Federal cuts imperil Tennessee health care

Thursday, July 28, 2011

photo Jim Brexler

NASHVILLE - Tennessee hospitals, other health care providers and advocacy groups are making a statewide push to educate and warn the public and elected officials on the dangers of proposed federal budget cuts to health care.

The Coalition to Control Spending with Care begins today with a newspaper advertising campaign in five major cities, including Chattanooga.

The ad features a baby sitting in soapy water.

"Everyone agrees we must rein in federal spending," the ad says. "However, simply cutting without considering the consequences is a bit like throwing the proverbial baby out with the bath water. In our urgency, we have to consider the human cost to our most vulnerable citizens and those who care for them.

"Otherwise," the ad says, "the cuts will be devastating."

The coalition warns that some legislation being advanced in Washington, D.C., could cut anywhere from $100 billion to $300 billion from Medicare alone over the next decade. That could have a $2.8 billion to $4 billion impact in Tennessee, which the group calls "a very tough pill to swallow."

Tony Garr, policy director of the Tennessee Health Care Campaign, an advocacy group participating in the coalition, said no one is "offering anything by way of helping control costs on health care. There's nothing about the underlying issues of why we spend so much on our health care in this country compared to other developed countries."

The problem, Garr said, "is our fee-for-service [health-care model] is killing us and it's not making us any healthier."

Controlling health care spending in the long term is "critical in securing our country's financial future," Tennessee Hospital Association President Craig Becker, whose group is another coalition member, said in a news release.

"However, a narrow focus on just federal health spending will cause serious harm to Medicare and Medicaid patients and their families, while placing tremendous financial pressure on states and providers."

In a recent interview, Erlanger Health Systems President and CEO Jim Brexler noted that much of the federal debate in Washington "is really about what it will take to allow for the debt ceiling to be passed."

But "no one's even talked about what are the implications of those cuts," Brexler said. "No one has."

Despite its stance, the group is still advocating fiscal restraint, said Brexler.

"I think we all - hospitals, doctors, patients, families and insurers - we all need to get serious about how to work with less resources," Brexler said. "All those are themes that aren't going to get away."

The federal deficit and the debt ceiling fight between Democratic President Obama and congressional Republicans also are threatening states' use of provider taxes. Tennessee levies a 4.52 percent assessment on hospitals to help fund Medicaid for the poor.

The fee raises an estimated $449 million annually, which draws down about $870 million in federal matching dollars. If not for the fee, the state would have faced $1.3 billion in TennCare cuts this year.

Other proposed Medicaid cuts have been talked up as "being part of any package," said Edwin Park, vice president for health care at the Center for Budget and Policy Priorities, a D.C.-based group that advocates for poor and moderate-income people.

"They all propose a number of cuts to federal Medicaid funding," he said. "That effectively means you're shifting costs to the states."

Other members of the coalition include AARP, Hospital Alliance of Tennessee, Tennessee Public and Teaching Hospital Association, Tennessee Primary Care Association, the Tennessee Association of Mental Health Operators, The Arc of Tennessee and National Alliance on Mental Illness.