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December 06, 2004

Must-Read: HillaryCare Meets Reality in Tennessee

It worked precisely as we all knew it wouldn't:

We think it was Justice Brandeis who said the states should be laboratories for reform. Regarding health care, Tennessee tried a decade ago and the price is now coming due. Hillary Rodham Clinton should call her pollster if she plans on carrying the state in 2008.

In 1994, Tennessee passed what was then a very hot New Democrat idea--call it government managed care--a version of the reform the former first lady was also pitching nationwide. TennCare promised the impossible dream of politicians everywhere: Lower health-care costs while covering more of the "uninsured." They got the impossible, all right. After 10 years of mismanagement and lawsuits, TennCare now eats up one-third of the state's entire budget and is growing fast. Governor Phil Bredesen, a Democrat, is preparing to pull the plug and return the state to the less lunatic subsidies of Medicaid.


The skyrocketing costs led previous Governor Don Sundquist, the Republican who had inherited the program, to try to impose a state income tax. His efforts failed, fortunately, but in 2002 Mr. Bredesen was elected promising to cut TennCare's costs.

That, too, has been impossible. Left-wing legal activists have sued the state with impunity to underwrite the cost of nearly unlimited care. A Nashville non-profit called the Tennessee Justice Center has hamstrung reforms for years by suing to enforce a series of consent decrees, some of which predate TennCare.

Prescription drug costs alone increased 23% last year, as there are effectively no limits on the number or types of drugs the system will pay for. If a doctor prescribes aspirin, TennCare pays for it. Ditto for antacids for heartburn and other over-the-counter products. If TennCare denies a claim for a drug or any other type of care, an appeal can be filed for next to nothing. Fighting each appeal costs the state as much as $1,600 in legal fees. With 10,000 appeals filed every month, it's often easier and cheaper to pay a claim, regardless of the merits.

Gee, who'd've guessed?

Thanks to NickS.

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posted by Ace at 12:59 PM

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