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Ramsey Prescribes County-Centered Health Plan

Lt. Gov. Ron Ramsey, R-Blountville, proposes using local health departments to meet the needs of TennCare patients in a way that would ease the load on emergency rooms and save taxpayers’ money all at the same time.

Ramsey said the idea is an example of thinking outside the box on how to restructure state government. Under Ramsey’s plan, health departments in the 95 counties would serve as the primary care provider for patients who are often prone to use emergency rooms as their point of primary care, which is enormously expensive, he said.

“I’ve been trying to examine what I’m going to do as the next governor to really restructure state government, because that’s going to happen,” Ramsey said. “One of the biggest expenses is our TennCare Medicaid program, and one of the biggest expenses there is that those who are on TennCare use our emergency rooms as our primary provider.”

Ramsey said his plan would use medical schools in each of its three grand divisions, the University of Tennessee Health Science Center in Memphis, Meharry Medical College in Nashville and the East Tennessee State University James H. Quillen College of Medicine in Johnson City. Ramsey would have the medical schools’ students staff the health departments.

“I think this could really work and not only provide better care for people instead of ending up in emergency rooms but also saving taxpayers’ money,” Ramsey said.

Ramsey said he had talked with several health directors in the state and that he expects some will be helping him with the plan. He said he has also talked to the Tennessee Medical Association about the plan to see if it will work.

“I do think the majority of people think it will work,” he said.

The plan came from a sort of brainstorming session Ramsey had with other state senators one night, he said.

“I can remember when I was a young man, and I got my immunizations and I got my primary care, we went to those county health departments,” Ramsey said. “I’m 55 years old. Yet when TennCare came in in the early 90s, we basically neutered those health departments just to draw that money into the central system, to draw down more federal funds.

“I think it wouldn’t be that hard to go back to that system to where we have those patients across the state using that as primary care. You can imagine the savings that would be.”

The cost of health care continues to be a major headache for the state. The troubles of TennCare are well known, although there seems to be a general feeling that TennCare costs are under far better control now than in years past. That has not erased concerns about people who need coverage, however. And the federal health care reform law, unless adjusted, is expected to have a large impact on states, where complaints of unfunded mandates on expanding coverage have risen.

“If you go into an emergency room in particular, first of all, they’re going to run all kinds of tests just to cover themselves because of lawsuits on hospitals,” Ramsey said. “Those on a primary system, through that screening system, if it’s only the sniffles or a headache or stuffy nose, they could treat it there. But if it’s something more important, they can send them on to another doctor.”