The 96th letter: The conversation

Dear Governor Haslam:

This is my 96th letter to you.

At the end of most letters I say “start the conversation about expanding Tenn Care…”  There effectively isnt one because you are not talking.


Please start the conversation.

Until tommorrow.

Yours truly,

Larry Drain


Governor Haslam: from Todd Shelton

Dear Governor Haslam,
I appreciated your responding on July 18th, to my letter. It ask you to “fill the gap” in Tennessee health insurance by getting on board with other states accepting “medicaid expansion” throughout the Affordable Care Act.
You made a statement that “The Affordable Care Act will cost Tennesseans almost $2 billion over the next eight years, even without adding any additional people to the rolls.” All of the figures I see have income producing figures for the state. These figures  would have the state spending a 200 million dollars while getting in return over a billion dollars a year in direct payments from the federal government and a huge tax increase from the 5 1/2 % tax on each insurance policy sold through the ACA. This also includes the approx. $50 million dollars a year the state saves due to the ending CoverKids, Access TN and Cover RX. And these figures don’t show the millions that the state got to prepare itself for the ACA and medicaid expansion.
The figures I get from the HCFA Budget FY2014 at, U.S> Census Bureau 2012 Small Area health Insurance Estimates and reform and others show that up through 2019, the state will pay out approx. 200 million dollars while receiving some 6 billion dollars in federal revenue and savings. This doesn’t even figure in the huge job boost and spending boost in the health care industry that occurs as 100 of thousands of Tennesseans get health Insurance who don’t have it now.
What I am asking is that you show us your figures that you are working with. I would be glad to show you mine. Yours have to be public but I can’t find them. Maybe both of our figures are a little off but we should get that worked out, especially if I am closer to correct than you. It would make a lot difference to hundreds if thousands of Tennesseans who don’t have insurance right now.
I look forward to you response,
Todd Shelton

The 95th letter: Abundance

Dear Governor Haslam:

This is my 95th letter to you.

Life , liberty, and the pursuit of happiness.  Sound familiar??

Health care is the door to an abundant life.  You may never realize it until you dont have it, but take it from someone who doesnt have it– it is the door to so many other things.

Open the door to abundance for all Tennesseans.

Start the conversation about Tenn Care expansion.

Until tommorrow.

Yours truly

Larry Drain

Governor Haslam: from Laura Sell

Dear Governor Haslam,

I have never written you before, but for the first time, I am ashamed to be a Tennessean.

I am one of the lucky ones, because I have always had health insurance when I needed it. I am retired, but not yet eligible for Medicare. Luckily, my husband’s company still carries insurance for me. If I was single, I might be without options, despite a successful career. Sadly, the complexity of the Tenncare system keeps most folks from understanding what has been happening. Those who have employer insurance or Medicare or are affluent often have no idea of the suffering which is hidden from their view. Two friends of mine are examples of this:

One friend got kidney cancer and could not work. After surgery and chemo and spending tens of thousands of dollars of savings, he faced bankruptcy. The taxpayers paid Blount Memorial.
Another is a college student who works as a waitress. She will lose her Tenncare at the end of this year, when she turns 21, despite working to better herself.

When I see or hear of people needing health care who are being ignored, my best suggestion is that they consider moving to Kentucky. At least there they can have hope and receive necessary medical treatment before they get sicker.

Tenncare seems like a house of mirrors at Halloween with some 40 different categories which can be almost impossible to navigate. Who gets covered and who does not is very capricious. There is no state computer system to process applications, and there are no individuals at the Department of Human Services to help.

If Tenncare was a structure, it would have a few rooms which are livable-those providing for children and caregiver relatives who can use the Marketplace to apply. Many other rooms would be condemned, due to the many holes in the system which are tricky, not working or require a legal advocate to get through. And lastly, there would be a door leading to nowhere for those who do not have children or breast cancer and don’t earn more than poverty level wages-like Larry and Linda Drain.

If you were living in a house like the one I describe and could get an interest free loan, you probably would take it. With Medicaid expansion, Tennessee can get it completely paid for in 2015 and 2016 and get 90% paid for after that. And we can improve the health of our citizens and our economy. The alternative is to live in the only state in the country with such a dysfunctional system.

Please listen to Larry and Linda Drain and others who need your attention. You can be a hero for Tennesseans. We deserve more than smoke and mirrors.


Laura Sell

A third 94th letter: us

Dear Governor Haslam:

This is my 3rd 94th letter to you.

We are tired and struggling.  Perhaps I am not supposed to say that right now.  I dont know.  People tell us we are heroic and treat us like we are very special.  It is so very nice to be treated kindly by so many  people, but I dont feel very heroic or very special.  We are the most ordinary of people trying so hard to cope with extraordinary circumstances.  And the last 48 hours have been hard.  Just hard.

