PHOTO: Bill Lee, left, on his Fairview farm, and Karl Dean, right, in his Nashville campaign office./Brooke Wanser
By BROOKE WANSER
In August, Tennesseans saw an unorthodox gubernatorial election in which Republican Bill Lee, a first-time political candidate, and Democrat Karl Dean, a former Nashville mayor, emerged victorious from their party primaries.
In a June poll from NBC News and The Wall Street Journal, 38 percent of voters nationwide revealed healthcare to be their top priority, followed closely by concern for jobs and the economy.
In advance of the November 6 general election, the Home Page reached out to both Dean and Lee about their personal beliefs about health, plans for healthcare policy, and the state’s current outcomes.
Read their takes on various aspects of the healthcare puzzle below.
What will your healthcare policy be? Are there certain programs you want to institute?
He has repeatedly said Medicaid expansion is his top priority. “We simply do not get our fair share of Medicaid dollars, and we’ve lost $4 billion [in federal Medicaid funds],” Dean said, noting the closure of several rural hospitals in the past few months. “It was a political decision, and now we can look back on it. Rural hospitals have certain challenges, but it [their closure] is very much related to lack of Medicaid.”
His top priority is finding a way to lower costs in the midst of inflation in the healthcare market. “I will work to give patients affordable options, create additional flexibility for providers to innovate, and establish real incentives for controlling cost,” Lee wrote. “But most importantly, we have to make patients part of the solution and put a real focus on wellness.”
How would policy differ if there’s a Republican majority in the house, versus a Democratic majority?
Dean said he is hopeful members of the legislature will look at the consequences of failing to expand Medicaid. “Our federal tax dollars are going to other states. We know that we have tens of thousands without insurance, and it [failing to expand Medicaid] has been a total failure,” he said. But, “I don’t think the answer is to throw our hands up and say we can’t get it done.” He believes the majority of Tennesseans support expansion, and noted the recent example of Virginia’s Medicaid expansion earlier this year. An obvious model right now is Virginia [which expanded Medicaid this spring]. “You’ve got to make sure you continue to control costs,” he said. “Ultimately, you’re not going to get a handle on things unless you do that.”
“I look forward to working with the legislature to address the basic concepts I laid out above,” Lee reiterated. “If we want to get to the root of what’s driving up our health care costs in Tennessee, we have to work together on ensuring that we’re going beyond the conversation on health coverage, and begin talking about overall health and wellness as well.”
How do you plan to combat the opioid crisis?
Dean said recent funding provisions in the latest state budget for controlling the effects of the opioid epidemic have been helpful. Indeed, the state’s medical commissioner has noted recent progress, including shutting down unlawful pain management clinics and reducing the number of opioids prescribed in the state.
Of the additional budgeted dollars, “I think that’s a start, but that’s not nearly enough,” Dean said. He noted the important role law enforcement plays in apprehending drug dealers, and the overlapping area of mental health issues that need to be addressed for successful recovery outcomes.
Lee also said that law enforcement would have to play a prominent role in climbing out from under the crisis.
“We also must invest in public information campaigns to help patients and their families understand the risks of prescription and counterfeit drugs that may look safe, but are actually very dangerous,” Lee said.
“Most importantly, we need to not only look at the responses, but we need to address that cause, and many times, that stems from addiction,” he finished. “We need to help those who are addicted with early diagnosis and treatment to ensure we’re helping individuals before it is too late.”
What do you think about the state of TennCare, and what do you think should be done about it?
Dean believes TennCare has been an overall success, “but it’s one of those things, you can never take your eye off it,” he explained.
He also noted the need to utilize more preventative care. “One of the things you don’t get with Medicaid expansion, people who don’t have insurance aren’t getting checkups,” Dean said. Tennessee ranks in the bottom ten states for healthcare, and Dean wants to improve that by expanding access and encouraging healthy behaviors as a preventative measure.
“Every dollar we spend on TennCare is a dollar we can’t spend on schools, roads, or law enforcement, so we have to keep those costs under control,” Lee said.
He explained his desire to utilize new technology to implement system reforms to “help them make healthier decisions, all while giving providers additional flexibility to deliver cost-savings.”
“We shouldn’t advance it [TennCare] by placing more of our state revenues into an unsustainable federal program that puts Washington DC in charge of our budget priorities,” Lee added. “We’ve done that before, and it nearly bankrupted our state.”
A recent study said Tennessee has the worst rates of childhood obesity in the nation. How would you combat this, as governor?
Dean acknowledged that Tennessee is one of the most obese states in country. He noted his initiatives from his time as mayor of Nashville, including the Mayor’s Challenge 5k Walk/Run, the Mayor’s Field Day, and programs like building sidewalks. “It all ties into public education and having access to healthcare there,” he said. “Health needs to be part of the curriculum at school, and students should have access to nurses. You’ve got to make the investment in our schools, you can’t say you’re going to cut school funding and say you’re serious about this. This is literally threatening these kids’ lives.”
Lee believes partnering with nonprofit and faith-based organizations is the solution to fighting childhood obesity. “Where communities traditionally come together is where we can solve these problems best,” he wrote.
He also noted his time chairing the YMCA of Middle Tennessee, which operates one of the largest after-school programs in the state. “They have excelled at educating our young people about healthy lifestyles and healthy eating,” he said. He hopes to take a similar tack and incorporate a scaled model like that statewide.
Responses from Lee were via email, while responses from Dean were conveyed during a phone interview.