published Thursday, July 5th, 2012

Please, no Son of TennCare!

The recent Supreme Court ruling that allows our government to mandate that each citizen purchase insurance as required by the Patient Protection and Affordable Care Act through the definition of a tax presents a defining moment for states.

As a function of Obamacare, states are given the option to independently construct health insurance exchanges with federal grants in preparation for full implementation of the law or to participate in a federal exchange. Of America's 50 states, 35 have moved forward to ready for the law by working to establish minimal benefit plans.

As of May 2012, according to the Kaiser Family Foundation, Tennessee has received more than $8 million in federal grants, Alabama $8.5 million, and North Carolina over $12 million to take action. Georgia has not taken any federal funding to date.

In 1994, through an executive order, a "managed care" program was put into place through a waiver Tennessee received to modify our state Medicaid program that provides health care for the poor. TennCare was born.

According to a legislative briefing paper prepared by then-Comptroller John Morgan, spending on Tennessee's Medicaid population was $895.8 million in 1993. After the implementation of TennCare, that figure ballooned to $1.68 billion in 2001, a doubling in eight years. Gov. Bill Haslam's 2013 current draft budget includes a proposed $2.86 billion from the state for a total of $8.96 billion projected spending on TennCare.

Over the years, the perils of government engaging in a private function of commerce were discovered in TennCare. The state budget was placed in serious jeopardy due to the malignant expansion of the costs and a promise of health care coverage.

The state health exchanges, promoted in Tennessee as the "Expedia" of health options, will allow a qualifying individual to navigate through the options to make their selection that ultimately will receive the federal funding to the state program.

So, what's the problem with TennCare and the fear of a spawn of TennCare? Both would offer a defined benefit rather than a defined contribution.

A defined benefit promises services X, Y and Z will be offered. Whether an individual needs X or only Y and Z is not a factor. For example, does a 55-year-old uninsured man need health coverage that includes prenatal care? The plan that includes a standard fit of X, Y and Z in a defined benefit serves as the floor and the option that will receive the greatest funding through government subsidy.

A defined contribution, in contrast, permits a patient to serve as the consumer, choosing health care coverage through options and variations that best meet the needs of individuals based on their ages, their pre-existing conditions, their risk of trauma, etc.

Guess which of the two is easier to manage during a time of rising costs? Guess which option actually serves as a competitive market force to increase options and patient control?

Obamacare will move forward toward full implementation in 2014. States must decide whether to expand Medicaid for the uninsured poor and whether to complete the state exchange process. However, Tennessee must not create the Son of TennCare by following the same template that includes tremendous budget demands.

Let's use the opportunity to shift the solution to the private sector, create competition, and watch health care costs and the number of the uninsured decline.

Comments do not represent the opinions of the Chattanooga Times Free Press, nor does it review every comment. Profanities, slurs and libelous remarks are prohibited. For more information you can view our Terms & Conditions and/or Ethics policy.
Lr103 said...

government to mandate that each citizen purchase insurance

Bold print. That's where the lie exist. Most citizens already carry healthcare insurance if only through their employers. The rest, if their income falls below a certain level would automtically be covered. The right wingnuts claim to be so religions and Godly Christians but everything they spew from that pie hold is either an exaggeration or a lie. If your beliefs were really sincere you'd be afraid of that dude in the sky sending down a gigantic lightening bolt to strike you right in your rear!

July 5, 2012 at 7:49 a.m.

Lr103 So what you are saying is that Obamacare really isn't neccessary?

July 5, 2012 at 12:38 p.m.
Lr103 said...

No FPP. Just that the righties are up to their old tricks, exaggerations and lies. Powerful insurance companies and their lobbyists fear individuals who now pay for their own healthcare insurance coverage will instead have an option to buy cheaper insurance from the government. That along with doing away with pre-existing condition penalties.

July 5, 2012 at 6:21 p.m.
Leaf said...

That insurance companies still exist at all is a huge win for the insurance lobby. But still they complain. Still they want to be richer. Which insurance company do you work for, sonny?

July 6, 2012 at 10:32 a.m.
conservative said...

There would be no Demoncrat party without freeloaders! There would be no Demoncrat party without freeloaders!

July 6, 2012 at 11:04 a.m.
Humphrey said...

there would be no republic party without heartless idiots

July 6, 2012 at 5:54 p.m.
please login to post a comment

videos »         

photos »         

e-edition »


Find a Business

400 East 11th St., Chattanooga, TN 37403
General Information (423) 756-6900
Copyright, Permissions, Terms & Conditions, Privacy Policy, Ethics policy - Copyright ©2014, Chattanooga Publishing Company, Inc. All rights reserved.
This document may not be reprinted without the express written permission of Chattanooga Publishing Company, Inc.