Editorial: Haslam wise to begin Obamacare preparations

Tennessee Gov. Bill Haslam's administration wisely had been laying the groundwork for establishing a health insurance exchange in anticipation of Thursday's U.S. Supreme Court ruling upholding the Affordable Care Act.

Though he said he has concerns about the health care reform law and would like to see it repealed, Haslam prepared for any eventuality.

"I think we've played this right, in the sense of being ready either way it goes," Haslam said before the decision.

By a 5 to 4 vote, the Supreme Court upheld virtually all the controversial law, which will extend health insurance coverage to an estimated 30 million more Americans.

The divisive mandate that Americans buy health insurance or pay a tax penalty stands. Writing for the majority, Chief Justice John Roberts said the provision wouldn't pass muster under the Commerce Clause but is constitutional when viewed as falling under Congress' taxing authority. Roberts, who typically sides with conservatives in close cases, aligned himself with the court's liberal members.

The ruling was a clear victory for Obama as the election campaign escalates and an undoubted morale boost for the White House. Republicans, including Haslam and U.S. Sen. Lamar Alexander, immediately announced plans to push ahead with their mantra, "repeal and replace."

"The Supreme Court may have failed to declare the entire health care law unconstitutional, but it is still n historic mistake that expanded a health care system we already knew we couldn't afford," Alexander said in a statement. "Congress should repeal the law and then proceed step by step to reduce the cost of health care so more Americans can afford to buy insurance."

Haslam said the ruling shows the need to elect Mitt Romney president so "we can be sure the entire law will be repealed."

That may not be as easy as it sounds. Polls show that parts of the law are truly popular with Republican rank and file:

n Allowing young adults to stay on their parents' insurance until age 26.

n Ending annual and lifetime limits on health insurance payouts.

n Not allowing children with health problems to be denied insurance.

n And, by 2014, not allowing people with pre-existing medical conditions to be denied coverage.

"Repeal" will be tough, "replace" even harder. The House Republican alternative of vouchers to buy health insurance, even under its new name, "premium support," has not caught on with voters. And then there is the awkward fact that the Affordable Care Act closely parallels Romney's own plan as Massachusetts governor.

The administration did suffer one serious setback. The law greatly expands Medicaid — medical coverage for the poor and disabled — to cover another 17 million, but the court struck down a provision that revokes all of a state's Medicaid funding if it refuses to go along with the expansion. Haslam said his administration would review the state's options for TennCare, Tennessee's Medicaid program.

"What was unanticipated is the section of the opinion that says states cannot be forced to expand their Medicaid program. This particular portion of the ruling is significant, but it is premature to know the exact ramifications," Haslam said in a statement issued after the ruling.

Meanwhile, state officials should continue moving forward to establish the health insurance exchange. Unless the law is repealed, people will have to be able to buy policies through the exchange beginning in 2014. The Affordable Care Act has divided Tennesseans as it has all Americans, but now it is confirmed as the law of the land and Tennessee officials have a duty to implement its provisions.

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Comments » 80

tnvarmit#526548 writes:

I think the Editorial Board should be forced to sit down and actually read all of it's Archives related too Tenncare & all the promises the government made and the corruption and abuses including threats against the disabled that were made.

Insanity is doing the same thing wrong over and over again expecting different results. Insanity is believing that federal health care can and will work. Europe is now broke and Canada's So called Free Health Care System Requires Months Of Waits on what is considered do it ASAP surgery here. So scratch Europe and Canada off as your examples of how great it is.

If government ran health care is so perfect then why do Canadians come to the U.S. for needed surgeries that is those who can afford it? Because they have this thing about wanting to live through a treatable medical issue and not die waiting months on RATIONED treatment perhaps?

Shame on the media in this nation. It should be picking this apart piece by piece looking for fault and reporting the weakness of this program and the dangers you purposely choose to ignore and not inform the public of. Instead the Media in this nation has not done it's job but rather has compromised it's integrity by being shills for it. The media is getting far too friendly for my comfort with our government which makes conditions ripe for tyranny. Of course if a Conservative ever gets back in the White House {last one we had was elected in 1980 & 84} the media will suddenly start doing it's so called unbiased investigative reporting job again. Now am I right?

Media cares about it's First Amendment Rights of the press and the others are negotiable it seems. BTW free health care is not a Constitutional Right. But this government has driven away a system where charities could operate and serve the public. Health care has been mandated to death by government. Each new mandate things get worse and prices go up. Get a clue.

When the exodus of doctors begins as they start closing their practice due to stress and another added 20 more hours a week put on them and this Editorial Board gripes about the doctor shortages, I’ll have a copy of this comment to refresh your memories.

If we can have Free Public Health Care then why can’t we have a free newspaper delivered every day too our homes? By free I mean the media provide it free to al. The cost? Oh that’s easy. I’ll do Liberal Math. The cost can come out of your shareholders profits how’s that? I want my free newspaper entitlements and I want them now.

Tnbehr08 writes:

Oh quit whining and complaining...No one questions the need for billions of $$ in excessive spending for the military, education, and many other programs. it's way overtime the American people quit griping about the'Affordable Health care Act' and accept it's the law of the land and begin supporting it. or do we want to go back to the old ways of patchwork health care and millions being left out? I definitely think not and millions of others agree!

markomd writes:

I once again recommend that KNS abandon using the simplistic and derisive term 'Obamacare' and substitute ACA or Affordable Care Act.

This law came into being via Congress, was signed by President Obama and has been certified as constitutionally sound by the Supreme Court of the United States.

The ACA is now the law of the land and it is not going to vanish despite the fact that most Americans, myself included, find some portions of the law unpalatable and in need of major revision or excision.

As the editors correctly state in this column, the vast majority of Americans accept and favor major portions of the law.

We would be far wiser to encourage our congressional representatives and senators to improve the ACA by eliminating undesirable portions and replacing them with more palatable alternatives.

