Health Care Costs in TN

The current issue of The Economist has an article regarding TennCare, the Tennessee administration of Medicaid, the federal-state healthcare system for the poor. The Espousa is a policy wonk on Medicare (the version for the elderly) and I can't ever remember which is which.

The two important points of the article are :

In 2004 it chewed up nearly one-third of the state's total budget. Facing an $8 billion programme with the potential to swell to $12 billion in 2008, Phil Bredesen, Tennessee's Democratic governor (but one with a reputation as a fiscal conservative to protect), now wants to take 323,000 people off TennCare's 1.3m roll, saving $575m.

and

Most of TennCare's financial problems, however, stemmed from rising costs and over-generosity. TennCare pays for nearly every drug prescribed. It imposes no limits on days in hospital or the number of prescriptions allowed each month. Unsurprisingly, each TennCare enrolee gets, on average, 30 prescriptions per year. Yet Tennesseans are an unhealthy lot. The 2004 annual survey by United Health Foundation, a health-care consortium, ranked Tennessee 48th out of the 50 states. Obesity has doubled since 1990.

The scandal does not help the Democrats. Both the national health-care proposals endorsed by the Clintons in 1993 and John Kerry's plans to renegotiate drug prices at the federal level had echoes of TennCare. But Republicans, too, have their hands full with Medicaid. George Pataki, New York's governor, has just announced a plan to cap the state's soaring Medicaid payouts, and Jeb Bush, the governor of Florida, is attempting to shift the costs to private insurers. TennCare may be a model again—albeit an unwelcome one.

My standard line regarding government healthcare is: If you want to see the government at work in healthcare, you don't have to wait until a program is passed. Instead, simply go to your nearest Veteran's Administration Hospital. Walk the halls for 15 minutes and you will come out not wanting the government in any part of providing your healthcare. And you'll be ashamed of what we provide our veterans.