Les Jones

I don't think this is critical... but one quarter of "Tennesseans" isn't necessarily the same as one quarter of "workers on Tenncare."

You're probably right. Some of the people on TennCare are on Medicaid, which means they're probably not working.

Concluding "Tenncare is simply too large" is like looking at the evidence of global warming and concluding the Sun is too hot. With that remark Krumm shows that he hasn't even grasped the basics. Les, your claim that some people on TennCare are on Medicaid shows that you suffer the same affliction as Krumm.

"Les, your claim that some people on TennCare are on Medicaid shows that you suffer the same affliction as Krumm."

What affliction is that - being able to Google? Link:

"In 1994 the State of Tennessee implemented a new health care reform plan called TennCare. TennCare extended coverage to the Medicaid population and coverage to individuals who were determined to be uninsured or uninsurable, using a system of Managed Care Organizations (MCO)."

"Concluding "Tenncare is simply too large" is like looking at the evidence of global warming and concluding the Sun is too hot."

A safety net that 1/4th of the population can climb on is too big, IMO.

TennCare replaced Medicaid. If you are eligible for Medicaid and you live in Tennessee, you are covered by TennCare. It's an important point that a lot of TennCare critics miss because they haven't bothered to understand the basics. If you do away with TennCare, you just throw Tennessee back into the federal program, which is more expensive and inefficient.

The size of the safety net is not the problem. The problem is the number of people who need a safety net. Talking about the size of the net just means your avoiding the real problem.

I think we're splitting semantic hairs here. TennCare is administering Medicaid to people in Tennessee, but those people are on Medicaid. If TennCare were to go away that fraction of TennCare enrollees would still receive Medicaid benefits.

I'll probably regret asking this, but what do you think is the real problem?

that fraction of TennCare enrollees would still receive Medicaid benefits

Yes, and Tennessee would send a check to the federal government that's even larger than the cost of administering TennCare.

People on TennCare are not on Medicaid. Tennessee applied for and received a waiver from the feds exempting it from participation in Medicaid when it created the TennCare system.

what do you think is the real problem?

Millions of Americans have no health insurance. Most personal bankruptcies result from medical misfortune. The traditional employer-based health care system is flagrantly broken.

"Millions of Americans have no health insurance."

Because healthcare is expensive. Having the government pay for it doesn't make it less expensive. It would just shift the burden to the taxpayers. Worse, when the government pays for something, it tends to get more expensive. Healthcare costs and education costs are going up faster than the rate of inflation because the got. subsidizes them IMO.

"Most personal bankruptcies result from medical misfortune."

That's not true. Among other things, that study included g@mbling and drug addiction as "medical problems."

Don't forget road-building costs, war-fighting costs, nation-building costs, energy costs and the rest of the delicious menu of pork being doled out by one of the most irresponsible Congresses and executives ever to shift burdens to American taxpayers.

I don't disagree with your statement as far as it goes. I do think statements like "the safety net is too big" are misleading and wrong-headed. The size of the safety net is determined by the problem it tries to solve. Criticizing the safety net for being big is pointless unless it is bigger than the problem. It's not.

TennCare critics like Krumm are to health care problems what 6-year-old boys who think girls are gross are to marital problems. "Government spending is gross" is immature politics.