I, for one, do not wish to see the internecine warfare that has rendered Congress impotent continue.

In this republic of 314 million souls, we need to find common ground unless we prefer to reject the Union and reignite a civil war at tremendous cost.

Using the term ‘Obamacare’, as facile as it may be, is divisive and counterproductive to solving the real problems the ACA, however flawed, is designed to ameliorate.

‘Nuff said.

tnvarmit#526548 writes:

in response to Tnbehr08:

Oh quit whining and complaining...No one questions the need for billions of $$ in excessive spending for the military, education, and many other programs. it's way overtime the American people quit griping about the'Affordable Health care Act' and accept it's the law of the land and begin supporting it. or do we want to go back to the old ways of patchwork health care and millions being left out? I definitely think not and millions of others agree!

I can tell you stories about Tenncare that would make your head spin. Are you a person who once worked and became disabled? Did you know Tenncare tried several times to dump the disabled from enrollment? Did you know that under Medicaid as long as a disabled person met the fisical guidelines meaning broke they were covered? Did you know that under Tenncare they were turned down but welfare Moms weren't? The very ones Medicaid was for became the ones Tenncare wanted off the roll. Don't tell me I can trust government.

Medicaid was a safety net program set up solely for the disabled worker & survivor children and the very poor elderly. Making it Universal Health Care not only destroyed the program but all accountability that it once had.

Medicaid used to be under direct oversight of the Tennessee Inspector Generals Office. This was done to ensure actual services were provided and abuse was dealt with. Tenncare answered to no one. Who will Obamacare answer too? Obama? LOL.

I've been following health care issues even before Tenncare was ever thought of lets just say way over two decades now. Maybe just maybe I learned a few things and I'm sounding a justifable warning of what is in store for all. Did you ever consider that?

StateofEastTN writes:

The U.S. has been providing healthcare to other countries for decades with U.S. workers tax money. Though the ACA is way late in coming about, it's about time our charity (if you choose to call it that) starts at home.

tn_conservative_guy writes:

Haslam continues to prove himself to be a weak governor. He has a chance to stand up for conservative values along with more than a dozen other governors and refuse to initiate the worst piece of legislation in American history. Instead, he "goes with the flow" and Tennessee suffers again.

Damitman writes:

in response to tnvarmit#526548:

I can tell you stories about Tenncare that would make your head spin. Are you a person who once worked and became disabled? Did you know Tenncare tried several times to dump the disabled from enrollment? Did you know that under Medicaid as long as a disabled person met the fisical guidelines meaning broke they were covered? Did you know that under Tenncare they were turned down but welfare Moms weren't? The very ones Medicaid was for became the ones Tenncare wanted off the roll. Don't tell me I can trust government.

Medicaid was a safety net program set up solely for the disabled worker & survivor children and the very poor elderly. Making it Universal Health Care not only destroyed the program but all accountability that it once had.

Medicaid used to be under direct oversight of the Tennessee Inspector Generals Office. This was done to ensure actual services were provided and abuse was dealt with. Tenncare answered to no one. Who will Obamacare answer too? Obama? LOL.

I've been following health care issues even before Tenncare was ever thought of lets just say way over two decades now. Maybe just maybe I learned a few things and I'm sounding a justifable warning of what is in store for all. Did you ever consider that?

All these things were done under a republican governor! I remember well how Don Sundquist and state rerublicans tried to destroy what Ned had created. Don't complain about the federal government when this is a state run federal subsadised program!! Everyone wants to lay blame why don't the republicans say what they want to replace it with when they repeal it and don't say vouchers. That's their answer to everything. Schools health care and welfare. Grow up!!!!

Willowwind2 writes:

It is not whining or complaining to question a 2500 plus page document, of which many in congress HAVE NOT READ; this document needs to thoroughly reviewed and studied line by line; would you sign a blank check; I would welcome a better, cheaper health care premium. I pay 35 percent of my income health ins. premiums; barebones coverage (no vacations, no nights out, no going to the movies) while those who are exempt from this program yet support it have the money to travel across the planet, Congress is exempt; Pelosi's district exempt; and twice the premiums have directly gone up for obamacare which does not take effect until 2014; we in Michigan are charged an added 5 percent every month for the medicaid end of it; rural drs. are paying one years salary for an ordered electronic patient charts directly due to Obama care; do some research before you think this is better; and the one liners of those who state we who want a thorough look at this that state we don't care is just a tool to get those who don't research or study this to believe fiction...since when has the govt. done anything w/out huge rip offs; no proper accounting; look at medicare fraud the list goes on...and on..I care always have; but this plan takes effect in 2014; why? how come such a life changing program not gone under the microscope by news sources? why are they not getting to the meat of every sentence; its not a little thing..why is everyone so afraid to explore all of it; reveal it..that speaks volumes to me.

Tnbehr08 writes:

in response to Damitman:

All these things were done under a republican governor! I remember well how Don Sundquist and state rerublicans tried to destroy what Ned had created. Don't complain about the federal government when this is a state run federal subsadised program!! Everyone wants to lay blame why don't the republicans say what they want to replace it with when they repeal it and don't say vouchers. That's their answer to everything. Schools health care and welfare. Grow up!!!!

Hey Tenncare is anything but perfect..However it was a beginning and definitely needs tweaking. That being said we need a universal health care program for all and with a public open for those that can't afford it. We cannot continue on this road we're currently on. The republicans don't seem to be offering anything tangible. The Dems took the initiative on this one and were successful on getting it thru. So quit wining and accept and support this!

AmericanBornTaxpayer writes:

in response to markomd:

I once again recommend that KNS abandon using the simplistic and derisive term 'Obamacare' and substitute ACA or Affordable Care Act.

This law came into being via Congress, was signed by President Obama and has been certified as constitutionally sound by the Supreme Court of the United States.

The ACA is now the law of the land and it is not going to vanish despite the fact that most Americans, myself included, find some portions of the law unpalatable and in need of major revision or excision.

