More than a year after the state launched the Pathways to Coverage program, offering Medicaid in exchange for work or other state-approved activities, advocates say the program is too difficult…
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Guest Blog By Holly Lang
Each day, the crisis of affordable care grows for uninsured and underinsured Georgians.
An estimated one-third of all insured Georgians went without adequate health care coverage in 2007, a number that continues to grow each year. Increasingly so, many plans do not pay for preventative care, such as physicals and Pap smears, which are so important when it comes to health.
And for uninsured, the numbers are even worse.
Each day, 430 people in Georgia lose their health care coverage. And for every 100 people who lost their job in 2008, 20 became unemployed.
One in every three of the Georgia’s non-elderly adults – nearly 3 million people – had no health insurance at some point in 2007 and 2008. And of those 3 million people, more than two-thirds had a job while uninsured.
These were numbers calculated before the recession, when so many lost their jobs and their insurance.
In addition, many uninsured patients qualify for federal and state financial assistance programs they are not utilizing. For example, in Fulton County alone, it is estimated that 20 percent of the county’s uninsured population qualify for existing public options such as Medicaid or PeachCare but are not enrolled.
The rate of the uninsured among African Americans is nearly double what it is for Caucasians in Georgia, and Georgia is one of the states that leads the nation in the rates of uninsured Hispanics – more than two out of three lack coverage.
For Hispanic families having moved to the country less than five years ago, most public health insurance plans aren’t an option, regardless of their legal status.
The proposed legislation currently being debated by our nation’s Senate is meant to help all Americans receive affordable health care. And while Georgia Watch remains neutral on national legislation because of our state focus, we applaud any efforts to help make health care more accessible and affordable for all Georgians.
But regardless of what happens at our nation’s Capitol, we have a problem in Georgia now, and there are measures we can take to face what is a crisis of affordable care.
- We need our nonprofit hospitals to provide community benefits that are equal to the tax breaks they receive, breaks that collectively number high in the hundreds of millions. Nonprofit hospitals are receiving direct financial assistance by not having to pay those taxes, and they should return the favor by providing financial assistance to those in their communities who need help.
- We need more options for those who can’t afford health care because of pre-existing conditions. Right now, Georgia is one of 16 states that does not offer high risk programs, which are state programs that offer health insurance to those deemed “uninsurable” and can’t buy coverage in their market, or are charged premiums that are so high many can’t afford it and still eat.
- And we need hospitals to offer the same prices to uninsured patients as they do insurance companies, which averages at a 60 percent discount.
- We need hospitals to cut back charges at hospitals so they are fairer to Georgians. Costs are what it actually costs to provide care to someone. Charges are the inflated amount hospitals say that covers costs of caring for the uninsured and for the loss of providing care through Medicaid and Medicare. But so often these charges are spiked in such a way that any uninsured or underinsured patient can’t afford the care, and they buckle under the cost. For example, we received a call earlier this week from a patient who was charged $600 for an IV dye that cost the hospital only $14. That’s more than 4,000 times more the cost. There is no justification for that.
- We need to re-emphasize the importance of primary care, care that can be delivered at local health clinics and doctors’ offices. Georgians need a health ‘home,’ a place they go to when they aren’t well, and when they need a physical.
- We need better awareness – and more funding – for area clinics so patients are able to stay out of the hospital as much they can, especially the emergency room, the most expensive place to receive care. Preventative care also lets a patient know when they have a potential problem that could not only prove devastating to their health but also their pocketbooks.
- We need hospitals and area clinics to better work together so patients are able to have a better continuum of care, which is proven to improve health and affordability.
- We need all hospitals to have the same qualifications for financial aid throughout the state, which would make it easier for patients to navigate the system. Right now, most hospitals have different requirements that can be confusing to patients. By having the same or very similar eligibility and documentation requirements at all hospitals, patients will know better how to access financial assistance.
By enacting and enforcing measures in both state and hospital policy, we could help relieve the burden on our state’s residents, regardless of what happens in Washington. While we applaud all efforts to talk about these issues on a national level, we also need to make sure we look inside Georgia first.
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