We dont have your wealth or power or influence.  We dont even begin to have resources like those available to you.  The deck is stacked so much in your favor it is not funny.  And some days it seems…..well it seems so impossible.  I feel like I am with Goliath and I cant find my stones.

Maybe our advantage is we have no choice.  Left to your political strategies and seeming lack of any real commitment to health care reform our life as we know it will be destroyed.  This is not the first bad days.  Nor will it be the last.  But the simple truth is regardless of how hard I cant choose not to.

My goal in these letters has been to be civil to you.  I have wanted to talk as one person to another and somehow screaming and blaming feel like I am making myself a victim and I cant do that.  The truth is I often want to scream and blame.  But I tell myself the real victim, in a very real way, is you.  You have given up integrity for gain and rather or not you know it you are much worse for it.  The real victims are the so many people fighting real and dangerous illnesses and knowing when times comes to get medical help, when their lives are on the line, that no one will be there simply because they cost too much.   They are a fiscal irrelevance in a state that treats their humanity as irrelevant.

I hope tomorrow is better.  But like I said it doesnt matter.  Some hard things are worth doing.  You may destroy our lives as we know them.  Maybe you have the power.  You most certainly can destroy many other lives.  You can mortgage the moral integrity of this state in service of your political ambitions.  But we will never be quiet.

A long time ago a friend told me a central truth….. “WE ARE PEOPLE AND THIS IS WRONG!!!!  WE ARE PEOPLE AND THIS IS WRONG!!!!”

The biggest sin is not to be loud and not be heard but to be silent when someone might.

Until tomorrow. 

Yours  truly

Larry Drain

A second 94th letter: vacation

Dear Governor Haslam:

This is my second 94th letter to you.

It occurs to me you are on vacation.  Between now and the election I wonder if you do not have at least a little bit of a free ride.  I think the votes to extend Tenn Care are close to being there if not already.  But until they are elected moderate republicans answer to you.  They cant afford to have you or the Tea Party come out against them.  But after the election they must answer to the people in their district and even more importantly to their conscience.  And talking to the people who talk to them their conscience is going to give them problems.  Decent people dont like to be a party to the death or destruction of others, particularly when those others only crimes are to be poor and to be sick.  I wonder if you will not begin to have a lot of them begin to ask you about the state of your conscience.

I dont think it will get cold in October and November.  I think it will get hot.  Really, really hot.

Enjoy it while you can.  Vacations dont last forever.

Until tomorrow.

Yours truly,

Larry Drain

Governor Haslam: from Gretchen Kidd

Dear Governor Haslam,

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness – That to secure these rights, governments are instituted among Men, deriving their just powers from the consent of the governed, . . . “ – Declaration of Independence

Unalienable rights…life…

I hear lots of Republicans spouting rhetoric about the “right to life.”  In a sense they are correct.  All men and women should have the right to live. So, I really must question why you and our state legislature are are opposed to the expansion of Medicaid in Tennessee.  Do you honestly not understand that Tennesseans—your neighbors—are DYING because you refuse to expand Medicaid?  Governor, you have the facts available to you.  You don’t even have to bother doing the research because Larry Drain sends you updates every day that prove expanding Medicaid will improve the quality of life for Tennesseans not just medically but financially.

Governor Haslam, I have health insurance. My husband has a good job with excellent benefits. I had a freak accident five years ago when I fell leaving a restaurant in Knoxville.  I spent a solid month in the University of Tennessee Medical Center. I had eleven surgeries that year and needed home nursing services and months of physical therapy.  Had I not had insurance, I am sure we would have lost everything including our home. I am completely disabled now.  I can barely walk or stand.  I had to give up my job as a public school teacher.  One health problem has led to another, and I now take ten medications every day including two types of insulin for diabetes that has become much more severe due to my lack of mobility.

Even considering the pain I face daily and the severity of my other health issues, I am one of the lucky ones.  I can afford my prescriptions. My insurance plan covers my weekly visit to the chiropractor and massage therapist. I can visit my primary care doctor if I have a sinus infection and not worry that the expense will compromise my food budget.

My neighbor next door isn’t so lucky.  He fell into the Haslam Chasm: he did not qualify for TennCare (55 year old childless male), and he made too little as a stockman in a pet store to purchase a plan on the Marketplace. He had a heart attack last spring and needed a stint…actually he needed two.  He only received the first one because he was in imminent danger of dying.  The doctor and hospital told him to come back later for the second one.  Of course he hasn’t been able to do that because he has no insurance.  He has tried to return to work, but he is barely able to do his job due to the fatigue and weakness associated with having a clogged artery to his heart.  His hours have been cut back on his doctor’s orders.  He and his wife, who has very serious COPD, cannot afford their medications or “luxuries” like food and clothing.  Do you honestly believe that it would hurt Tennessee to accept federal dollars to provide health care to my neighbors?  Tennessee is losing revenue because they cannot afford to purchase the necessities of life.  They could both work if they could afford their medications and health treatments. Instead, their health expenses get passed along to those of us who can pay in the form of higher charges from doctors and hospitals.

