Picking up on a theme that made former Gov. Phil Bredesen a favorite Democrat among national Republicans on the subject of health care reform, Bill Haslam said Tuesday a dose of “economic reality” is needed to keep down the cost of medical services.
Haslam said patients typically don’t think much about costs when they shoulder little or none of the burden of payment. The governor even phrased his diagnosis of what ails Medicaid in the way Bredesen used to. Low-income recipients of care — and for that matter, consumers in general — don’t have “enough economic skin in the game, if you will,” said Haslam.
Haslam delivered his remarks before hundreds of high school girls at the Volunteer Girls State organization at Lipscomb University in Nashville. The annual event involves rising seniors from schools throughout the state who are chosen based on academic and leadership potential. First Lady Crissy Haslam joined her husband in answering questions after he gave a speech.
One of the questions for the governor from a student was about TennCare reform. But Haslam chose to broaden the issue to government-run health care programs in general and the health care system in even broader terms as the nation grapples with rising costs.
“Regardless of what you do next in life, you need to understand all the issues around health care,” Haslam told the students.
Haslam explained that health care costs to the country are going up 8-10 percent each year and that government revenues have either been flat or are going up about 2 percent. He said that’s a problem if health care takes up about one-third of a budget.
“There are some real cost pressures put on you,” he said. “How are you going to afford that?”
Haslam used the difference in ways people seek health care and shop for their groceries to make his point.
“The person who receives health care doesn’t really pay for it, in almost all cases, whether you be a TennCare recipient or whether you are on an insurance plan,” he said. “So you don’t really pay any attention to what something costs.
“You go to the doctor, and they say, ‘Let’s take a CT scan and an MRI, and none of us ever go, ‘Oh, really, how much is that going to cost?’ — because somebody else is paying for it, right? Because there’s not enough economic skin in the game, if you will.”
The way people pay for health care is unique, he said.
“You don’t do that with anything else,” Haslam said. “You don’t go to the grocery, and the butcher says, ‘You know, you look like you need six rib-eyes and two chickens and eight pork chops, and you go, ‘Great, that’s perfect.’ No. You go, ‘Oh, really, how much are those?’
“Obviously, health care decisions are much different than supermarket decisions, but until there is some economic tension invested in the system where people say, ‘Oh, I want to think about that and the costs involved before I do that,’ I think we’re going to have some problems.”
The governor referred to the national health care law passed under President Obama and how Congress is currently debating how to cover the costs of Medicaid and Medicare. He said the costs can’t continue to be covered at their current rate.
“The question is who is going to come up with a solution that will be politically feasible,” he said. “If it were easy, somebody would have already done it, just to be honest with you.”
Haslam, a Republican, recently won unanimous approval from the House and Senate for his $30.8 billion budget, and one of the major factors in winning favor from Democrats was how Haslam restored millions of dollars in cuts that were on the block for TennCare. The state received favorable news on revenues that allowed for the restoration of many items Democrats preferred in the budget process, including health care needs.
A coalition of health care advocates who had opposed the cuts included the Tennessee Health Care Campaign, the Tennessee Justice Center, Tennessee Disability Coalition, National Alliance on Mental Illness-Tennessee, Tennesseans for Fair Taxation and Tennessee Citizen Action.
“I’m going to push for a system that encourages a little bit more economic reality in our health care decisions, so that we can always take care of those most vulnerable,” Haslam said Tuesday.
He also fielded a student’s question about childhood obesity.
“It is a major issue facing us as Tennesseans,” he said. “We rank about third from the bottom in health factors as a state, and child obesity is one of the prime factors of that. As we become more sedentary as a people — and that’s true of children and adults by the way; every study shows that we all sit around a lot more than we used to — it’s impacting our health.”
He said some conditions that result in high health care costs can’t be helped.
“But a lot of our health issues are preventable,” he said, mentioning tobacco use as well as obesity. “What it’s doing is it’s eating up so much more of our state budget we don’t have the money to put into other things we’d like to, like higher education or K-12 education.”
Crissy Haslam noted that Vanderbilt University Medical Center is even addressing pre-school obesity. She said some schools are growing gardens and having “Fresh Fridays” for eating from the garden.
“There are a lot of interesting things getting started, and I think you will see it continue,” she said.