Tuesday, August 20, 2002

Guess the Reporter's Sympathies

The banner headline of today's Commercial Appeal makes it clear: TennCare's crash diet puts enrollees at risk; Advocates fear for 300,000 in leaner, meaner agency. Good ol' Paula Wade is back and tilting away.

The story purports to "report" on the changes coming to TennCare with redetermination and the splitting of the program on January 1. But from paragraph one, it's clear this isn't just reporting.
TennCare advocates fear that as many as 300,000
non-Medicaid TennCare enrollees may lose their health coverage
in a bureaucratic maze under TennCare's restructuring.
The story isn't neutral, but begins from the advocates' point of view. Ostensibly reporting from the advocates' side, Wade then uses the story to push a pro-TennCare, almost pro-socialism, agenda. There's no effort at balance, nor even an admission of another point of view. Let's keep reading.

TennCare enrollment has climbed to about 1.4 million, and the
restructuring was ordered in response to political and budget
pressures. Lawmakers were determined to scale back the
program and answer claims that TennCare rolls were bloated
with people who didn't belong there.
Missing from this paragraph:

* TennCare's 1.4 million is one-quarter of Tennessee's population. That's a load that the originators of TennCare never intended. After TC was initiated, many companies dropped insurance plans specifically expecting TC to pick them up, saving these companies money. At your expense.

* "[I]n response to political and budget pressures..." makes it sound as though this wasn't a problem in need of addressing, but a change motivated by lesser, more evil, desires.

* "Lawmakers were determined to scale back the program...." The alternative was a huge tax increase, on top of an already huge increase needed just to meet previous spending. This year, that was a no-sale and not lawmakers' fault (except that their extravagant promises and commitments led us here). Given that, scaling back was the only other choice. Also, the program, by nearly universal agreement, has grown far larger than planned.

* "[C]laims that TennCare rolls were bloated with people who didn't belong there...." This isn't a claim, but a documented fact. This is a bit of disingenuous wording, par for Wade's course.

Throughout the story, Wade puts the new process, called redetermination, in quotes. In the newspaper trade they're called "scare quotes," meaning that by setting off a word or phrase you create in the reader a sense that something's wrong or off about the term. But then the whole story is laden with scare:
TennCare advocates fear the state's daunting "redetermination"
process is so difficult, regimented, and deadline-driven that many
qualified TennCare patients - especially those who are medically
fragile, mentally disabled or marginally functional - will not be able
to make the appointment, find all the required documents or
understand the forms.

"The state's most fragile individuals are being told to run a
gauntlet, and if they can come out the other side, fine. If not, too
bad," said TennCare advocate Gordon Bonnyman, who on Friday
asked a federal judge to enjoin the state from cutting off
TennCare coverage.
See? The change is inflexible and inhuman; it will hurt the very people it should be protecting. Note that Bonnyman is uncritically quoted in the article, and favorably referred to by another person quoted. But many believe that needed changes to TC have been blocked, and Bonnyman has added expensive and unwanted features to TC. But then, the whole story doesn't quote anyone critical of its thesis, nor even mention them except derogatorally.

By the way, it's "gantlet." One runs a gantlet, not a guantlet. A guantlet is a glove; a gantlet is a double row of men. Whoever edited this one did a piss-poor job. Witness:
Martins, who became TennCare director July 15, is one of the
creators of TennCare and oversaw the state's original chaotic
conversion from Medicaid to TennCare under then-Gov. Ned
McWher ter in 1994. At the time, he described that startup as
being like building an airplane during takeoff. This time, Martins is
replacing a couple engines in midflight.
Notice that the first image is a quote, from Martins. But the last line is purely the invention of Wade, in a news story no less! That's been a widespread failing of the press for more than a decade, beginning in the Seventies when such writing was the newest vogue, the New Journalism. The press regularly confuses this journalism with reporting, even though they are two very separate things.

Under these rules, no matter what happens in the
redetermination and application process, whether it's a doctor's
fault for not getting the right information to the enrollee, or it's
DHS's fault for not completing the process, or it gets lost in the
mail - no matter what happens, it's the enrollee who's at risk,"
said Tony Garr, director of the Tennessee Health Care Campaign,
an advocacy group for TennCare enrollees.

Already, with relatively few cases in the pipeline, advocates
relate stories of people waiting four hours for appointments, of
lost cases and of DHS workers insisting that a man come in
person for his redetermination even though he was in the
hospital and on a respirator. And on Aug. 6, the system that
tracks appointments for DHS was overwhelmed and

"It doesn't exactly inspire confidence," said Carol West lake,
director of the Tennessee Disability Coalition. "They've been
telling us and telling us they can handle the workload, and after
the first big mailing the system breaks down."
Gee. That sounds like standard-issue government business as usual. We all have stories of dealing with corporations and government offices that treat us this way.

"Because we screamed and because Gordon sued them, they are
trying," said Westlake, who noted that TennCare officials have
adjusted the rules to allow fragile people to mail in documents
and complete interviews by telephone, to require fewer medical
records to prove medical status, to waive the 45-day deadline for
completing the application process for "good cause" and to work
with mental health officials to make sure mentally ill enrollees
don't lose coverage.
In other words, legislators wrote the rules, intending one thing, but the bureaucrats have got their hands on things, with the assistance of lobbyists who will benefit from it, and already started to slacken the intent of the laws. But that's not a bad thing, is it? Not in Wade's world.

It's all just more of the CA's slant. Write hysterical stories of worst-case scenarios. Spread fear and disinformation. Take the really bad situation as your start and then write as though trying to fix things is actually an effort to hurt people.

TennCare was an effort to put Hillary Clinton's health care plans into action--to prove that Eurostyle socialism and national health care works. We've seen the result. Is it any wonder that Clinton has never come down here to praise our efforts? That she's stayed far, far away?

Until next time,
Your Working Boy

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