BREDESEN: MEDICAID = SOCIALISM

Gov. Phil Bredesen said Tuesday the nation’s Medicaid program shares more with socialism than practicality and needs fundamental reform. "The way in which Medicaid pays for services has more in common with a socialist economy than the commonsense economic and business principles that do such a good job allocating resources efficiently in other parts of our American life," the governor said. His remarks came at a conference in Raleigh, N.C., of policymakers studying health care issues. The governor has proposed substantial cuts in benefits and enrollees in TennCare, the state’s expanded Medicaid program for the poor and uninsured. Te nnCare now covers some 1.3 million people at a combined state and federal cost of $8.7 billion. The governor wants to drop 323,000 non-Medicaid eligible people from the program and save $575 million in state dollars next year.

Attending Tuesday’s conference in Raleigh was Ron Pollack, executive director of Families USA, a Washington-based advocacy group which has criticized Mr. Bredesen’s approach to curbing TennCare costs. Mr. Pollack said he did a "double take" when he heard Gov. Bredesen compare Medicaid to socialism. "I don’t know what he was smoking before he gave his speech. But I think he had a pretty high dosage of whatever it was," he said. "It’s hard to give a straight-faced comment about it." The nation’s health care system is "overwhelmingly a private health care system," Mr. Pollack said. "What we do is provide a safety net for people who can’t get coverage in the private sector." Under Gov. Bredesen, that "safety net is becoming much more hole than webbing," Mr. Pollack said. "To talk about it as a socialistic health care system, I think someone should inform him the Cold War is over."

The governor, locked in an increasingly bitter legal and political struggle to overhaul TennCare, said changes to the current federal system should have three guiding principles: "Everybody pays something; pay first for what is most important; pay for what works." "Our hearts are there," Gov. Bredesen said. "What I want to say today is our heads need to get there, too."

However, Mr. Pollack said when he heard the governor speak, he didn’t recognize anything the governor was doing in Tennessee. "He didn’t say anything about cutting 323,000 people from the program," he said.

President Bush, meanwhile, is moving forward with plans to curb Medicaid spending at the national level. His new budget recommends cutting federal spending in Medicaid by $45 billion over the next 10 years.

In his remarks Gov. Bredesen said that while Tennessee has a "particularly acute problem because of the scope of our program, we are just the leading edge of what is happening across the nation." He said one study estimates that 22 states can expect to allocate more than half of all new tax revenue in the next five years to Medicaid. "Medicaid is a clear and present danger to the budgets and priorities of the states," he said.....

Gov. Bredesen said charging patients even a token fee for each visit to a doctor would add "economic tension" and be a start toward reform. "This is not about being hardhearted," he said. "It’s a basic truth (that) people value the things they pay for and don’t value what is free." He also recommended prioritizing medical care. For example, he said, the government should pay for prenatal care and necessary surgery before covering the costs of antihistamines and heartburn medication. Tennessee spends more than $200 million a year on those two categories of drugs alone, he said. He also said that states should reject paying for some medicines that haven’t been proven to be effective.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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