The 69th letter: More than a form letter

Dear Governor Haslam:

This is my 69th letter to you.

You recently received a letter from Kathryn Flaherty in Connecticut. That letter is reprinted below. You replied with a form letter that is almost word for word the same canned response to questions about Tenn Care expansion you always give.

She deserved more.


Until tomorrow.

Yours truly,

Larry Drain

Dear Governor Haslam

I am writing to you today to ask (nay, beg) you to please give my friend Larry the courtesy of a meeting. He has written you a letter each day about the situation he and his wife face because of mounting medical bills and Tennessee’s decision not to expand Medicaid.

I am sure your staff has brought to your attention the fact that Larry’s and Linda’s story has now attracted the attention of not only local, but national, media.

I would think that even if it were for no other reason than political optics – although I would sincerely hope that this would not be the sole reason you would have such a meeting – I cannot comprehend why you have not yet met with one of your constituents.

I live in Connecticut. Maybe things are just done differently in Tennessee. I can assure you, if someone here had written to one of our elected officials with the persistence and zeal of my friend Larry, that elected official would have made the time to assure that a meeting took place long before now.

I apologize to my friend for having delayed so long in taking the time to write to you.

Kathleen Flaherty

Dear Kathleen:

Thank you for contacting me regarding Larry and Linda Drain. There is not a more important or more complex issue facing Tennesseans today than healthcare, where costs and entitlement programs are on an unsustainable path and already crowding out other budget priorities. The Affordable Care Act will cost Tennesseans almost $2 billion over the next eight years, even without adding any additional people to the rolls.

Last year, I informed the Legislature that Tennessee will not expand TennCare rolls under the Affordable Care Act, but will instead work to leverage the available federal dollars to pursue real health care reform.
I believe Tennessee can be a model for what true health care reform looks like, so we’ve been working toward a different plan: A Tennessee Plan for Health Reform. The “Tennessee Plan” would take on the critical issue of aligning incentives among users, payers and providers of health care. Specifically, the plan would leverage available federal dollars to purchase private health insurance for Tennesseans up to 138 percent of the federal poverty level who don’t have access to health insurance, which would translate to 175,000 more insured Tennesseans. The plan would reform the payment structure for providers so they are compensated for health outcomes, not just services performed.

To succeed, we need cooperation and assurances from the Department of Health and Human Services. So far, we have not been able to get those assurances.

I’ve visited every county in Tennessee, and all along the way I’ve met people who don’t have healthcare coverage and whose families are in incredibly difficult positions. I will continue to pursue a vision for a healthier Tennessee with access to health care, but at a lower cost for our state and our country. It is my hope that we can provide quality health care for more Tennesseans while transforming the relationship among health care users, providers, and payers.

If Tennessee can do that, we all win. I will continue to work on this plan, and appreciate your support as we continue to seek the necessary flexibility from Health and Human Services.

Warmest regards,

Bill Haslam

The 68th letter: Freedom

Dear Governor Haslam:

This is my 68th letter to you.

We talk a lot in this country about freedom. I have you heard you talk about freedom.

Freedom from insurance is not freedom. The only people I have heard defend that freedom dont have it. No one gives up their insurance as a blow for freedom.

No one should worry about the catastrophe of ordinary illness. It doesnt have to be.

Extend Tenn Care. Strike a blow for real freedom.

Until tomorrow.

Yours truly,

Larry Drain

The 67th letter: poverty

Dear Governor Haslam:

This is my 67th letter to you.

Its about poverty.  What you believe about health care is intricately tied to what you believe about poverty.  And Tennessee has a lot of poor people so what you believe about poverty says a lot what you believe about Tennesseans.

There are people who believe that poor people are basically lazy and lazy people should not have access to health care.  The idea that health is earned by work seems barbaric in a state in which 60% of people with mental illness are unemployed, in which blacks and other minorities are disproportionately unemployed, and in which getting sick without insurance keeps you from having a job.  It is barbaric to be okay with shorter and sicker lives for poor people because you think they are  lazy.

By not speaking up and by telling people that believe stuff like this their ideas deserve serious consideration you are part of the problem Governor.

Governor a lot of poor people voted for you.  They are ready for you to be their governor too.

Expand Tenn Care.  It is way past time.

Until tomorrow,

Yours truly,

Larry Drain

The 64th letter: community

Dear Governor Haslam:

This is my 64th letter to you.  I have missed a couple of days and apologize.  As sometimes happens life got in the way.

Maybe you dont see it.  Maybe you dont know but your decisions (or lack of decisions) about Tenn Care expansion have hurt Tennessee.  It affects our sense of community.  Anytime one group of people must suffer as a matter of policy, anytime your gain is my pain we both become less. When rich people must be protected from poor people by governmental edict we are, in the end, all poor.

You make Tennessee us vs. them. When will Tennessee be about us?

Expand Tenn Care.

Until tomorrow.

Yours truly,

Larry Drain

The 63rd letter: And the trouble you are in

Dear Governor Haslam:

This is my 63rd letter to you.

You are in trouble. I think you know that. You have to come up with an answer to over 160000 Tennesseans on Tenn Care. More and more it is becoming obvious that they will not go away and that the growing suffering in Tennessee goes past party lines. The recent appeals court decision if it goes to the Supreme Court and is upheld would put thousands of other Tennesseans out of insurance. You are the one who made the decision not to have a state exchange. Now today comes news of a major law suit being filed. Your administration has been caught with their pants down.

Perhaps it has changed just a little. At one time I think the main question was rather or not you could avoid making the Tea Party mad. If things keep going the way they are going and you do nothing to get on the top of the situation you will soon have to find out how much the Tea Party can protect you.

Governor when I first started writing you I think the whole question of health care reform was basically dead in Tennessee. It is now alive and very alive. You have to act. Thinking it over or trying and blaming the federal government for why it doesnt work out is more and more just an empty gesture. You are driving the boat and we are hitting the icebergs. It is on you. The particulars of the law suit make that very obvious. The ball has dropped so many times it thinks it belongs on the floor.

I will give you a piece of unsolicited advice. The one common element in all this choices is Darrin Gordon. His antagonistic response to the federal government letter probably triggered the law suit. With him at the helm no one is really going to believe that Tenn Care will ever work honestly and openly with anyone. You might consider other options, particularly if you want to work out of the current impasse.

Governor if it seems to you like things are getting worse they are. You are on a very dangerous road. Turn. A lot of folks are wondering what it would be like if they were as important as all the Darrin Gordons and Tea Party folks and all the other people who now have your ear. People want to be for you. But you must first be for them.

Act now.

Until tomorrow.

Yours truly,

Larry Drain

Tennessean: ‘Dysfunction’ rules TennCare, lawsuit says

From Tennessean

‘Dysfunction’ rules TennCare, lawsuit says

Babies who went without medical coverage, a mother of three with high blood pressure and a woman with kidney failure are among the plaintiffs in a federal lawsuit filed today contending that TennCare illegally denied them Medicaid benefits. Three nonprofit legal firms — the Southern Poverty Law Center, the Tennessee Justice Center and the National Health Law Program — are representing the plaintiffs. TennCare has also come under fire from the federal director of Medicaid programs, who this month sent a letter putting the agency on notice that it had failed to abide by its legal obligations. The suit comes after TennCare Director Darin Gordon sent a defiant response to that letter, blaming many of the state’s problems on the federal website

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