As the editors correctly state in this column, the vast majority of Americans accept and favor major portions of the law.

We would be far wiser to encourage our congressional representatives and senators to improve the ACA by eliminating undesirable portions and replacing them with more palatable alternatives.

I, for one, do not wish to see the internecine warfare that has rendered Congress impotent continue.

In this republic of 314 million souls, we need to find common ground unless we prefer to reject the Union and reignite a civil war at tremendous cost.

Using the term ‘Obamacare’, as facile as it may be, is divisive and counterproductive to solving the real problems the ACA, however flawed, is designed to ameliorate.

‘Nuff said.

The vast majority of Americans doesn’t want or need "obamacare" with its tax structure and death panels. WE The People have been enduring his ilk's tyranny and will do all we can to refuse to follow the bad law as the federal government refuses to follow and enforce immigration law. Then we have weak Sen Lamar worried about helicopter fly overs and ozone.

Obama Care is in itself divisive and counterproductive to solving the real problems. It is so great the people who forced it upon us won't have to live by it themselves. That says enough about anything.
Bad law from Bad people who care only about political power. If obumer keeps his job Freedom and this country are doomed. Maybe we are already.

Number69 writes:

The key is when Bill said either way. The truth is Mitt will be elected in November and before winter is over we will have real health care REFORM in in our country.

Say, do you know of anyone who has give the money they were going to spend on a wedding gift to Obama yet? Just wondering?

EllieMae writes:

in response to Tnbehr08:

Hey Tenncare is anything but perfect..However it was a beginning and definitely needs tweaking. That being said we need a universal health care program for all and with a public open for those that can't afford it. We cannot continue on this road we're currently on. The republicans don't seem to be offering anything tangible. The Dems took the initiative on this one and were successful on getting it thru. So quit wining and accept and support this!

Agree. The Republicans have never offered anything, except for, ironically, this very program that they are now fighting against. So it's blatantly obvious they don't want and never wanted any kind of health care program for the American people.

They vehemently fought Hillary when she tried; they never even brought up the health care issue when Bush was President and now they have fought Obama tooth and nail.

Ten years from now, people will look back and not believe that there was even a fuss over this. The GOP is and always has been on the wrong side of this issue, all the way.

hillbillybulldog writes:

All debating aside...since when did we gain the idea that the governor, any governor, HAD to chose between two options of any issue? Doesn't our wonderful and educated governor know that he can just tell the feds "uh...nah...we are going to let the people of TN create their own health care enterprises through true capitalism because that is the only way to keep tyranny out of our state"? I don't get why so many patriots run their mouths but do nothing. Pretty soon they (the feds) will be charging the mouth runners tax on the C02 emissions from talking too much because the United Nations said so.

Really people...Haslam has GOT to go. He has no interest in you and me. My immediate thought is that he'll use his newly appointed Sharia Finance person, Ali, to implement Sharia Law into the newly designed health care he is so carefully considering. Watch and see...

EllieMae writes:

Dr. Mark, I know the righties tried to initially use the term "Obamacare" derisively, but honestly, I don't have a problem with the phrase, as it truly was Obama who made this possible. Give credit where credit it due.

It is interesting that now that it has passed the scrutiny of the SC, everyone wants to change the name. Seems to me that the righties are realizing that they may have really messed up in their zeal to slam Obama and their ugly attempt to name-call is going to come back and bite them right in the arse. Good!

vernon writes:

Haslam is a nice guy but he ll never take a stand on anything,his ambitions for higher office force him to be "the great settler" of issues.Rocking the boat could hurt him later.
As I understand the ruling though, participation in Osamacare is voluntary by state and if a state refuses they can t be penalized as earlier threatened by Osama.Right?

vernon writes:

Heck if 20 % of the states refuse to participate there s no penalty and without the cost sharing the cost per state for states that do participate goes through the roof and the whole thing implodes.

Number69 writes:

"Obamacare" was coined by MSNBC. Just as global warming became a hated tag, MSNBC and the WH moved Obamacare into afordable health care.
Again, America is really starting to unite in their effort to send Obama and all his care packages back to Chicago, yep it is an exciting time for our nation!

EllieMae writes:

in response to vernon:

Haslam is a nice guy but he ll never take a stand on anything,his ambitions for higher office force him to be "the great settler" of issues.Rocking the boat could hurt him later.
As I understand the ruling though, participation in Osamacare is voluntary by state and if a state refuses they can t be penalized as earlier threatened by Osama.Right?

Osama is dead. He was killed by Navy SEALS under the Obama administration. Geez, can't you guys get anything right? No wonder no one takes you seriously.

cejensen writes:

Obamacare is not nearly as good as Republicare which has as its main feature.....oh, that's right, they don't have a plan, just more-of-the-same which was bankrupting us and leaving 30M-40M Americans without health care except for the emergency room care----the most expensive, least effective form of health care.

Obamacare is not perfect, but it is better than every other plan proposed so far. As good as Obamacare is, its still falls short of the health care of Europe, Japan, Canada and the rest of the industrialized societies.

what_a_joke writes:

Since we now have healthcare similar to europe. Can we now mirror their immigration policies.

bobo02 (Inactive) writes:

in response to Tnbehr08:

Oh quit whining and complaining...No one questions the need for billions of $$ in excessive spending for the military, education, and many other programs. it's way overtime the American people quit griping about the'Affordable Health care Act' and accept it's the law of the land and begin supporting it. or do we want to go back to the old ways of patchwork health care and millions being left out? I definitely think not and millions of others agree!

Exactly, thank you. Time for the childish temper tantrums and overly dramatic exaggerations and outright lies to end.

In one or two years' time we will look back on how health care/health insurance was handled back in these, the bad old days, and shake our heads in shame that it took us this long to do the right thing.

vernon writes:

in response to EllieMae:

Osama is dead. He was killed by Navy SEALS under the Obama administration. Geez, can't you guys get anything right? No wonder no one takes you seriously.

