In Rebuke of Tennessee Governor, Koch Group Shows Its Power

"In December, Tennessee Gov. Bill Haslam, a Republican, got the deal he wanted from the Obama administration: Tennessee would accept more than $1 billion in federal funding to expand Medicaid, as allowed for in the Affordable Care Act, but Obama aides would allow Haslam to essentially write staunchly conservative ideas into the program's rules for the state. He dubbed the reformed Medicaid program "Insure Tennessee."

But the state's chapter of Americans for Prosperity, the national conservative group whose foundation is chaired by controversial billionaire David Koch, argued Haslam was just trying to trick conservatives into implementing Obamacare in their state by giving it a new name. AFP campaigned aggressively Haslam's plans for the next six weeks, even running radio ads blasting GOP state legislators who said they might vote for it.

On Wednesday, Haslam's bill died in a committee of the Tennessee state senate. The vote was one of the clearest illustrations of the increasing power of AFP and other conservative groups funded in part by the Koch brothers.

When the coalition of conservative groups allied with Charles and David Koch announced recently they would spend $889 million over the next two years, much of the discussion was about how that money could shape the upcoming presidential election. But AFP and other Koch-backed conservative organizations may be having their biggest impact on state politics, where targeted advertising and a strong organization can make a huge difference.

"We're the third-worst state in the country for accepting federal dollars," said Andrew Ogles, AFP's state director said in an interview here. "It's time for us to stop. Anytime we have a problem, instead of coming up with a Tennessee solution, we run to the federal government with our hands out. No more."

Medicaid {the original program} was workable. Had is merely been left alone and rules enforced it would have covered those that private sector had no intentions of ever covering due to nature of disability etc. They kept expanding it to cover the issues the moral collapse of The Great Society was causing such as Welfare Mothers and Welfare Check Kids.

Ironically I became disabled after Tenncare began. When my wife had become disabled in 1985 and her insurer BC/BS canceled her policy when she transferred to spinal rehab she was Medicaid eligible. When mine hit Tenncare was in place and I was turned down. I had to go get a statement from an insurer saying they would not cover me. Really with my disability a private insurer could have covered as my normal medical cost aren't that much. Kind of hard to explain but I lost sensory processing abilities which makes concentration difficult and also involves seizures triggered by certain sounds or optic events. That happened in 1994. It was caused by a condition I later discovered I was born with and had dealt with all my life.

There has to be a means to help those who really due to disabilities need it and many times prior state governments have been able to get the job done efficiently that was beyond private sectors norms. The Polio epidemic as an example.

Tenncare became a Dumping Ground for those insurers considered High Risk and they were placed in HMO's. High Risk meaning Diabetics, Hypertension, etc. That's why companies like BC/BS pushed so hard for it. They got cream of the crop then for true private insurance. The HMO ACT Ted Kennedy created destroyed private insurances and drastically downgraded our healthcare system. True private insurance then became unaffordable by intended design.

Im going to be quite frank with you, so forgive me if this is a little blunt, but the very idea of insurance as practice today is an economic deaster in the making.

You simply cannot remove the consuming party from the concern of price without necessarily causing that price to go up as fast as it can. The advent of insurance for non-catastrophic cases is precisely what has been driving the cost of healthcare for everyone up the roof.
This is basic human nature, and it will never go away so long as we have any real control over our lives and what we are able to buy and risk.

The insurance industry as it now exist must be largely destroyed, those high risk pools you talk about should have been the only clients getting paid out. Even then there has to be some limit, we have reach the point in medical technology where we can technical at great cost do almost anything, and that capability is only growing.

In all other fields of human endever this extraordinary capability is contained by costs so that most people never fly supersonic or go to space, or drive ferrari sports cars. Because of health insurance that is not the case in healthcare instead people’s concept is based on demand in compete ignorance of supply as if it should somehow just exist. Well it doesn’t exist in numbers and technology for everyone and the only thing the Government can do about it is force us to spend far more than most of us think reasonable for this area of life, or alternatively prevent advancement(by funding cut offs) so that the technology that is available can be available to everyone. In other-words you can forget about most of the break-thous trickling down to the majority of people. Or getting access to that 1 highly expensive treatment for your rare medical need.

Indeed based upon current research already being done, it is possible in the next 20 years we could have the means for people to not die of old age. Will that highly expensive option ever make it to the masses? I don’t know if none of us are allowed to even pay top dollar to try it.

