

It's all there. Why aren't we agitating for exactly this?

so when it is a bill pertaining to Right to Life issues like the bill last year pertaining to death certificates for aborted fetuses. It is Senator Fenney, M.D. When it is a bill about fixing CoverTN it is Senator Fenney, M.D.

Got it. Thanks.

BTW, if you ever met me, you will realize that your assumption about me is wrong.

It's Sen. Finney, not Fenney.

So, on medical legislation it is Sen. Finney, M.D.

If you or someone you know is not insured it has been suggested. go to this site

(link...)

see what procedure costs then offer that plus %10