Just a little joke, Ellie,relax

vernon writes:

in response to cejensen:

Obamacare is not nearly as good as Republicare which has as its main feature.....oh, that's right, they don't have a plan, just more-of-the-same which was bankrupting us and leaving 30M-40M Americans without health care except for the emergency room care----the most expensive, least effective form of health care.

Obamacare is not perfect, but it is better than every other plan proposed so far. As good as Obamacare is, its still falls short of the health care of Europe, Japan, Canada and the rest of the industrialized societies.

Of course you know the easiest way to get that great health care in those other countries,do I even need to say it?

Tacamo01 writes:

in response to vernon:

Haslam is a nice guy but he ll never take a stand on anything,his ambitions for higher office force him to be "the great settler" of issues.Rocking the boat could hurt him later.
As I understand the ruling though, participation in Osamacare is voluntary by state and if a state refuses they can t be penalized as earlier threatened by Osama.Right?

Finally someone else that understands Gov Bill's plans for the future and the KNS has the ball rolling in this part of the state.

The states are supposed to submit their plans for the health insurance exchange this fall to the Feds. For those states that are not ready with there plans (about 22) the Feds have already anticipated this and will move forward and run the program until the states are ready.

November is only 4 months away and IMO TN should wait to see who's elected before planning for the future of the HCA.

markomd writes:

in response to EllieMae:

Dr. Mark, I know the righties tried to initially use the term "Obamacare" derisively, but honestly, I don't have a problem with the phrase, as it truly was Obama who made this possible. Give credit where credit it due.

It is interesting that now that it has passed the scrutiny of the SC, everyone wants to change the name. Seems to me that the righties are realizing that they may have really messed up in their zeal to slam Obama and their ugly attempt to name-call is going to come back and bite them right in the arse. Good!

Hi, EllieMae.

Nice to hear from you.

You and I don't always agree but we always manage to have a respectful debate, and I value that exchange.

I agree with you that President Obama is the ACA's symbolic father but the Congress is its symbolic mother and Chief Justice Roberts, as a pro-life jurist/obstetrician, refused to perform a late-term abortion and saved the pre-born baby’s life.

I remain amazed that Chief Justice Roberts submerged his own political leanings and let the Constitution speak.

It was a bravura performance very much in keeping with the SCOTUS’ long tradition of judicial conservatism and may help restore the country’s disenchantment with our highest court.

As absurd as I find certain aspects, the ACA is the Law of the Land and it's not going to disappear merely because some zealots don't like it.

The zealots will raise a loud hue and cry but short of deep-sixing President Obama and the entire Congress they have painted themselves into a corner by trying to play the legal issues both ways.

It may take another full generation to render the ACA palatable to virtually all Americans, but at least Romneycare, I mean Obamacare, is on the books and available for constructive modification.

Respectfully yours,
MGBMD

markomd writes:

in response to AmericanBornTaxpayer:

The vast majority of Americans doesn’t want or need "obamacare" with its tax structure and death panels. WE The People have been enduring his ilk's tyranny and will do all we can to refuse to follow the bad law as the federal government refuses to follow and enforce immigration law. Then we have weak Sen Lamar worried about helicopter fly overs and ozone.

Obama Care is in itself divisive and counterproductive to solving the real problems. It is so great the people who forced it upon us won't have to live by it themselves. That says enough about anything.
Bad law from Bad people who care only about political power. If obumer keeps his job Freedom and this country are doomed. Maybe we are already.

Overheated and overstated.

OldRedneck writes:

First, let's deal with some of the kooky hysteria.

Canadians do not flock to the US for surgery. During the health care debate, the medical insurance industry trotted out ONE Canadian woman who claimed she was dying of brain cancer and had to come to the US for life-saving surgery. LIE. In fact, she had a minor pituitary gland cyst that was not life-threatening and was not a medical emergency.

The claim that no one has read the ACA is more rightwing nonsense that comes from the ravings of Rush Limbo and the airheads on Fox.

Now -- let's get serious.

-- 80 percent of Americans have health insurance through their employers. They will be little affected by the ACA.

-- 15 percent of Americans are self-insured. They will be helped significantly by the ACA because the health care exchanges will result in competition and lower premiums.

-- The five percent of Americans without coverage either will be forced to join the exchanges or they will be hit with a freeloader penalty.

The ACA provision that requires health insurance companies to spend no more than 20 percent of their revenue on administrative costs will help control premium growth.

As pointed out in this editorial, several provisions are VERY popular and were needed.

Finally, the ACA is the first step toward a national health insurance program -- basically, Medicare for all -- which is what we should have done in 1973 when Richard Nixon proposed it.

cejensen writes:

vernon writes:
in response to cejensen:

Obamacare is not nearly as good as Republicare which has as its main feature.....oh, that's right, they don't have a plan, just more-of-the-same which was bankrupting us and leaving 30M-40M Americans without health care except for the emergency room care----the most expensive, least effective form of health care.

Obamacare is not perfect, but it is better than every other plan proposed so far. As good as Obamacare is, its still falls short of the health care of Europe, Japan, Canada and the rest of the industrialized societies.

Of course you know the easiest way to get that great health care in those other countries,do I even need to say it?
............................
The easiest way to get great health care for everyone is to....imitate. Imitate the plans that work, which is single payer, government healthcare, call it socialized if you like, but it works, and that's what counts.

soulbrother writes:

It's not the ACA that's flawed...It's the ignorant, inbred Tennessee hillbillies that are not known for their brilliance....

I heard Governor Haslam had to buy 25 CAT bulldozers in order to dole out all the oxycontin....

vernon writes:

in response to Tacamo01:

Finally someone else that understands Gov Bill's plans for the future and the KNS has the ball rolling in this part of the state.

The states are supposed to submit their plans for the health insurance exchange this fall to the Feds. For those states that are not ready with there plans (about 22) the Feds have already anticipated this and will move forward and run the program until the states are ready.

