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Friday, May 27, 2005

SS Tenncare

Governor Bredesen is a successful businessman with much touted experience in healthcare and HMOs. But it must be noted, that he made money in healthcare by removing high-risk people from their health plans. He has brought this same management style and strategy to TennCare.I'm going to use an analogy I'll call, the SS TennCare:

Pre-TennCare, there were a large number of folks who had their own insurance program of some sort or another. It was like a good, little boat floating along and riding the waves in the ocean. All of a sudden, along comes the luxury cruise ship the SS TennCare. Everyone abandons their private ships and climbs aboard the big new cruiser. It cruised along ok for a while, but with neglect it began to sprink leaks, take on water, and start to sink. The only problem is that by this time, the cruiser has let all the private boats float away-none are even on the horizon.

The captain says he doesn't want to plug the holes and bailing out the water takes too long-he's got to keep it sailing. His solution? Lighten the load by throwing passengers overboard.

Well, the Governor, (oops, I mean the captain) is throwing people off as fast as he can and hoping there is no mutiny. The passengers he has thrown overboard are starting to scream and swallow water when what do you know? A shipment of “surplus” lumber arrives from shore. The captain orders a small boat built---it won't be big enough to hold everyone he's thrown overboard---just the ones that are screaming and flailing the loudest and strongest.

The small boat is slapped together and the crew is invited on deck at the last minute to help him heave it into the water (in a year). Now everyone is hoping the new boat floats because the captain doesn't want to hear the screaming anymore. The new crew has their fingers and toes crossed in hopes that boards don't start flying off. They know the new boat isn't big enough or sturdy enough. They look around and see people in the water grabbing sticks and toothpicks-anything they can to keep them afloat.

One lowly ensign finally speaks up. “This won't do. Call back the other boats. They have made the easy money chartering around the rich passengers for too long. It is time to carry some of the poor passengers again if they want to sail in these waters.”

The ensign addresses the captain: “We need to fix the holes in the SS TennCare-we need to start bailing and plugging. You're throwing together makeshift boats, but you promised to fix this boat first.Use the lumber to fix this boat now or help the people in the water now before they all dround while we fix up a good boat”

To be continued...
Sequel release date: undetermined time in the future.


  1. You forgot the opening line.

    "In a Galaxy, Far Far Away"

    Folks Hilliary care, oopsie I meant TennCare, is out of control.

    This is the same thing Hilliary was wanting to do to the nation.

  2. How can the banking infrastructure be utilized to help deliver healthcare? Attend the Medical Banking Leadership Forum in Nashville, TN
    July 8, 2005

    Join an exceptional learning experience - facilitated by the Vanderbilt Center for Better Health - with leading HSA executives. We will map emerging areas of integration between banks and healthcare and hear case studies of how bank IT is supporting our emerging "medical internet". Hear a timely update from the Commission on Systemic Interoperability and news about the Charitable Communities Network initiative. Agenda

  3. Ed,
    The integration of banks and healthcare seems suspicious. Like it would lead to banks helping people afford more expensive health care, for the benefit of the HC industry and banks alike, instead of demanding more reasonably priced healthcare. Consumer driven HC is the point of HSA's, right? I am sure there are amplitive aspects of what they are doing as well, which I don't mean to discount, I am just making general point about their relationship.


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