Monday, February 1, 2010
Legislature / Woods TennCare Plays the Piñata Again: Bonnyman Calls Bredesen 'Tragically Misguided'
Posted by Jeff Woods on Mon, Feb 1, 2010 at 4:52 PM
The Med is something of an unusual animal in the world of hospitals today, and it needs to either find some permanent long-term source of charity funding or structure itself so that it has a higher proportion of paying patients, which is what more typically happens in cities around the country.And until that time, the governor added, the Med shouldn't bother him with its little problems. He's still chapped over all the grief he took in 2005 when he essentially gutted TennCare. Since then, he's been whacking away year after year. As the governor said again today during a media budget briefing, "The process we went through back in 2005 was extraordinarily painful. I mean, I didn't enjoy having protesters sleeping 24/7 in the hallway outside my office for six months." And that's "not to mention, you know, all the other impacts that it had," the governor quickly added, hoping to sound sufficiently concerned about carbon-based life forms who are in ill health. Bredesen says, "TennCare is such a big piece of the budget, you can't get from here to there without substantial cuts in TennCare." There's a certain truth to that--TennCare is one-fourth of the state budget--but at the same time Bredesen's slashing there, he's recommending the state spend $167 million to give state workers 3 percent bonuses. State workers deserve a little something extra in their paychecks as much as anyone, but at the expense of poor sick people? Gordon Bonnyman, the governor's nemesis at the Tennessee Justice Center, calls Bredesen out of touch with ordinary Tennesseans and his latest TennCare cuts "tragically misguided." Here's his email to Pith regarding the governor's budget recommendations:
The governor continues to run TennCare the way he ran his private HMO, by focusing on how much surplus it can generate. He continues to divert hundreds of millions of dollars in TennCare reserves, refusing to spend funds that were appropriated to help desperately ill Tennesseans and the hospitals that serve them. That is tragically misguided and reflects how far removed the governor is from the harsh realities of many Tennessee families. The governor 's policies endanger a hospital infrastructure that all Tennesseans count on. As a result of the TennCare cuts of 2005, many rural and public city hospitals are already struggling, and his new round of cuts will force some to cut services or close altogether. The governor singles out The MED, the large public hospital that serves Memphis, as a source of personal irritation to him. He makes it painfully clear that it is not his problem whether the hospital survives and suggests that it is the hospital's fault that it is in trouble. That is ironic, since The MED's financial problems can be traced directly to the fact that TennCare has taken away millions in the hospital's revenues over the past five years, is diverting federal funds that The MED has earned, and has burdened the hospital with the uncompensated care of thousands of uninsured patients who have lost their TennCare. This is not just about the poor or uninsured. The MED operates the major trauma center for Tennessee's largest city. It operates the principal neonatal intensive care unit in a city with the highest infant mortality rate in the nation. It is the research and training facility for UT Medical and Nursing Schools. Nashville General Hospital at Meharry is also imperiled by the proposed cuts. It not only provides a safety net for Nashvillians who lose their insurance. General is also the principal teaching and research facility for Meharry Medical College, which would have difficulty maintaining its accreditation if General closed. There are rural communities that will lose their hospitals if these cuts go through. Those hospitals are among the largest employers in their communities. If the hospitals close, it is hard to recruit or retain doctors. Industry is less likely to relocate to a community that lacks a local hospital. The closure of these hospitals will not only hurt the delivery of care but will alter the communities forever. The governor does not see these results as the moral and management failures that they are, If he does not accept his responsibility to ensure the continuation of these critically important services, it is up to the legislature and our other elected officials to do so.
Comments (20)
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Bonnyman is so 1994. Remember those days? Everybody thought they could have everything, with no day of reckoning; no accountability. Bubbles expanded, then burst. Now we're slogging through this piece of shit economy and the liberal intelligentsia wants to keep plowing fistful of dollars into a Medicaid program that's broken. How about some solutions, for once, instead of the 1,114,757th complaint about how government isn't doing enough.
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This is like a re-run of the most-cheesy "Batman" episode ever. Gordon Bonnyman is the half-wit villian coming back for his umpteenth ass whipping.
Bredesen, like a responsible chief executive, is trying to balance the budget again, weighing competing priorities like education and public safety. All Bonnyman can do is scream, "Throw the taxpayers' money at our bloated health insurance program for the poor."
Tennessee, thankfully, has been ignoring Bonnyman for several years now. Let's keep ignoring him.
Bonnyman, much like the Hitler video, has jumped the shark. Spare us your whining, please.
It will be a front line story to watch when you "30,40,50" somethings parents are old. Your inheritance and earnings will go away because you will use it to sustain yourself,children, parents as they are accustom. You won't have clue what happened because your health and wealth will be divided between waring siblings from multiple marriages and all will be hoping for something like TennCare, for your parents or for yourselves. No one is that far away with our healthcare system.
Nashville's TennCare recipients will be okay. We're getting a new convention center. That'll fix General's woes. With all the new jobs created, everyone will have affordable health insurance. Nothing to it. Don't forget your extra change in the parking meters for the homeless. Maybe we can then get the maximum up to $10,001 per patient.
Isn't Bonneyman supposed to be an "advocate"? He doesn't seem very effective if lawmakers ignore him year after year and keep balancing the budget on the back of TennCare. Or maybe TennCare is that big and bloated, and can shoulder the cuts. Or maybe people are sick and tired of hearing about TennCare after 20 years of financial crisis. Or maybe Bonneyman needs to go, because he's sure not effective at preventing anything.
