The federal health care law has a lot in common with TennCare, says former U.S. Senate Majority Leader Bill Frist.
“They both began with a benefit package that was very rich and had no effective cost controls or cost accountability in the system,” Frist said during a recent conversation in Washington.
There are elements within the bill he likes, Frist says, but the costs render it unsustainable in its present form.
Frist, a former heart surgeon, was elected to the U.S. Senate in 1994, reelected in 2000, and retired at the end of his second term. He served as majority leader from 2005 until Jan. 3, 2007.
Keeping a frenetic pace since his departure from the Senate, his activities are focused in four main areas: domestic health; global health; global poverty and education; and education. His wide-ranging activities are found at three websites, www.billfrist.com;www.tennesseescore.org; and www.hopethroughhealinghands.org.
With respect to the nation’s new health care law, Frist says that he sees it resulting in what occurred in Tennessee with TennCare: growth in access and unrestrained spending will result in a demand for much higher revenues (taxes), reduced benefits, or both.
“Underlying both Tennessee then and the country now is health care spending growth at 2.5 percent faster than economic growth,” he said. “With benefits and spending growing faster than the economy – and revenues only growing at the size of the economy – it’s inevitable that at some point there has to be increased revenues or cutting benefits compared to the time the laws were passed that created the program.”
Massachusetts’ universal health care program experience is another model Frist cites in his concerns about the new U.S. law.
“In the law’s first three years coverage was expanded in Massachusetts, but costs were not controlled. Now we see costs exploding with Massachusetts having the most expensive health care in America. Waiting times to find a primary care physician have increased 25 percent, to 44 days. Almost 60 percent of Massachusetts primary care physicians are accepting no new patients.”
Frist is “disappointed” that the Democrat Senate majority used the budgetary process of reconciliation to pass the health care bill on a purely partisan majority vote. He said that no other piece of social legislation – including civil rights, Social Security, and the original Medicare and Medicaid bills – was passed with a purely partisan Senate vote.
While discussing health care Frist frequently returns to the other subject dominating his thoughts: education.
A Tennessee-focused project is Tennessee SCORE, the State Collaborative On Reforming Education. He says he’s made education a focus in large measure because of the direct correlation between an individual’s health status and the education level he or she has achieved.
“A study with Robert Wood Johnson foundation to measure infant mortality found that it is worse in Tennessee than in any other state when factoring in the difference between the educated and uneducated,” he said. “Education is the single largest determinant of health care outcomes. It affects how long one lives, and the quality of that person’s life.”
Frist said that even as Tennessee struggled educationally, the business community wasn’t participating as fully as it could or should in finding solutions.
“The governor (Phil Bredesen) had just started his higher standards push. I said that I can pull together, from outside of government, 100 people: philanthropists; educators; charter school advocates; leaders from other states that have been through this; and others.”
Thus, Tennessee SCORE was formed.
“We started convening people and had nine statewide meetings, 86 town meetings and hundreds of interviews,” Frist said. “It contributed to reforming the state’s charter school law and to winning the national competition on education reform called Race to the Top.
“Our grassroots collaborative isn’t a tool of anybody. It’s not a government commission. It doesn’t matter who’s in and who’s not. Our sole focus is building a system that educates children for today’s world. It was originally a year-long project, but it has been so effective we’ve kept it going and will play an important role as our state transitions to the policies of the next governor.”
With that, it was time to end the conversation. His assistant signaled that it was time to move along.
One last question: what does he think is coming in the fall elections?
“I think the House (of Representatives) will switch,” he said, meaning it will become Republican controlled.
With that, he was on his way. Places to go. Things to do. Lots of them.
By: George Korda
George Korda is political analyst for WATE-TV. He hosts “State Your Case” Sunday afternoons from noon to 3 p.m. on FM 100, WNOX and appears on the “Hallerin Hilton Hill” show regularly on WNOX. He is president of Korda Communications, a public relations and communications consulting firm.