Now, for just a moment, I would like to speak to you about Larry and Linda Drain.  I imagine you are getting heartily sick of hearing from folks on their behalf.  Tough.  Do something about it.  Larry and Linda deserve a response from you.  I suspect you will send me your form letter full of rhetoric, but please don’t bother.  Use that time and energy to respond to the Drains.  Ignoring him makes you look arrogant and uncaring.  Of course failing to expand Medicaid makes you look foolish and irresponsible, so perhaps you are unconcerned with the perceptions of your constituents.  You need to get concerned about Larry and Linda.  They are a very sympathetic example of why Tennessee needs the expansion.  Your gubernatorial race is all but in the bag, but I suspect you have aspirations for  higher office.  Good luck with that: Tennesseans might not mind you sacrificing the lives of its citizens for political football, but the rest of America will not be impressed by your callousness.

I highly doubt you bother to read your own email, so this message is for the staffer who does. My email doesn’t say anything the governor hasn’t heard a thousand times, but we are tired of being ignored.  A form letter response is cold comfort to those who must choose between prescriptions and food for their families.  Dying should never be one of the options just because you cannot afford medical treatment.  As a staff person, how can you support a governor who wouldn’t support you if you fell into the Medicaid gap?  Please don’t bother sending me a form letter response.  It is insulting.


Gretchen S. Kidd

The 94th letter: Hospitals

Dear Governor Haslam:

This is my 94th letter to you.

I was at a conference this weekend and listened to people talk about the plight of hospitals in their areas.  A bunch of hospitals are in real trouble and it sounded like to me that we can expect in the next couple of months several bad announcements.  The destruction of the health care system in Tennessee is not going to be back page news much longer.

It is time for an announcement from you.  Save the Tennessee Health Care system.  Expand Tenn Care.

It is time to start the conversation for real.  Stop beating around the bush.  It is dying…….And so are your people.

Until tomorrow.

Yours truly,

Larry Drain

The rural ambassadors

The Tennessee Justice Center has started a program they call the “Rural Ambassadors.”  It is a simple idea but one long ago needed.

Health care in Tennessee, due to the lack of Tenn Care expansion is in trouble.  The burden of uncompensated care has fallen on hospitals ill equipped to carry it on their own.  In the process not only has the health of the uninsured affected.  Things are more dangerous for all of us.

Things are bad in Tennessee.  It is lethal in rural Tennessee.  What do you do when you go to the hospital and there isnt one. This past weekend Linda and I went to the first Rural Ambassadors conference.  Not only did we find out that one hospital has closed but that several are anywhere from a month to a couple of months away from possibly closing.  They have run out of time and without change will soon not be there.

I listened to someone talk about what it was like to have someone have a heart attack and help be too far away.  It made me sick.

The point of the Rural Ambassador program is to give voice to the rural poor and uninsured.  It is to give people hit harder and hurt more than most the chance to have a voice.

A long time ago I heard someone say it best.  “We are people and this is wrong….We are people and this is wrong….We are people and this is wrong.”

It was a good weekend for us.  And we hope the start of better weeks and better weekends for Tennessee.  It was a weekend to be heard.  May Tennessee be a place someday that needs no ambassadors.  May we all be heard.

The second 93rd letter: Begging

Dear Governor Haslam:

This is my second 93rd letter to you.

I spent a good part of the afternoon looking at videos on You Tube.  I discovered that Tennessee has a section there.  Kind of a hall of shame.  There is a wide variety of videos that share a common theme and a common story.

A poor person without insurance is sick.  They have tried everything to get help.  Looked everywhere.  And there is no help.  Finally they get on You Tube and on the videos beg the state government of the state they live in not to kill them because they are poor.  Sometimes people speak for themselves.  Parents sometimes speak for their children.  The message everywhere is the same.  Please….Please….Please…..

People die because they cost too much.

We now have a choice.  We have the ability to say no one costs too much.  Without your action more will go on the wall of shame.  There will be more pleases.  People will beg for their lives.  You can beat them to the punch.  Act now.  Open the conversation.

One video especially caught my attention.  Ty Green.  Does he ring a bell with you.  Probably not.  You are very busy.  You ought to take a look at his mother begging for the life of her son.  He’s dead now… No one listened soon enough to make a difference.  He will not be the last Ty Green.


Until tomorrow.

Yours truly,

Larry Drain