Ayn Rand, meet Knox County Commission

Sandra ClarkGossip and Lies

Let’s be clear. Philosopher Ayn Rand would not favor a government-sponsored program to help indigent people obtain medical care. No way, no how. But she might have run screaming from Thursday’s meeting of Knox County Commission.


Because the writer of “Atlas Shrugged” and “The Fountainhead,” who defined terms like “moochers” and “looters” and valued logic, would have been stunned to hear the debate on Brad Anders’ motion to restore some $1.3 million cut by Mayor Glenn Jacobs from current-year funding for indigent medical care.

Brad Anders

Spoiler alert: The motion failed 3-8, and Jacobs’ budget was adopted as presented.

Jacobs said he had wanted to cut more from the program, which serves some 1,100 people with income of $500/month or less. “The providers were not comfortable with that,” he said, so he cut less and promised he would not offer future cuts.

John Schoonmaker, who chairs the commission’s finance committee, opined that the cut would not affect patient care. “The people still have access to healthcare. Really, this is a financial-assistance program for providers.” He likened it to the negotiations by insurance companies. “It’s not that we’re denying service, we’re just working with our providers to come up with a reasonable cost.”

Dr. Martha Buchanan, director of the county’s health department, said those providers are every hospital in town plus Cherokee Health Systems, which provides outpatient primary care and mental-health services.

“We pay the hospitals 10 percent or less of their rate and pay specialty providers, such as cardiologists, about 15 percent of their rate,” said Buchanan. “The total amount (of funding) is used every year.”

Anders said: “You can’t serve the same amount of people with less dollars.” He said indigent-care funds are used for inmates in the juvenile-justice and jail systems. “The hospitals are doing this for 10 to 15 percent of cost, and you’re wanting to cut that.”

Michele Carringer was torn. Both her husband and her daughter are physicians at UT Medical Center. In a rambling monologue, she wondered if she should vote or recuse. She mentioned the media two or three times, implying those pesky reporters were stirring this up.

“Speaking from my heart,” she said, “I would never be for denying anybody healthcare. … Physicians are making less money every day and are working longer instead of retiring.”

But Carringer sided with Jacobs, saying she trusts him. “He says he met with providers and they were fine with this.”

The motion to restore the cuts got votes from Anders, Evelyn Gill and Hugh Nystrom.

Voting no were Justin Biggs, Larsen Jay, Charles Busler, Richie Beeler, Carson Dailey, Schoonmaker, Carringer and Randy Smith.

Jacobs acknowledged that his cuts will put a strain on providers but said, “Our entire healthcare system is under strain right now. Frankly, because of too much government involvement.”

OK. So, we’ll keep the program, expect the same level of care and cut the funding. Those providers can just tighten their belts. Those doctors can pull an extra shift and the pharmacy can water down the meds.

Someplace in the woods, Ayn Rand is screaming.

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