November is only 4 months away and IMO TN should wait to see who's elected before planning for the future of the HCA.

So is the plan voluntary for each state?

soulbrother writes:

in response to cejensen:

vernon writes:
in response to cejensen:

Obamacare is not nearly as good as Republicare which has as its main feature.....oh, that's right, they don't have a plan, just more-of-the-same which was bankrupting us and leaving 30M-40M Americans without health care except for the emergency room care----the most expensive, least effective form of health care.

Obamacare is not perfect, but it is better than every other plan proposed so far. As good as Obamacare is, its still falls short of the health care of Europe, Japan, Canada and the rest of the industrialized societies.

Of course you know the easiest way to get that great health care in those other countries,do I even need to say it?
............................
The easiest way to get great health care for everyone is to....imitate. Imitate the plans that work, which is single payer, government healthcare, call it socialized if you like, but it works, and that's what counts.

I agree the evidence suggests that socialized care works best...but as Americans we don't imitate...WE INNOVATE...Socialized care is the best, but it's not perfect either...

1BigJim writes:

in response to tn_conservative_guy:

Haslam continues to prove himself to be a weak governor. He has a chance to stand up for conservative values along with more than a dozen other governors and refuse to initiate the worst piece of legislation in American history. Instead, he "goes with the flow" and Tennessee suffers again.

awesome point maybe he should have some b@ll$ and do like Booby Jindal has done in Louisiana and fight back! This is a pure case of the Federal Government imposing on states rights. We need a Governor like him or Jan Brewer that doesn't cower to an overstepping President ,congress and senate!

markomd writes:

in response to jc4usa:

(This comment was removed by the site staff.)

Hi, jc4.

I'm no great fan of President Obama but I do not consider him significantly more or less divisive than any other president in recent memory.

I have worked in state government and for the federal government. You're right. They are both inept.

Fortunately or otherwise, our Founding Fathers set up a tripartite Democratic Republic. It worked quite well for a relatively small, agrarian nation, but not so well for a nation of 314 million people.

The core problem is this: The vast majority of Americans consider our health care delivery "system" inadequate. Large-scale international studies of health care outcomes confirm that the United States is deteriorating in terms of health care outcomes at an alarming rate compared to the rest of the industrialized world.

I am not a cheerleader for the ACA, but no one seems willing to propose better options. Anyone can criticize someone else’s work, but it takes ingenuity and hard work to develop something better.

Complain about the ACA, state government and the Feds as you see fit, but I have signed on to eliminate the dross and shore up the timbers.

Regards,
MGBMD

ThinkTwice22 writes:

in response to OldRedneck:

First, let's deal with some of the kooky hysteria.

Canadians do not flock to the US for surgery. During the health care debate, the medical insurance industry trotted out ONE Canadian woman who claimed she was dying of brain cancer and had to come to the US for life-saving surgery. LIE. In fact, she had a minor pituitary gland cyst that was not life-threatening and was not a medical emergency.

The claim that no one has read the ACA is more rightwing nonsense that comes from the ravings of Rush Limbo and the airheads on Fox.

Now -- let's get serious.

-- 80 percent of Americans have health insurance through their employers. They will be little affected by the ACA.

-- 15 percent of Americans are self-insured. They will be helped significantly by the ACA because the health care exchanges will result in competition and lower premiums.

-- The five percent of Americans without coverage either will be forced to join the exchanges or they will be hit with a freeloader penalty.

The ACA provision that requires health insurance companies to spend no more than 20 percent of their revenue on administrative costs will help control premium growth.

As pointed out in this editorial, several provisions are VERY popular and were needed.

Finally, the ACA is the first step toward a national health insurance program -- basically, Medicare for all -- which is what we should have done in 1973 when Richard Nixon proposed it.

Yea! +100
Somebody's got it right! Thanks for this post.

markomd writes:

in response to OldRedneck:

First, let's deal with some of the kooky hysteria.

Canadians do not flock to the US for surgery. During the health care debate, the medical insurance industry trotted out ONE Canadian woman who claimed she was dying of brain cancer and had to come to the US for life-saving surgery. LIE. In fact, she had a minor pituitary gland cyst that was not life-threatening and was not a medical emergency.

The claim that no one has read the ACA is more rightwing nonsense that comes from the ravings of Rush Limbo and the airheads on Fox.

Now -- let's get serious.

-- 80 percent of Americans have health insurance through their employers. They will be little affected by the ACA.

-- 15 percent of Americans are self-insured. They will be helped significantly by the ACA because the health care exchanges will result in competition and lower premiums.

-- The five percent of Americans without coverage either will be forced to join the exchanges or they will be hit with a freeloader penalty.

The ACA provision that requires health insurance companies to spend no more than 20 percent of their revenue on administrative costs will help control premium growth.

As pointed out in this editorial, several provisions are VERY popular and were needed.

Finally, the ACA is the first step toward a national health insurance program -- basically, Medicare for all -- which is what we should have done in 1973 when Richard Nixon proposed it.

OldRedneck, I like you.

You are obviously mature enough to know up from down and you call it as you see it.

Nixon, nogoodnik that he was, had it right when he proposed Medicare-for-all in 1973.

I remember those years quite well. As corrupt as Nixon was, he surrounded himself with very competent policy people along with his band of felons.

Physicians for a National Health Policy (PNHP) has argued the same case for thirty years.

I signed on recently because I’ve concluded that physicians and public health/public policy mavens understand the issues far better than politicians do.

As a physician, I deal with the FUBAR aspects of American health care all day every day, and it’s a bloody mess.

The ACA in its first iteration is like a sloppy pigsty but I agree with you that it represents a valid first step in the right direction.

My attitude toward those who merely complain and say ‘no’ without contributing anything toward solving our health care delivery problems is to simply take the batteries out of my hearing aids.

Regards,
MGBMD

Tacamo01 writes:

in response to vernon:

So is the plan voluntary for each state?

