Tuesday, May 29, 2007

Phil Bredesen on TennCare

In an on-line posting (22-May- 2007) for the journal Health Affairs, Governor Bredesen discusses TennCare. (Health Affairs 26, no. 4 (2007): w456-w462).In an article entitled "Next Steps For Tennessee: A Conversation With Gov. Phil Bredesen," Alan Weil summarizes the Governor's observations. Quoting from the abstract:

In this conversation, conducted during the February 2007 meeting of the National Governors Association, Gov. Phil Bredesen of Tennessee discusses his views on health care, health information technology, and the challenges of changing a massive system with many moving parts. He talks about his involvement in the State Alliance for E-Health, which is working on privacy, licensure, and data communications across state lines. He discusses the state's TennCare program; his views on effective managed care; and his Cover Tennessee program, which seeks to provide low-income workers with an innovative low-cost insurance product focused on preventive care.

It is perhaps misleading to take any quote out of conduct, but the Governor's philosophy on patient-provider relationships and his emphasis on value comes through. One representative exchange.

Your TennCare experience didn’t sour you on your view that managed care is an appropriate delivery system?

Oh, no. I absolutely believe in managed care, practiced correctly. There are a lot of things out there under the rubric of “managed care,” some of which don’t do any managing of care at all. They just put another intermediary in between and then argue about rates.

But the notion of putting the primary care physician truly in charge, putting some economic incentives for effective treatment in there, putting some emphasis on preventive care and early access to care—all things that HMOs, properly constructed, try to do—I absolutely think that’s the wave of the future.

On the care of children:

I believe that children ought to have really broad access to care. There shouldn’t ever be any limitations on their getting care because of the unwillingness of a parent to pay a copay or something like that. When you get to adults, I don’t feel nearly so strongly. This is a free country, and adults make decisions about what’s important to them.

Sunday, May 13, 2007

Some Medicaid Citations

On April 16, the Alliance for Health Reform held a symposium entitled:
Medicaid 101: A Primer on the Health Insurance Program for Low-Income Americans. This symposium featured national experts and critical analysis. Transcripts of the session as well as presentations are included. Some are linked through this posting.
The speakers were:
  • Diane Rowland, executive director of the Kaiser Commission (presentation)
  • Trish Riley, director of the Maine Governor's Office of Health Policy and Finance (presentation)
  • Jeffery Crowley of Georgetown University's Health Policy Institute (presentation)
  • Ed Howard of the Alliance (moderator)