Don't worry about being frank I have a lot to say on the matter myself. LOL. The prices of healthcare in general could be brought down fast by some simple measures. First and foremost Tort Reform in relation to hospitals and doctors. Unless a doctor removes the wrong organ or limb type of mistakes their efforts should be protected from frivolous litigation.

Insures believe it or not share a huge part of the blame for it getting out of hand. Not the healthcare insurers but the malpractice insurers surrendering to insanity and legally via contract gagging the doctors from defending their practice and their medical reputation by prohibiting their testimony and demanding they settle.

The next issue is Idiot Jurors who see themselves as Santa Claus or Robin Hood passing out insane and often unnecessary monetary judgements which should have never been allowed. They know the doctor and hospital aren't guilty but hey it's the insurers money not the hospital or doctors they think. That is where administrative judges are needed to first vet the lawsuits to start with for their merit and have their own investigation before a trial is allowed. Malpractice insurance is astronomical one of the biggest cost.

Again rescind the HMO Act. It's been a disaster except to the parent corp Insurers who own them. Insurers use to invest premiums and had an on hand reserve set aside for meeting liabilities. The profits weren't made in premiums as such but rather the re-investment of premiums some of which was set back for liabilities the rest to shareholders. Insured persons had contracted coverage cut and dry all understood it. The treatment decisions process was left between doctor and patient. HMO's on the other hand are healthcare rationing systems with profits coming directly from premiums to shareholders or the private owner. Liability is controlled solely by rationing. If peoples automotive or homeowners insurance operated in such a manner there would be a revolt. I'm sorry Mr Smith you needed prior approval before your house burned down or you rear ended Mr Jones.

HMO's made healthcare coverage a short term investment bonanza at the expense of doctors. If the liabilities exceed incoming premiums for even a short duration they simply go bankrupt and come back under a different name. HMO's also operation under a litigation protection that insurers do not get.

OK for now the patients themselves. A decent policy should cover 80% after on a family policy the first $500 annual. That slows down the ones who use insurance for trivial matters. That too is where a lot of cost come in. I see my doctor on regular schedule twice a year on his recommendation. Some years like this year I have to see him more frequent most years I don't. My wife is on a once every four months schedule but she has some more serious issues. Most of her visits now are prevention check ups. I have an additional option she doesn't have. If needed I can use VA and I do so for my hearing aids and corrective insoles so I can walk.

At Home Long Term Health Care should be encouraged. Which cost more $6500 a month in a nursing home or providing a couple of home health visits to families who are caregivers taking care of family? In 30 years we've had about tops total sum of 15 visits maybe 20 at the most in that time.

The assisted living and nursing home corps lobbyist stand in the way of some needed reforms. As more persons are needing long term care a wise measure would be encouragement of family caregivers. Not all families have persons who have the character disposition to do the care though. I did a major part of my dads Hospice too. I'm the one in the family whom mentally can do it and I have not had one day of formal healthcare training LOL. I've worked in nursing homes in maintenance which is where I met my then future wife who was a CNA.

Next is put the churches back into running hospitals. Put the facilities under a Samaritan Clause meaning simply they operate as Non Profit Charities and as long as certified or licensed caregivers do the patient care the patient waves rights to litigation. That sounds more than fair to me. Keep the government out of them beyond prudent health & safety standards inspections. Also as charities operating as NPO's but pay wages waiver them from the labor laws which violate their church beliefs. IOW no forcing a Church ran hospital to provide birth control or offer it etc.

The best ran hospital in my hometown used to be a Catholic ran hospital and the Sisters ruled it LOL. Obama's insane nonsense meant it was sold to a private corp. MOst hospitals are now disassociated from their roots. In a city where four major hospitals once existed only one had a secular name and it was a state university medical center. All have changed their names. My last employer had Presbyterian in it's company name. We were self insured as far as employees went and it was a great system for all. They had a catastrophic policy to cover what was beyond their planned liability. IOW if some employee got gravely sick running up six figure expenses. We had IIRC a $250 annual deductible then 80% coverage with real quick reimbursements on covered expenses such as medications because the payroll clerk handled it all.

Many things can be done and should be done. I stated a few and I believe they would bring cost down astronomically if put into policy.

At two points in the past 30 years we could have been very rich. One involved a dentist doing malpractice with medications. He later killed a kid. The other involved six doctors failing to do a simple Physicians Desk Reference of my wife's Meds for possible adverse reactions that darn near killed her and they insisted was psychosis. Two hospitals three ER attending doctors failed to do it. Our solution instead? A letter to their Chief Of Staff one of which knew her as a patient before. We're not litigation happy persons. We're just trying to make it by day to day.

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