Just the Medicaid expansion. The states can not be penalized if they refuse to opt in for the expansion, however, the government is paying for the expansion the first 3 years and will be reduced down to 90% funding after.

Question for anyone, why is the President, Congress and their families exempt from the HCA? Page 114, line 22

cejensen writes:

soulbrother writes:
in response to cejensen:

vernon writes:
in response to cejensen:

Obamacare is not nearly as good as Republicare which has as its main feature.....oh, that's right, they don't have a plan, just more-of-the-same which was bankrupting us and leaving 30M-40M Americans without health care except for the emergency room care----the most expensive, least effective form of health care.

Obamacare is not perfect, but it is better than every other plan proposed so far. As good as Obamacare is, its still falls short of the health care of Europe, Japan, Canada and the rest of the industrialized societies.

Of course you know the easiest way to get that great health care in those other countries,do I even need to say it?
............................
The easiest way to get great health care for everyone is to....imitate. Imitate the plans that work, which is single payer, government healthcare, call it socialized if you like, but it works, and that's what counts.

I agree the evidence suggests that socialized care works best...but as Americans we don't imitate...WE INNOVATE...Socialized care is the best, but it's not perfect either...
...............................
I'm in favor of innovation. Let's take the best of the proven health care systems and see if we can add improvements through innovation.

Currently, our problem is the Anti-Innovation crowd refuses to do anything except what we've been doing....and that has been bankrupting us and doesn't work for a large percent of our citizens.

Sadly, it is improper English to use innovation and Conservative in the same sentence.

bretticus25#294810 writes:

in response to markomd:

I once again recommend that KNS abandon using the simplistic and derisive term 'Obamacare' and substitute ACA or Affordable Care Act.

This law came into being via Congress, was signed by President Obama and has been certified as constitutionally sound by the Supreme Court of the United States.

The ACA is now the law of the land and it is not going to vanish despite the fact that most Americans, myself included, find some portions of the law unpalatable and in need of major revision or excision.

As the editors correctly state in this column, the vast majority of Americans accept and favor major portions of the law.

We would be far wiser to encourage our congressional representatives and senators to improve the ACA by eliminating undesirable portions and replacing them with more palatable alternatives.

I, for one, do not wish to see the internecine warfare that has rendered Congress impotent continue.

In this republic of 314 million souls, we need to find common ground unless we prefer to reject the Union and reignite a civil war at tremendous cost.

Using the term ‘Obamacare’, as facile as it may be, is divisive and counterproductive to solving the real problems the ACA, however flawed, is designed to ameliorate.

‘Nuff said.

The reason everyone calls this Obamacare is because there were so many people in this country who didn't want it.

It was hastily put together, and squeaked by in a congress that was quickly voted out. Now, again, it was squeaked by in the SCOTUS, who, unfortunately, can't be replaced.

Telling the majority of people in this country that even though their will was misrepresented by Obama and his contemporaries, and this was nonetheless shoved down their throats, that we need to respect this law by sanitizing it from Obamacare to ACA....

If it is really that great, and the minority view isn't going to financially destroy this country, and if the medical profession will flourish with the best Americans seeking to be doctors...... then Obama should be proud that his law is better known with his name on it.

Even the 2003 invasion of Iraq, clearly a George W Bush idea, should have been called the Bush war. But this health care matter was so unilateral and polarizing, we can't help but forever call it Obamacare. I will refer to it through success, or failure. If it brings rationing, or if it makes medicine thrive with cutting edge treatments that will be given away freely to everyone, it is still Obamacare.

When every last American pays an insurance company their hard earned money just to be well, then is still stuck with the bill when they get sick, as we do now, I'm giving credit to Obama for cutting deals with the insurance companies. We have to thank someone, and thanking a law without names and faces is not realistic.

When I see 3rd and 4th generational welfare families, I think of the social engineers behind it. When I see some of them lucky enough to live past 65 who have smoked and drugged their whole lives, and now get carte blanche access to hospitals, stents, ventilators, surgeries, drugs, multispecialty visits, ICU, home health, physical therapy, rehab, etc, all with a cigarette dangling out at taxpayer expense, I think of Johnson.

When, out of the ashes, a politician returns medical care back to free market, we will put her name on it too.

cejensen writes:

When I see 3rd and 4th generational welfare families, I think of the social engineers behind it. When I see some of them lucky enough to live past 65 who have smoked and drugged their whole lives, and now get carte blanche access to hospitals, stents, ventilators, surgeries, drugs, multispecialty visits, ICU, home health, physical therapy, rehab, etc, all with a cigarette dangling out at taxpayer expense, I think of Johnson.
------------------------------
When you look at the grinding poverty in the slums of South America, India and SE Asia...that we don't have, you should also think of Johnson.

When you think of unparalleled economic and social stability, compared to the revolts, civil war and internal strife that other countries with massive poverty have endured, you should also think of Johnson.

I suspect many of those that think money spent on unemployment, welfare and to mitigate of the worst of our poverty, has been wasted, did not live through the '60s, or have failed to educate themselves on those times.

We did not have most of the social support programs and yes, it was every person for himself, and if you didn't have a job, you had nothing but despair---our cities burned as a result; Watts, Los Angeles, Detroit, et al.

The same crowd that look down on minorities and less successful economic classes, had the same attitude then. They said, "look at those fools, they are burning down their own cities and neighborhoods".

But in fact, they were not burning down their property...because they had none. They did not have anything to protect, so why not burn everything in sight? Welfare, unemployment and the other social programs effectively give them "a piece of the rock", even if the rock looks more like a pebble.

That pebble gives them hope and affords them a meager existence. If we fail to take advantage of that peace and quiet these programs have bought us, and use it to improve education, training and the prospect for those that grow up in a culture of poverty, then shame on us.

Simply setting back, looking down our noses and saying tsk, tsk, tsk, will solve nothing, even though it seems to be the only action proposed by many of those that have no plan of action.

