TennCare costs cannot jeopardize other services
Based on the reports coming from Capitol Hill, it appears Gov. Phil Bredesen is doing an admirable job in his quest to run the state with a sense of fiscal responsibility.
Sometimes that means making choices with severe ramifications and the governor’s current TennCare dilemma certainly fits that description. Bredesen has said he sees no way Tennessee can continue to operate TennCare, a health care program which insures some 1.3 million state residents, under the current system. That includes around 6,000 TennCare enrollees here in Warren County.
Back when TennCare was established a decade ago, health care costs were not skyrocketing the way they are today. As it now stands, TennCare is projected to cost the state $3.2 billion over the next year.
One reason for the soaring costs is prescription medication. A recent state study determined the average American fills 10 prescriptions a year. The average TennCare enrollee fills 30.
That is not an acceptable number when dealing with state-supported health care. While all citizens should have access to health care – regardless of income – there must be restrictions.
Like so many government programs, TennCare has been abused. There is no other logical explanation as to why some 1.3 million people would average 30 prescriptions a year.
The governor is being fair to TennCare recipients while at the same time drawing a definite line. Bredesen’s reform plan aims to limit some TennCare enrollees to 12 doctor visits per year, 45 days in the hospital each year, eight outpatient hospital visits a year, 10 lab procedures or X-rays, and six prescriptions a month.
Opposing lawyers with the Tennessee Justice Center contend such limitations are too restrictive. And the center has won several lawsuits against TennCare for not meeting the basic health needs of Tennesseans.
What’s important to remember in all this maneuvering is health care is vital, but so are many other services the state provides – most notably education. The last time the Standard checked, Tennessee ranks near the bottom, not the top, in educational achievement. It’s not a desirable place to be, but state leaders have developed plans to climb out of the basement. Most notable among those plans is a state-wide preschool program to get children off on the right educational foot.
But like all state projects, from paving roads to paving the way to better jobs in Tennessee, such a program needs money. And it’s nearly impossible to find much wiggle room in these lean economic times when TennCare is devouring most of the state’s budget.
Keeping TennCare is a priority and one which should be examined to its fullest extent. But keeping TennCare under its current condition – if it means giving enrollees the freedom to abuse the system with unlimited doctor visits and prescriptions – is not the state’s best option.
That’s not fair to all the families who work hard to pay for their own health insurance without state aid.