2018 Gubernatorial Candidates Respond to Pressing Health Policy Issues Facing Tennesseans

November 1, 2018 - Earlier this week, we sent an email and an infographic our department created to policy advisors for both Democratic candidate Karl Dean and Republican candidate Bill Lee, asking them to respond to topics related to pressing health policy issues facing Tennesseans. As of the time of this posting, we have received responses from the campaign for Karl Dean. We will update when/if we have responses from the Bill Lee campaign.




On Rural Health...

Karl Dean: The first and most important thing we need to do is expand Medicaid, which will provide health insurance for approximately 300,000 Tennesseans in the coverage gap; create another weapon to fight the opioid crisis; and give rural hospitals a much better chance financially by reimbursing them for more of the care they offer. Tennessee is second only to Texas, a much larger state, in hospital closures, and that can be devastating to a rural community in terms of both health and economic development. I’ll present a plan for Medicaid expansion to the Tennessee General Assembly very quickly after taking office in January. It’s fiscally irresponsible for us to be paying for Medicaid expansion in more than 30 other states but not bringing any of that money - $1.4 billion a year - back home to Tennessee when so many of our fellow citizens are hurting and increasingly losing access to healthcare.

We also need to be helping Tennesseans understand the consequences of poor health choices. As a state, we’re trailing most of the nation on almost every major health indicator. As mayor of Nashville, I stressed the importance of making the healthy choice the easy choice, and I would take a similar approach as governor and use my position to spread that message.

Finally, I would push hard for rural broadband, which would open up even more opportunities for healthcare in the state’s rural areas.


On Opioid Use...

Dean: Campaigning across the state for the past 20 months has been an eye-opening experience in a number of ways, but I don’t think anything has struck me as much as the extent of the opioid crisis. I’ve toured a Johnson City children’s hospital that had to add space for premature babies who were born suffering from opioid withdrawals. I’ve heard from law enforcement, treatment providers and social workers on the challenges they’re facing with both criminal and mental health issues related to opioids.

Governor Haslam’s plan is a good start, but we can do more. As governor, I would take a four-pronged approach:

  • Public education about the dangers of opioids.
  • Ensuring that people addicted to opioids get the treatment they need. Failing to expand Medicaid as a state put us in a weaker position on this front than we needed to be in, because it denied us a new funding source that would have created new treatment options. It’s time to change that.
  • Supporting law enforcement to arrest those who are profiting.
  • Eliminating over-prescription of narcotics.


On Smoking...

Dean: We have to keep working to make sure people understand just how bad tobacco is for your body, whether you’re smoking, chewing or dipping. Education has had some impact, and we’ve just got to keep at it. I would ask my health commissioner and his or her team to look at our current education programs and determine what’s working and where and how we can do better.


On Disparities...

Dean: Education, healthcare and jobs will be my top three priorities as governor, and they’re all closely connected. I would invest in education. No one can argue with a straight face that the state of Tennessee spends too much money on education. We need to be paying our teachers more so we can attract and keep the best; we need to be putting more money into high-quality pre-K programs; we need to be doing more for after-school programming, and we need to create more access to technical and vocational education, recognizing that college isn’t for everyone. Education was my single highest priority as mayor of Nashville, which meant I protected it during the recession and the aftermath of the 2010 flood, when revenues were tight, and I invested in it during the boom years of my second term. Overall, we increased Metro Schools’ budget 37 percent in eight years and invested $620 million in capital projects. My approach as governor would be the same.

We need to take economic development just as seriously. When I was mayor, 70,000 private-sector jobs were created in Nashville, and we invested more than $2 billion in infrastructure projects, from the Music City Center to less heralded stormwater and sewer work. The scale will be different in other communities, of course, but we can achieve similar results across this great state if we play to each area’s strengths; develop our workforce; invest in universal access to the Internet through rural broadband; protect our natural beauty, which attracts a lot of people here; address transportation issues; and make sure that we always have an inclusive, welcoming, dynamic environment that will draw talent rather than turning it away.  


On Accountability...

Dean: I’m always willing to look at different and more efficient ways to do things and would be happy to consider any examples that the Department of Health Policy wants to share.

Thank you for this opportunity to talk about healthcare, which is one of the biggest challenges Tennessee faces, from urban to rural areas. It will be one of my top three priorities, along with education and jobs, as governor.