Laura Colbert, executive director of Georgians for a Healthy Future, agreed the issues of drug prices and transparency, coupled with the role PBMs play in the equation, will come up…
By Dr. Harry J. Heiman and Cindy Zeldin
This column was originally published in the Athens Banner-Herald on August 26, 2011.
The recent debt-ceiling debate and prime-time display of our elected leaders’ inability to work together epitomized the challenges of advancing thoughtful and impactful public policies. Following the deal in Congress, news coverage quickly moved to speculation about the “super committee,” tasked with slashing an additional $1.2 trillion in federal spending over the next decade. Lost in the coverage, and seemingly in the discussion, has been the potential impact of the committee’s decisions on vital services for the most vulnerable in our communities. At a time when the number of people without health insurance continues to rise, Medicaid and other programs that support health care access for low-income children, families, and the disabled remain at risk.
Reduced federal and state funding for Medicaid and the health safety net would be particularly traumatic for Georgia, which has been hit hard by the economic downturn and suffers from high poverty, high unemployment, and high rates of uninsured people. Nearly two million Georgians — one in five — are uninsured, and more than one in six live in poverty. These numbers are even worse in many of Georgia’s rural and inner-city communities. At 37 percent, Athens-Clarke County has one of the highest rates of uninsured people in the state. The consequence of these worsening economic indicators is increased distress experienced by Georgia’s most vulnerable citizens. This distress is reflected in Georgia’s dismal health indicators: high obesity rates, high infant mortality rates and overall poor health outcomes.
In doctors’ offices and hospitals, this distress is seen in patients delaying or forgoing needed medical care and suffering the consequences. Uninsured patients put off refilling essential medications for their high blood pressure and diabetes, delay important cancer screening tests like mammograms and colonoscopies, and often end up being seen in the emergency department and getting hospitalized for preventable illnesses and complications. They suffer and we collectively pay the costs.
The Medicaid program is the backbone of our health care safety net, providing coverage to about 1.7 million low-income and disabled Georgians, mostly children. The Medicaid program demonstrably improves access to health care and financial security for patients in the program, and does so at relatively low per-capita costs. A recent study published by the National Bureau of Economic Research found that people with Medicaid, as compared to the uninsured, were more likely to have a regular source of care and to see a doctor. Medicaid increased access to outpatient care, hospital care, prescription drugs and preventive services such as mammograms and cholesterol checks. The study also found that Medicaid improved financial security — people with Medicaid were less likely to have unpaid medical bills or to have to borrow money to pay for medical expenses.
The benefits of Medicaid, however, are not limited to the patients within the program. Medicaid is also an important economic generator for Georgia. Federal and state dollars allocated for Medicaid pay for doctors and other health care providers, medical supplies, and pharmaceuticals. Through what is known as the “multiplier effect” these dollars flow through local health care economies and generate jobs and economic activity well beyond their initial investment. A recent study by Families USA found that a 5 percent cut in Medicaid spending in Georgia would put $670 million in economic activity and nearly 6,000 jobs at risk.
Medicaid has a positive, tangible impact on access to care, health outcomes and our state’s economy. Cuts to Medicaid would translate to more Georgians forgoing care and suffering worse health and lower productivity. Health care is one of the few sectors of the economy that has grown during the economic downturn, and cutting Medicaid would stunt this economic engine at a time when it is most needed. Now is not the time to reduce funding to Medicaid. We should be doing everything we can to bolster this important and efficient program.
Dr. Harry J. Heiman is director of health policy for the Satcher Health Leadership Institute at the Morehouse School of Medicine. Cindy Zeldin is the executive director of Georgians for a Healthy Future.