Caneoverthere writes:

in response to markomd:

OldRedneck, I like you.

You are obviously mature enough to know up from down and you call it as you see it.

Nixon, nogoodnik that he was, had it right when he proposed Medicare-for-all in 1973.

I remember those years quite well. As corrupt as Nixon was, he surrounded himself with very competent policy people along with his band of felons.

Physicians for a National Health Policy (PNHP) has argued the same case for thirty years.

I signed on recently because I’ve concluded that physicians and public health/public policy mavens understand the issues far better than politicians do.

As a physician, I deal with the FUBAR aspects of American health care all day every day, and it’s a bloody mess.

The ACA in its first iteration is like a sloppy pigsty but I agree with you that it represents a valid first step in the right direction.

My attitude toward those who merely complain and say ‘no’ without contributing anything toward solving our health care delivery problems is to simply take the batteries out of my hearing aids.

Regards,
MGBMD

I would agree with most of your points and would be interested in your opinion of Romney's ideas on this website for Repeal AND Replace.

I thought the concepts had merit - but I know nothing about general healthcare in the USA other than what I can find that is "somewhat objective".

IMHO Mitt is not going to do much to change ACA.

First - "he likes the concept"; secondly he has the perfect "out" in that he cannot get major changes through the senate.

By March of 2013 we will not be hearing much about Repeal.

Just my opinion - I could be wrong Again!

Sanfu writes:

in response to tn_conservative_guy:

Haslam continues to prove himself to be a weak governor. He has a chance to stand up for conservative values along with more than a dozen other governors and refuse to initiate the worst piece of legislation in American history. Instead, he "goes with the flow" and Tennessee suffers again.

Good point. I'm beginning to think we need to vote Haslam out in 2014. I'd be real surprised if he doesn't have a strong challenger in the GOP primary.

Tacamo01 writes:

in response to Sanfu:

Good point. I'm beginning to think we need to vote Haslam out in 2014. I'd be real surprised if he doesn't have a strong challenger in the GOP primary.

Too much $$ vs the other candidates that "might" consider running. He will be in for another term then will have his eyes on a bigger political future. IMO is why he is so concerned with what happens in Knox with the schools ect. His whole political achievements will be on the table for a national election. Yes, I think that he will run in 2016 or 2020 for president.

ThinkTwice22 writes:

in response to Tacamo01:

Just the Medicaid expansion. The states can not be penalized if they refuse to opt in for the expansion, however, the government is paying for the expansion the first 3 years and will be reduced down to 90% funding after.

Question for anyone, why is the President, Congress and their families exempt from the HCA? Page 114, line 22

That is a lie, check here: www.politifact.com/truth-o-meter/statements/2009/sep/11/chain-email/64000-question-e-mail-says-congress-exempt-health-/

By the way, I just googled "page 114, line 22" and it took me to all those posts that have tried to keep this lie alive.

Lie, untruth, falsehood...

godlesscommie writes:

in response to tnvarmit#526548:

I can tell you stories about Tenncare that would make your head spin. Are you a person who once worked and became disabled? Did you know Tenncare tried several times to dump the disabled from enrollment? Did you know that under Medicaid as long as a disabled person met the fisical guidelines meaning broke they were covered? Did you know that under Tenncare they were turned down but welfare Moms weren't? The very ones Medicaid was for became the ones Tenncare wanted off the roll. Don't tell me I can trust government.

Medicaid was a safety net program set up solely for the disabled worker & survivor children and the very poor elderly. Making it Universal Health Care not only destroyed the program but all accountability that it once had.

Medicaid used to be under direct oversight of the Tennessee Inspector Generals Office. This was done to ensure actual services were provided and abuse was dealt with. Tenncare answered to no one. Who will Obamacare answer too? Obama? LOL.

I've been following health care issues even before Tenncare was ever thought of lets just say way over two decades now. Maybe just maybe I learned a few things and I'm sounding a justifable warning of what is in store for all. Did you ever consider that?

Do you have anything but wild stories to tell. Do you have any statistical evidence of anything that you are saying. The only thing that is clear is that you are a bitter, mean spirited misanthrope. change is coming pal and all your naysaying and lies are not going to make any difference. The system we have is broken, and the changes made in the ACA are going to make things better not worse.

Tacamo01 writes:

in response to ThinkTwice22:

That is a lie, check here: www.politifact.com/truth-o-meter/statements/2009/sep/11/chain-email/64000-question-e-mail-says-congress-exempt-health-/

By the way, I just googled "page 114, line 22" and it took me to all those posts that have tried to keep this lie alive.

Lie, untruth, falsehood...

2009??? Page 114, line 22 of the Kennedy-Dodd "Affordable Health Choices Act" bill (PDF) clearly exempts members of congress and federal employees and their families.

Try reading the bill and not just using Google for your short answers, of course I could be wrong!

Sanfu writes:

in response to Tacamo01:

Too much $$ vs the other candidates that "might" consider running. He will be in for another term then will have his eyes on a bigger political future. IMO is why he is so concerned with what happens in Knox with the schools ect. His whole political achievements will be on the table for a national election. Yes, I think that he will run in 2016 or 2020 for president.

Those are interesting points, but I just don't see Opie Haslam as presidential material and I think he knows that. However, someday he could take Alexander's place. It would be a lifetime job.

tnvarmit#526548 writes:

in response to Damitman:

All these things were done under a republican governor! I remember well how Don Sundquist and state rerublicans tried to destroy what Ned had created. Don't complain about the federal government when this is a state run federal subsadised program!! Everyone wants to lay blame why don't the republicans say what they want to replace it with when they repeal it and don't say vouchers. That's their answer to everything. Schools health care and welfare. Grow up!!!!

WRONG!!!! It was Ned Ray McWherter's administration with the help of VP Gore right after Clinton got in that put Tenncare in and it was in fact some of his cabinet afterward who ended up RUNNING Tenncare HMO's. Check your facts.