Lawmakers ignore Gordon Bonneyman because they ascribe to the same school of political thought I have seen in these comments.
"I've got mine. You can go f*ck yourself."
You may not like spending money on sick poor people. You ought to know that most of us are just one cancer away from destitution. Listen to a few people tell you about the procedures they need, but cannot afford because they have no health insurance. Hear about the mother with young children and signs of breast cancer who will not go in to see a doctor because she has no health insurance and believes her children will be homeless if she seeks treatment.
Ten Thousand Dollars will get you upwards of a whole day in an ER. Ten Thousand Dollars is the cap Governor Bredesen is proposing for a year.
Just who do you think will end up paying the tab is the State of Tennessee makes these cuts? Remember, you pay local taxes as well as state taxes.
Would these "advocates" like to tell us where in the budget they would cut if the 1/4 that is TennCare is taken off the table?
Education maybe? That makes a lot of sense for Tennessee's future.
The Highway Patrol? That makes a lot of sense for the safety of Tennessee's roads.
Face it, these "advocates" make their money from "advocating" for TennCare. They don't care about the overall budget. They only care about their narrow special interest.
Bonnyman is right. There's no state in the country that limits Medicaid to $10,000 for hospital stays - and the reason is that it is a bullet to the head of every safety net hospital in the state.
It may be that Bredesen is basing this "budget necessity" on the assumption that federal enhancements to Medicaid will not continue. The reality is that they are likely to continue in some guise because every state in the country is having to cope with huge increases in Medicaid rolls - because of the recession and because of the failure to enact health reform. The feds will have to continue enhanced funding to Medicaid. But Bredesen has always wanted to cap Medicaid benefits, and he's using this as his excuse.
I can't understand why anyone would be surprised by the massive cuts in state services proposed by Governor Bredesen. In a deep recession like this one, sales tax revenues always go down. If your state government is entirely dependent on sales tax revenues, cuts in state services are the unavoidable result.
The current situation is a direct result of the decision not to implement a state income tax. It is an entirely predictable and logical consequence of our conscious choice to keep Tennessee solely dependent on sales tax revenues to fund government services.
As conservatives are fond of saying, choices have consequences. The wealthy, who were the among the strongest opposition to an income tax, will not be hurt by cuts to state medical services, or by the failure of the Med or General Hospital. The poor, who blindly followed Marsha Blackburn, Phil Valentine, and Phil Bredesen, will now be faced with the cost of their decision.
From where in the state budget do you want to take funds to maintain the current level of TennCare spending, loveforsale? State government can't print money, and the State Constitution requires a balanced budget. If you exclude TennCare from cuts, then you must cut some other areas of the budget even deeper. Tell us which areas you would cut. Should the state lay off more state employees?
You have at least two glaring inaccuracies in your comment, Mark.
Take a look at how income tax states are faring in the current recession. You'll be surprised to see they are doing worse than sales tax states. Remember the drop in personal incomes.
Also, "the wealthy" were not the chief opposition to an income tax in Tennessee. In fact, the country club Republicans were the driving force behind the push for one.
From where in the state budget do you want to take funds to maintain the current level of TennCare spending, loveforsale?
Nowhere. We need to increase revenues ie. raise taxes.
"The current situation is a direct result of the decision not to implement a state income tax."
These guys are a hoot. They keep showing up and parroting this nonsense oblivious to the fiscal implosions of income tax states across the country like California, New York, New Jersey, Michigan, etc.
It's practically a religious chant for them, as if repetition will call down divine intervention to make it come true.
Meanwhile, back in the real world the cause of the problem is the same as it always was - too much government spending.
I'm willing to pay more - even a state income tax - to save the lives of more Tennesseans.
What I'm not willing to do is nothing.
Bonnyman's right. Bredesen's wrong.
And "Harrison" and "Noodles Sarducci" are obviously lobbyists.
"I'm willing to pay more - even a state income tax - to save the lives of more Tennesseans."
No one is stopping you from paying more right now - it's called charity.
What you're really willing to do is volunteer other people's money.
How would you answer if a mother came to you asking for help for her son who has liver cancer? My guess is "I will."
Why do you think that the same does not apply to TennCare?
To Noodles Sarducci, OG Ben, and Gilbert Martin:
No one, including me, is suggesting raising taxes NOW. NOW is too late. The proper time to restructure Tennessee's tax system was several years ago, before the economic collapse. You won that battle then; you have to live with the results now.
If you truly believe that statewide incomes have fallen faster than sales, you aren't reading the same economic figures I'm seeing. States with income taxes ARE taking a hit now -- but not as significant as the hit impacting nine states which depend entirely on sales taxes. Ask the lawmakers in Florida, Nevada, South Dakota, Texas, Washington, Wyoming, and New Hampshire. I leave Alaska off this list, since the state revenue in Alaska is artificially propped up by oil revenues, of which Tennessee has none.
If you believe (as a matter of your principles) that the wealthiest among us have no obligation to help care for the poorest among us, you have that right. If you don't believe in a progressive tax system, with most of the burden falling on those who are best able to bear it, you have that right. If you believe that failing institutions, like the Med and General, should be allowed to fail, in an example of some kind of social Darwinism, you have that right as well.
I don't have to agree with you. And I don't. Until my view prevails at the ballot box, your view will prevail...and some who might have lived will die, and some who might have been healed will suffer.
Live with that.
Mark you aren't the least bit capable of proving that income tax states have ever produced any sort of superior outcome relative to non-income tax states due to the fact that they do have an income tax.
As for what I believe, it is that government has no authority to mandate charity. That is a private individual decision to make - not a collective one.
