Retired doctor speaks about TennCare issue at Democratic Club Meeting
By J.J. KINDRED
Staff Writer
SEVIERVILLE
- Dr. Joe Gulyash, a retired physician who had a practice in
California, says screening facilities around the state would help treat
more indigent people and likely attract more doctors and nurses to
assist Tennessee's TennCare program.
Gulyash,
89, told Sevier County Democratic Club members he has discussed
TennCare with State Sen. Raymond Finney, R-Maryville. TennCare is
Tennessee's Medicaid program."Being a doctor and (Finney) being a doctor,
I had the feeling that we could review a little bit about the
responsibilities as far as health care is concerned," said Gulyash.
Gulyash suggested to Finney the name of the Medicaid program be changed.
"Finney
said no way, because it took years to get it established, and if we
changed it, it would take years and a lot of money to change and get
everything re-established," Gulyash said. "Under the circumstances, he
would like to see it continue."
Gulyash suggested to Finney that
the state could set up screening facilities in counties and cities
throughout the state to be able to recruit physicians and nurse
practitioners.
"They can take care of more ordinary cases that
the average person ought be able to handle," he said. "The important
thing is by having these facilities established - whether private,
public or church-affiliated - I think that would be an asset for making
it possible for people to be seen in those facilities, and in case of
need, be transferred to doctors or dependent care."
Gulyash also recommends an educational program to explain procedures people can use at home.
Democratic
Club member Richard Henighan said when Gulyash met with Finney, the
senator had already called for a special session to deal with ethics
issues and TennCare.
"He was receptive to ideas on how to deal
with problems that the current situation has created for a number of
people," said Henighan. "He did not discuss specifics with [Gulyash] -
I'm not sure what his motivations are. He got many calls from
constituents who were suffering because of losing their TennCare
resources.
"As far as I know, he is one of the main people who
has helped our call for a special session including TennCare," Henighan
said.
©The Mountain Press 2005
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August 12, 2005
Editor:
In your editorial of July 31, you excused the governor's and
legislators' decision to end TennCare coverage for about 320,000
Tennesseans and significantly cut services for another 300,000. You
claimed it was a painful decision forced on the state because there
were no other solutions to the fiscal demands of the program.
However, this is most assuredly not the case. Alternative plans were
introduced into the Legislature this last year which proposed over $600
million in savings without the drastic cuts that have now been
implemented. These proposals are based on several ideas: drug
utilization review, in which inappropriate use of medications is
targeted instead of an across the board medication cut; disease
management, in which behavioral and health system based issues related
to poor outcomes and excessive costs are addressed; control on the
costs of very expensive mental health drugs which under the Tenncare
system were barely managed at all; creative cooperation with other
states or other countries to obtain medications at significantly lower
costs; and cutting the payments being made to the companies that
administer the program which are now made at about 10 times the rate
that similar services cost before TennCare began.
Consider this: Since the sickest 15 percent of TennCare enrollees
account for 75 percent of the costs, one must assume that to save
significant money under the plan being implemented, these are the main
folks to be cut. Otherwise no significant savings. But then these folks
either must die or someone will be paying for their care.
Under TennCare, $2 of every $3 spent was federal; under the new plan,
$3 of $3 will be local, from some Tennessean's pocket. This is a great
solution to a Tennessee fiscal problem.
Being medically uninsured is the sixth leading cause of death for
adults between 25 and 64 years of age. National statistics show that an
uninsured person with chronic disease such as diabetes or lung disease,
has a 25 percent greater risk of death each year than an insured person
with the same disease. A UT Center for Health Services Research study
in 2002 showed that a reduction of 160,000 people from the Tenncare
rolls would be expected to cause 221 extra deaths per year.
The "Sophie's Choice" you justified won't lead to the death of just one
person, as in the book, but rather more than 400 deaths/year.
I trust Tennesseans value human life too much to let such a needless policy stand.
Richard Henighan
Seymour
©The Mountain Press 2005
Sadly many if not most of us have witnessed the terrible story of Tom Delay
and others interfering in what most Americans believe should have been a private
family decision. At what point do we choose to cease medical care at the end of
our lives. Each case is personal and each decision is personal If
you have made that decision you may wish to down load and print out the
Tennessee Living Will. If you do choose to have a
Living Will you will need to make several copies and have them notarized after
signing them in front of witnesses. Give a copy to your physician and let
your family members and attorney know where a copy may be found if you are
incapacitated. At this time a resident of Tennessee does not need an Attorney to obtain a
Living Will . You may wish to seek legal advice and help with the other
documents listed below. Talk with your Doctor. He needs to know your wishes and
may be able to provide you with some of these forms such as well as a DNR ( Do
Not Resuscitate.)
Adults in all States have the right to make decisions about their
health care. They are given the right to accept or reject medical
or surgical treatment after being informed of their options.
Health care decisions can be made by you, or an agent you appoint to
make decisions if you are not capable of making the decision at that
time. Forms used for health care matters vary from State to
State, but generally are one or more of the following: Living
Will, Heath Care Directive, Durable Power of Attorney for Health Care,
health care proxy and others. A Living Will may also be called a
Declaration, Living Will Declaration, Health Care Declaration, Health
Care Directive, Advance Health Care Directive, Health Care Proxy and
others. Sometime you will see the form named Statutory Living
Will or Statutory Health Care Directive. Some States also
provide you with the option of more than one form, such as either a
Living Will or a Health Care Directive.
OUR OPINION ON A CURE FOR TENNCARE
See response to Tenn Care petition.
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