Ned Ray Allowed Medicaid to fall just to put in Tenncare. Medicaid at that time was not cooperating with Vendors meaning not paying them on time to create a faux crisis. He created a crisis that didn't exist before. I remember it well.

After that HMO's had a field day blackmailing the state saying unless they got raises they would leave. Corruption was rampant. BTW I bet you don't remember how one Parent Insurer that ran a HMO ran Full Page Scare Mongering ADDS in KNS about Medicaid failing and also told it's providers either you sign on or you are oput of their private insurer network. The dirty little secrets of Tenncare Liberals do not want you to remember.

cejensen writes:

tnvarmit#526548 writes:
in response to Damitman:

All these things were done under a republican governor! I remember well how Don Sundquist and state rerublicans tried to destroy what Ned had created. Don't complain about the federal government when this is a state run federal subsadised program!! Everyone wants to lay blame why don't the republicans say what they want to replace it with when they repeal it and don't say vouchers. That's their answer to everything. Schools health care and welfare. Grow up!!!!

WRONG!!!! It was Ned Ray McWherter's administration with the help of VP Gore right after Clinton got in that put Tenncare in and it was in fact some of his cabinet afterward who ended up RUNNING Tenncare HMO's. Check your facts.

Ned Ray Allowed Medicaid to fall just to put in Tenncare. Medicaid at that time was not cooperating with Vendors meaning not paying them on time to create a faux crisis. He created a crisis that didn't exist before. I remember it well.

After that HMO's had a field day blackmailing the state saying unless they got raises they would leave. Corruption was rampant. BTW I bet you don't remember how one Parent Insurer that ran a HMO ran Full Page Scare Mongering ADDS in KNS about Medicaid failing and also told it's providers either you sign on or you are oput of their private insurer network
--------------------------------
Varmit, Varmit, Vomit, your interpretation of the events is interesting, but not altogether correct.

The edict by the HMO had less to do with medicare, medicaid or anything else, as it did being a power play to coerce hospitals to capitulate to the HMO, who wanted to artificially control pricing and put their competitors out of business. More recently, Covenant Health has made similar moves---it is about suppressing and destroying the competition, and little to do with actual health care or health care programs. Covenant could care less about patient welfare than their market share, which is what its all about in this non-free market that we have in the medical delivery market.

tnvarmit#526548 writes:

in response to Willowwind2:

It is not whining or complaining to question a 2500 plus page document, of which many in congress HAVE NOT READ; this document needs to thoroughly reviewed and studied line by line; would you sign a blank check; I would welcome a better, cheaper health care premium. I pay 35 percent of my income health ins. premiums; barebones coverage (no vacations, no nights out, no going to the movies) while those who are exempt from this program yet support it have the money to travel across the planet, Congress is exempt; Pelosi's district exempt; and twice the premiums have directly gone up for obamacare which does not take effect until 2014; we in Michigan are charged an added 5 percent every month for the medicaid end of it; rural drs. are paying one years salary for an ordered electronic patient charts directly due to Obama care; do some research before you think this is better; and the one liners of those who state we who want a thorough look at this that state we don't care is just a tool to get those who don't research or study this to believe fiction...since when has the govt. done anything w/out huge rip offs; no proper accounting; look at medicare fraud the list goes on...and on..I care always have; but this plan takes effect in 2014; why? how come such a life changing program not gone under the microscope by news sources? why are they not getting to the meat of every sentence; its not a little thing..why is everyone so afraid to explore all of it; reveal it..that speaks volumes to me.

Right and had any Republican did what Nancy did saying "we have to pass it first to find out whats in it" This papers so called Editorial Board would be calling for their removal from office and run a 5 day series on it.

KNS has in fact a huge political bias. It shows when they have to use a person taking a dog in a court house as news of the day. Hurley isn't my Rep but KNS story like many others these days was overkill.

tnvarmit#526548 writes:

in response to cejensen:

tnvarmit#526548 writes:
in response to Damitman:

All these things were done under a republican governor! I remember well how Don Sundquist and state rerublicans tried to destroy what Ned had created. Don't complain about the federal government when this is a state run federal subsadised program!! Everyone wants to lay blame why don't the republicans say what they want to replace it with when they repeal it and don't say vouchers. That's their answer to everything. Schools health care and welfare. Grow up!!!!

WRONG!!!! It was Ned Ray McWherter's administration with the help of VP Gore right after Clinton got in that put Tenncare in and it was in fact some of his cabinet afterward who ended up RUNNING Tenncare HMO's. Check your facts.

Ned Ray Allowed Medicaid to fall just to put in Tenncare. Medicaid at that time was not cooperating with Vendors meaning not paying them on time to create a faux crisis. He created a crisis that didn't exist before. I remember it well.

After that HMO's had a field day blackmailing the state saying unless they got raises they would leave. Corruption was rampant. BTW I bet you don't remember how one Parent Insurer that ran a HMO ran Full Page Scare Mongering ADDS in KNS about Medicaid failing and also told it's providers either you sign on or you are oput of their private insurer network
--------------------------------
Varmit, Varmit, Vomit, your interpretation of the events is interesting, but not altogether correct.

The edict by the HMO had less to do with medicare, medicaid or anything else, as it did being a power play to coerce hospitals to capitulate to the HMO, who wanted to artificially control pricing and put their competitors out of business. More recently, Covenant Health has made similar moves---it is about suppressing and destroying the competition, and little to do with actual health care or health care programs. Covenant could care less about patient welfare than their market share, which is what its all about in this non-free market that we have in the medical delivery market.

Jensen don't play games with me on this issue. KNS archives themself back up all I have said. KNS BOARD can contact me in their messaging system and I'll show them inside their own paper's Archives just who I am.

There was daily full page add ran by an insurer who got the Lions Share of the Tenncare Business that did fear mongering saying Medicid was broke and failing. That same company told doctors either sign on or we drop you. This was to get Tenncare passed CJ.

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