Tenn.'s Retreat On Medicaid Points to Struggle -Planned Cuts May

[rodeodance]

Signal National Trend.

People in the know---and many in the health care professions say it is our health care is that is in CRISIS--NOT SS!!--

http://www.washingtonpost.com/ac2/wp-dyn/A16471-2005Jan17?language=printer

Tenn.'s Retreat On Medicaid Points to Struggle

Planned Cuts May Signal National Trend

By Ceci Connolly
Washington Post Staff Writer
Tuesday, January 18, 2005; Page A03


NASHVILLE -- They staged a die-in here Wednesday night -- to mourn the demise of one of the nation's most innovative health insurance programs for the working poor and to dramatize what advocates say will be the human toll of a bitter government decision.

On Jan. 10, Tennessee Gov. Phil Bredesen, a Democrat elected in 2002 on a promise to rescue TennCare, announced he is cutting 323,000 low-income adults from the program and limiting services for 400,000 others. Like many other governors, Bredesen said that Tennessee's expanded Medicaid program is devouring the state budget and that he cannot afford what had been hailed as one of the most generous government health plans in the nation.

"It might not be the level of care we want to provide, but it's the level of care we can afford without bankrupting our state," said Bredesen, a former mayor who made millions as a managed-care executive.

The announcement sent shivers through health care advocates nationwide who see in TennCare's retreat the start of a bleak trend to scale back government-paid care at the same time the private sector is trimming benefits. A day later, Florida Gov. Jeb Bush (R) proposed giving Medicaid clients vouchers for private health coverage, making Florida the first state to let insurers set benefits for poor clients. And this week, New York Gov. George E. Pataki (R) is scheduled to slash $1 billion from his state's Medicaid program.......

[baby_bear]

1. It's the same all over....thanks to Bush & people who voted for him

Unfunded mandates, federal tax cuts that have reduced revenue to the states, etc. etc. etc. What were people thinking when they voted for Bush, for slashing local taxes....

(Washington) State's cities awash in financial problems

http://seattlepi.nwsource.com/local/208328_cities18.html?searchpagefrom=1&searchdiff=1

<snip>

OLYMPIA -- Washington's cities are falling behind financially and are increasingly hard-pressed to provide basic services and decent roads for their 3.7 million residents, city leaders said yesterday. They released a bleak State of the Cities Report to the Legislature and reporters, describing it as sobering news that urban Washington is on the ropes.
...
About 73 percent said their finances are worse off than they were just five years ago, and 82 percent predicted that it will get worse.
...
Part of the problem is runaway health care costs for city employees, now increasing 15 percent a year, Bremerton Mayor Cary Bozeman said.
...
The survey said the cities face a $3.4 billion gap in meeting basic transportation needs over the next six years, with no clue where the money will come from.
</snip>

When is Congress going to face the real problems of this country instead of pretending that "the war on terror" is our only concern, or even a primary one?

[NNguyenMD]

2. God help Tennessee, another reason why a national sales tax would be a bad

idea. Tennessee, at least since I was last there in 2002, has no state income tax, but a very high state sales tax thats essentially left the state underfunded. A national sales tax is also heavily tilted toward middle class and poor, versus a progressive income tax that would better fund the state.

[Famine]

3. TennCare and income tax

The crisis in TennCare was deliberately created to some extent by advocates of an income tax for TN who wanted to "prove" that the sales tax couldn't sustain the level of state government that they wanted to provide. In TN, support for TennCare is seen as equivalent as support for an income tax and those who oppose an income tax have fought to end TennCare.

Whether a progressive income tax would better fund the state is dependent on how the brackets are set up but an income tax is extremely unpopular here. The issue has led to a Republican majority in the Senate for the first time in decades and cut the Democratic lead in the house to just a few votes. Open support for an income tax from the Democrats who have mainly avoided being pinned down on it would result in a Republican sweep of the state government.

Gov Bredeson did the only thing he possibly could to retain health care for the poor. He had to limit who could be on the program (currently about 20% of the entire state population) and limit the benefits to something the state could afford.

BTW, state tax revenues have grown considerably during the years since TennCare was instituted but TennCare costs have outstripped them by a long shot. Unless change was made every new dollar the state would bring in would have been spent on TennCare cutting off the rest of services like education from any growth in spending.