Lawyers join Bredesen on TennCare front

Knoxville News Sentinel ^ | 1/30/5 | Tom Humphrey

[SmithL]

At first blush, one might not expect lawyers representing the 323,000 adults who stand to lose TennCare coverage under Gov. Phil Bredesen's latest cutback plan to ally with the governor.

But that clearly seems to be the situation after last week's meeting of the Legislature's TennCare Oversight Committee. And that is surely bad news for Gordon Bonnyman and his colleagues at the Tennessee Justice Center in their underdog quest to turn the TennCare tide.

The lawyers are George Barrett, an aging attorney who has been opposing the state in court for one thing or another since the 1960s, and Ted Carey, a somewhat younger man who is also a licensed doctor.

In their first presentation to legislators, who mostly have engaged in hand-wringing over TennCare while trying to avoid taking sides in the finger-pointing between Bredesen and Bonnyman, they basically embraced Bredesen's line.

Further, while saying nice things about him, they tacitly bashed the ethical inclinations of Bonnyman, legendary lawyer for the underprivileged, in the process.

Bonnyman has been saying, in essence, that Bredesen's meat ax approach to cost-cutting is unnecessary; that the fault lies in TennCare structural problems and the failure to pursue alternative cost-saving measures - catching people who abuse their prescription drug privileges, for example.

Such steps, plus a push to have the federal government send Tennessee a "bridge grant" to temporarily stave off financial disaster until long-term cost-saving kicks in, would avoid the inevitable human tragedy - including death - of cutting people from the rolls, he says. In other words, it's the governor's fault.

Bredesen says, in essence, that this is a lot of bunk. Given the fiscal realities and the legal constraints imposed under court orders blamed on Bonnyman, the governor contends there is no real option but to cut 323,000 adults - Barrett and Carey's clients, remember - off the TennCare rolls.

There is no chance of a federal fairy slipping a bundle of money under the TennCare pillow, the administration contends, as the Bush administration looks for ways to cut federal spending on health care rather than increase it.

In other words, it's Bonnyman's fault.

Incidentally, Bredesen and Bonnyman do point the finger in the same direction when giving the historical background of TennCare problems - squarely at former Gov. Don Sundquist. Bonnyman, who is more blunt, says the "weak governor and his political problems" allowed the federal folks to take Tennessee to the cleaners in 2001 negotiations.

Barrett and Carey also pointed a finger at the former governor. But in the current controversy, they sided with Bredesen.

There is no way to bring TennCare spending under control and avoid cutbacks to their clients, they said, without getting relief from the consent decrees. If that happens, enough money would be freed up - Carey estimated $300 million, maybe more - would be available to provide at least some coverage to all or portions of the 323,000 that now will be axed.

When Bredesen-Bonnyman negotiations over the consent decrees broke down, the governor blamed Bonnyman's refusal to promise there would be no more lawsuits. He said that it would be unethical for an attorney to make such a commitment that would involve giving up his client's constitutional rights.

Not so, said Carey, contending that lawyers regularly waive client rights in the course of cutting a legal deal.

Carey also questioned Bonnyman's stance on one aspect of Bredesen's plans to control prescription drug costs. Without getting into the complex details, suffice to say that the upshot was a suggestion that Bonnyman - who says he endorses the idea in concept but faults Bredesen for not providing details - is stalling for time and maneuvering.

And so on.

The bottom line was buying into Bredesen's premise that the present plan of pain, followed by an effort to beat Bonnyman in court, is the best way to give some of the disenrolled adults a piece of the TennCare pie - albeit what Carey called "a shallow pie" - in the longer term.

That premise will be built into the state budget Bredesen presents Monday night. And, after appropriate legislative hand-wringing - and patching a few holes in the safety net - a bow to Bredesen now seems inevitable.

[SmithL]

TennCare is HillaryCare gone amok.