Yesterday I had the opportunity to attend Legislative Day at the Capitol with other Georgia physicians representing the Patient-Centered Physicians Coalition of Georgia. As an advocate for the American College of Physicians (ACP) I acted as a lobbyist for key health legislation in our state.
Highlights are as follows:
1. The Governor has proposed a 1.98% cut to Medicaid within the 2011 budget.
2. The Governor has also proposed a 1.6 percent premium tax on hospitals as a source of revenue.
3. The House has proposed a $1.00 tax, or “user’s fee,” on tobacco products as a source of revenue (House Bill 39).
4. Comprehensive tort reform (Senate Bill 3) was passed in Georgia in 2005. This included caps on non-economic damages for medical malpractice cases. This is under Supreme Court appeal and is likely to be back on the table.
5. Prompt Pay (House Bill 321, House Bill 342 and Senate Bill 62) reform is proposed, requiring prompt pay (15 days) by third party payors who now often delay payment up to 90 days.
In the state of Georgia Medicaid reimburses about 48% of what private payors reimburse. A cut to Medicaid would mean a 16% cut to current provider reimbursement for Medicaid patients. Poor payment by Medicaid has led many practices to drop Medicaid, limiting access to health care for Medicaid patients. Patients who are unable to access physicians use the emergency room for care and have worse health outcomes, leading to increased expense. Inadequate reimbursement will lead medical practices with a high percentage of Medicaid to have inadequate revenue to meet operating expense.
However, the reality is that the Georgia state budget projections for 2011 and 2012 are daunting: http://www.gbpi.org/documents/20090409FS.pdf . Global cuts—including education and teacher furloughs are occurring. I spoke with my district representative, Mary Oliver (D), who sees few choices given the current economic climate.
As a source of revenue, the Tobacco Tax is opposed by many congressional republicans, who are in general opposed to any additional taxes. They voice concern that it would primarily impact those of lower economic means. Those in favor, including The ACP, point out the 400 million in additional revenue it would generate for the state, and the positive impact it would have on public health, particularly youth smoking prevalence.
Georgia passed comprehensive tort reform in 2005 limiting non-economic damages to $350,000 in medical liability lawsuits. Medical groups point out that since this time malpractice insurance rates have stabilized and decreased. However this is currently under Supreme Court appeal. Just yesterday Illinois overturned tort reform legislation it passed in 2005. http://www.nytimes.com/2010/02/05/us/05malpractice.html?ref=us Opponents of tort reform, including representative Stacy Abrams (D) feel that tort reform is a “red herring,” not truly accountable for increased health cost within our system. Consumer advocate group Georgia Watch supports this view: http://www.tortdeform.com/archives/2006/09/tort_reform_in_georgia_dispell.html
The Patient-Centered Physicians Coalition of Georgia supports protection of tort reform in our state.
Where do you stand on these issues?
With all of the focus on the national debate I urge readers to understand what’s on the agenda for health care in your state, contact your representative, and let your voice be heard.