To the Editor.
—The excellent analysis of the TennCare program by Dr Mirvis and colleagues1 finally provides a benchmark for further debate regarding health care reform in our country. It also allows us to draw some tentative conclusions about the initial attempts at reform that have been implemented by various states.2 Their report has understandably caused concern among some of us in Oklahoma. Oklahoma's waivers were approved, and we began our "HCFA managed care demonstration project" on July 1, 1995.Without knowing the details of their deliberations, it is difficult to understand how public policy experts could so miss the mark in their estimates of costs and savings. In my opinion, it cannot simply be explained as trying too much in too short a time frame. Minnesota officials have been implementing their program in a more incremental manner over the last several years, and despite a 2% provider
Dewberry GP. TennCare. JAMA. 1996;275(9):684. doi:10.1001/jama.1996.03530330027018