The child is probably on Tenncare, which was an experimental pilot program of Hillarycare started in the mid-90’s in TN. Within a couple years there was massive fraud and way more people on it than it was originally designed to serve. Gov. Bredesen supposedly tried to get it under control and, from what I understand, did have some success but the program is nevertheless a behemoth entitlement that indeed removes a lot of decision making from the doctor and patient. TN doesn’t have an income tax but lawmakers tried to impose one a few years ago to cover the booming cost of Tenncare. The taxpayers of TN revolted (not the first time) and it was resolved for the time being by an increase to 9% sales tax, an amount that placed rural little red Tennessee up in the same sales tax bracket as high tax and cost of living blue states such as we see in the Northeast.
Rarely do we hear about what an expensive, bureaucratic disaster Tenncare has been. We’ve heard about Romney’s socialized medicine program cost overruns in MA, but Tenncare was way ahead of MA. My recollection is that the people of TN did not want Tenncare, but it was foisted on them in order to try to get a handle on their growing share of federally-mandated Medicaid costs. Specialists are leaving the program and most won’t take Tenncare patients anymore. Blue Cross and Blue Shield have a big hand in the program as managed care providers and they wield the capitation ax. From what I understand, Tenncare is not an unmitigated disaster but it’s a huge mess that simply can’t be controlled so “ethics” panels decide care based on costs without a lot of other considerations. The program is a snap-shot of typical government entitlement stupidity - too many people in the wago, too much bureaucracy steering the wagon, and too few people pushing the wagon. Insurance premiums went up for all Tennesseans carrying private insurance in order to offset the reduced payments paid to the carriers by the state. Now think about that for a moment. If insurance could be purchased over state lines, there would be competition. Carriers that aren’t participating in Tenncare would have lower premiums because patients wouldn’t be subsidizing the reduced premium payments from the state for the Tenncare load. If people could do that, then the subsidy dollars would trickle away to the lower premiums of the non-Tenncare carriers. By not allowing other carriers to compete, premiums are kept artificially high in order to subsidize the state’s refusal/inability to pay more per capita Tenncare patient. So, not only is the government incentivized to not allow competition, any time there is a government program involved there is also no incentive for the “private” providers to lower costs other than through rationing. They’re not going to cut their own costs through efficiencies because that impacts the overall gross product of the entire health industry. It’s more desirable to shortchange patients rather than contractors and vendors - their buddies - in the industry such that they only experience reductions that occur as a result of shortchanging the patients.
Thanks for all that info. Sounds a lot like why I don’t want Obamacare.