TennCare enrollees urge governor to be cautious
NASHVILLE (AP) — A group of anxious TennCare enrollees urged Gov. Phil Bredesen to be careful Thursday as he ponders how to change the state’s health care program for the poor and uninsured.
Bredesen will present his TennCare proposal to the joint session of the Legislature next week. On Wednesday he released an independent report from that outlines possible options.
Some of the options include limits on prescription drugs, the biggest concern of the enrollees who spoke at a Capitol Hill news conference. Several of the options suggest capping prescriptions at six per month.
“I encourage the governor and Legislature to take a very, very careful look at what they do,” said Lori Smith of Nashville, who has lupus and multiple sclerosis and relies on drugs provided by TennCare to control both. “They could be handing out death sentences.”
Carol Westlake of the Tennessee Disabilities Coalition said the group was encouraged by much of what the McKinsey & Co. report suggested, especially its emphasis on disease management.
“It’s too easy to think simply of cutting benefits or enrollment,” she said. “We think these are false choices and false economies. It’s critical to use good management to deliver good health care, but arbitrary prescription limits could prevent a doctor from providing good medicine.”
Don DuVaul of Westport fell off his father’s roof nine years ago and broke his back. He’s been paraplegic since.
“If TennCare folds up, I’m dead,” he said. “TennCare has been my life since ’95. I’m going to school, I play wheelchair basketball, I’m doing all I can do. I’m still one box (of medicines) away from being dead.”
Brian and Janet Ross, newlyweds who both have serious medical conditions, said a hard limit on prescriptions would force them into impossible choices.
Speaking slowly and carefully, Brian Ross said he would have to choose between his anti-psychotic medicine or his anti-seizure medicine.
“Whichever one they cut out will hurt me, one way or another,” he said.
Janet Ross said it is “terrifying to think” her husband will be either catatonic or restrained in a hospital for some period at the end of each month until he can get the next month’s fill of prescriptions.
“It’s a matter of life and death,” she said. “It’s a terrible position to be in. We’d like the governor to consider the human cost of his actions as well.”
Brian McGuire of the Tennessee chapter of AARP said he had asked McKinsey if they had factored the “collateral damage of scrip limits” into their estimated cost savings — such things as increased hospital visits — and they said they had not.
“Six prescriptions a month is far from the norm,” McGuire said. “With one exception, all of the states surrounding Tennessee allow more than six per month.”
McGuire said the governor could cap prescriptions, but allow for increased usage when a doctor deems it medically necessary for the best care of the patient.
“There are ways to make a scrip limit work, but it has to be very easy for the physician” to prescribe more drugs if necessary, he said. “There should be no limit on any drug considered lifesaving.”
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