Fall has definitely taken center stage since last I sent The Loop. The wind chimes outside my window are whippin’ in the wind, while the screen door is flappin’ every now and then reminding me there is a storm brewing on this last day of October.With Governor Haslam saying it is unlikely the state will present an agreement with the federal government on Medicaid expansion before the new year, a window to speak with the Governor's office concerning a more fiscally-responsible alternative to state exchanges and medicaid expansion opened up for me last month.I want to thank Governor Haslam for taking time to hear from my friend, C.L. Gray, an M.D., who presented a common-sense approach that would give states the ability and incentive to create lean, efficient Medicaid programs. With our national debt now approaching $17 trillion and states operating under the current system of unlimited federal matching dollars, out of control spending continues to be propelled.The more states spend on Medicaid, the more money they receive from Washington - the trajectory is unsustainable for the feds and the states, leaving us cash-strapped, overextended, and most certainly headed for a huge train wreck not far down the tracks.Folks, the federal government has proven it is not capable of running healthcare.