It's Time To Insure Tennessee - And Response

  • Friday, January 30, 2015

Tennessee has a problem. 

What is the value of saving the lives of 1,000 Tennesseans each year? That is exactly what can be expected if 176,000 Tennesseans gain health insurance through Insure Tennessee. A New England Journal of Medicine study showed that expansion of Medicaid was associated with a 6% reduction in yearly mortality for people in the 34-65 age group. Statistically, expanding coverage prevented one death for every 176 who gained insurance through Medicaid each year.

This is especially important because Tennessee's health, as measured by the health of its population, has dropped from 42nd to a dismal 45th in the United States. Combine this with the fact that the U.S. ranks last among developed countries in population health, and it is fair to say that our state is one of the unhealthiest places in the entire developed world. Much of this can be attributed to unhealthy behaviors, such as cigarette smoking and obesity, but another major factor is that roughly 15% of our population does not have access to our healthcare system because they lack health insurance.

As a practicing anesthesiologist, it is painful to see patients come to surgery with conditions that could have been prevented with earlier medical care. We see young women with advanced cancer that could have been cured if diagnosed sooner, but they postponed care because they were uninsured. Hypertension and diabetes, two easily treated chronic diseases, go untreated in the uninsured population and lead to catastrophic results like heart attack, stroke, and renal failure.

Uninsured patients who are involved in car accidents or suffer broken bones from a fall can quickly accumulate medical costs, in some cases forcing them into bankruptcy. In fact, Tennessee led the nation in bankruptcies last year at a rate of 1 in 164, with medical costs being a major contributor. I don't think people should be afraid to ask for help when they need it, or go bankrupt just because they got admitted to a hospital.

We are all getting older. In this country, 10,000 baby boomers turn 65 every day. Our healthcare needs increase with age and Tennessee needs a strong healthcare system to meet these challenges. Hospitals in Tennessee are facing billions of dollars of Medicare cuts in the next 10 years; just the three hospitals in Hamilton County are looking at cuts that amount to $479 million. Without Insure Tennessee, many hospitals will be forced to scale down services and personnel to adjust to these changes. In some cases, particularly in rural areas, hospitals will close altogether, forcing local residents to travel long distances for medical care. Our physician workforce will also be negatively affected without Insure Tennessee. About 1/3 of the physicians in training in Tennessee are funded by hospital budgets, some of which have already been reduced. While Insure Tennessee will provide access to health insurance for thousands, it also should be viewed as an investment in Tennessee's healthcare infrastructure because it will help support the hospitals and physicians we need – now and in the future.

Governor Haslam has worked hard to find the Tennessee solution for the problem of the uninsured and to protect the healthcare systems we all depend on. He rejected the entitlement form of Medicaid, choosing instead a market-based approach that allows hard-working individuals to buy into their employer’s plan through premium support, or a TennCare type plan that requires the individual to pay premiums and co-pays just like a private policy. Healthy behaviors will reduce the amount these individuals will pay, thus incentivizing them to take personal responsibility for their health. Only by changing behavior will we be able to improve Tennessee's overall health. 

Opponents of this plan have sought to confuse the issue by claiming a decision to support the Governor's two-year pilot plan would be irreversible. There seems to be no end to the "what if's". They offer no plan to address the pressing healthcare needs of our state by saying that "we simply can't afford it". It is unconscionable that we allow hundreds of thousands of hard-working Tennesseans, including more than 20,000 veterans, to continue go without healthcare access, while sending hundreds of millions of Tennessee tax dollars to other states. This is “fiscal irresponsibility."

Governor Haslam has presented a conservative healthcare reform plan that leverages our tax dollars to improve Tennessee's health, while maintaining adequate safeguards to protect taxpayers.

There comes a time to move past politics into practical solutions that will benefit all Tennesseans. It's time to Insure Tennessee...now.
 
Christopher E. Young, MD
Immediate Past President
Tennessee Medical Association

 

* * *

Dr. Young,

Well said and on point.

Tim Gobble

Former TN sheriff who has seen first hand the devastating effects on those who suffer without adequate health insurance.

Insure TN is the morally right thing to do.

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