BY TIM CHAVEZ
10-16-05

In Heather Bridges' fragility can the moral cruelty and fiscal insanity of the governor's TennCare cuts be seen.
Even advocates for people such as Heather have acknowledged the need to rein in TennCare costs. That's why advocates gave major concessions to Gov. Phil Bredesen in 2003. That's why advocates pushed a retro drug review plan to stop prescription fraud.
TennCare's founder of its pharmacy program said the state could save $500 million a year. But the Bredesen administration earlier this year disputed the figures and delayed in acting, in favor of cutting enrollees and reducing coverage of monthly medicines.
In looking at Heather, like those who gathered last Tuesday for a TennCare town hall meeting in Nashville, the wrongness and depravity in the governor's cuts shock the senses and sicken the soul.
The 29-year-old north Nashville woman is into her ninth year of ALS, or Lou Gehrig's disease. And like 100,000 other Tennesseans whom even the governor has identified as the most needy healthwise and moneywise, her covered monthly prescriptions have been cut to five. That compares with the 12 her doctors say she needs.
Heather has been reduced to playing Russian roulette with her health. She says she has been forced to do without a medicine, for instance, that minimizes congestion and fights off pneumonia. She said she has been hospitalized three times with pneumonia. And now, the choice Bredesen has forced upon her will most likely put Heather in the hospital again. So for a medicine that costs less than $100 a month, the state is willing to instead incur tens of thousands of dollars in hospital bills. TennCare will have to pick up that tab.
Medicines are about maintaining a person's health and keeping him or her out of the hospital. Advocates have been trying to get the governor to adopt soft limits on prescriptions for the most needy TennCare enrollees. For instance, Heather wouldn't have to risk pneumonia if she received six or seven covered meds monthly instead of five.
Heather lives on an $800 a month disability check, and of course, her parents are trying to help her financially, but the uncovered monthly medicines just add another burden. She is paralyzed. She is on a ventilator at night. And she gets around with a motorized wheelchair.
Bredesen promised to enact soft limits for the most needy enrollees if he got what he wanted from the federal court on TennCare this past summer. And he won his concessions. But for some reason, he then turned his back on the 100,000 people like Heather across Tennessee.
Heather graduated in 1994 with high grades from Hillwood High School in Nashville. Then ALS struck.
Yet the three state senators who represent nearly all of Nashville still have not done the one thing that could help Heather the most: endorse a special legislative session on TennCare. Thirty-five state lawmakers have done just that so far.

Please contact these three Nashville state senators, and ask them why they won't help Heather and 100,000 most needy Tennesseans with a special session.

• Sen. Thelma Harper, 615-741-2453, sen.thelma.harper@legislature.state.tn.us

• Sen. Joe Haynes, 615-741-6679, fax 615-741-2533,
sen.joe.haynes @legislature.state. tn.us

• Sen. Douglas Henry, 615-741-3291, fax 615-741-2380,
sen.doug.henry@legislature.state. tn.us

Say a prayer for Heather and her parents that the cruelty of ALS at such a young age will not be surpassed by the cruelty of a governor's policy that makes no moral or fiscal sense.

And pray for yourselves that you will have the courage to speak up and tell your lawmakers to support a special session for 100,000 of the most needy Tennesseans.

Yet another TennCare patient has 'let go'

By TIM CHAVEZ
11-6-05

How many more premature deaths are morally and politically acceptable in Tennessee under the governor's TennCare cuts?
That question will loom larger as we enter winter and the season of light. More sick Tennesseans are going to die prematurely from the stress of a nonsensical and unfair TennCare appeals process and their own chronic health conditions.
Last July, I wrote about Judy Ritchie of Hixson, Tenn. Her family, particularly her sisters, were working frantically to lobby lawmakers and the governor to get her reinstated on TennCare. She had a life-threatening condition undermining her blood's ability to clot. A $10,000-a-month shot covered by TennCare literally kept her from bleeding to death.
Last week, Judy Ritchie, 63, died.
Her sister, Lorene Jones of Florida, said it was only after she found permanent care for her husband with Alzheimer's in the home of one of his daughters that "she finally let go." She would not hear of a nursing home, Jones said. She felt he would die there and in the end, he thought she had given up on him, Jones said. No, she had given up on herself in a state that brags about all its churches and living faith openly. For her, it was time to die.
As with many people with chronic health conditions, it is not just one malady that must be managed. Ritchie also was a diabetic, and she had a severe acid reflux problem. It was that problem that ultimately showed itself to be pancreatic cancer, and it had spread to her liver.
America's health-care system is coming apart at the seams. The problem has just hit the most vulnerable first. People such as Judy Ritchie have been caught in that netherworld, working all their lives until a medical condition forces them from self-sufficiency. Still, they are too young to qualify for Medicare.
And just as Tennessee has cracked down on TennCare, Washington has cracked down on handsome Social Security disability benefits. It can take two years just to be heard for these benefits, and even then, you may need an attorney for the most difficult step of legal proof.
While her TennCare case was under appeal, Ritchie was still able to see a doctor, but she always was worried about the mounting costs to the household that she might never be able to repay. Each visit, she was told that TennCare would come after her for any bills she had piled up during appeals if her case was turned down, Jones said.
This cruel Catch 22 also applies to the subject of my column last Sunday, ALS patient Heather Bridges. I wrote about the efforts of safety net director Jim Shulman to help Bridges with needed meds to keep her out of the hospital. In e-mail correspondence Shulman did tell Heather that she could get all her meds while her case was on appeal. But he did not stress that the added cost would be hers to bear if her appeal was denied, and it has been since last Sunday.
It takes a lot of courage for a family to speak out about the premature death of their loved one, but now I know three such families in connection with TennCare cuts in Tennessee. And the calls keep coming in about reports of more deaths. I promise to give these families the chance to be heard, too.
Right before her sister's death, Lorene Jones wrote the governor: "So Gov. Bredesen, you may well say that she was going to die anyway, even with TennCare. But I will have a hard time praying for your soul for the stress you put her through in this summer 2005. I just want you all to know Judy won't be needing TennCare anymore."
So how many more premature deaths are acceptable under TennCare cuts in Tennessee, particularly as we enter the season of light and charity and good will to all?

Ten?

Twenty?

Thirty?

Fifty?

Tennesseans must provide an answer.