Profile: Joshua Mitchell

Nine-year-old Joshua Mitchell is an example of the potential of TennCare, Tennessee's innovative program to cover some 500,000 previously uninsured children and adults. Joshua has sickle cell anemia, a hereditary disease of the blood that causes painful attacks in the joints and organs and significantly shortens the life span.

When an attack of sickle cell anemia strikes, Joshua's mother, Angela, usually takes him to the emergency room at Vanderbilt University Hospital and he is often admitted to the hospital for several days. TennCare pays for these visits. However, for a brief period during the spring of 2000, Joshua's TennCare coverage lapsed and Vanderbilt was less welcoming. When he went to the ER, he was given morphine, a cup of Gatorade and then turned away, without admission.

Joshua's story reveals the importance of TennCare to someone with a chronic condition. If it were not for the medical coverage provided by TennCare, Angela would never be able to afford the sickle cell specialist that Joshua sees routinely or the periodic hospitalization needed to control the episodes of crushing pain caused by the disease. Angela works six, sometimes seven days a week as a waitress, and she herself is uninsured because she can't afford her employer's insurance plan. "With TennCare, you can get the care you need," says Angela. "Without it, you're out of luck."