Rural hospital closures continue to decimate local communities in Georgia. Gov. Nathan Deal, House Speaker David Ralston and House Minority Leader Stacey Abrams, among other policymakers, have all publicly addressed the issue.
In other words: Everyone knows it’s a problem. But partisan politics once again gets in the way of implementing a common-sense solution.
Gov. Deal and conservative leaders want to snub President Obama and the federal government by refusing to expand Medicaid. But it’s Georgia’s rural families, and not Ga. politicians, that must bear the consequences of the Medicaid blockade.
Five rural hospitals have closed under Gov. Deal’s watch. Dozens more are struggling. They are the financial lifeblood of their communities, providing stable, good paying jobs, and, oftentimes, the only source of health care for indigent patients in rural areas.
One local blogger described the loss of their local hospital, and the swift impact it had on the community:
“Thursday afternoon a few minutes before the end of business, Hutcheson [Medical Center] briskly fired a sizable percentage of its remaining employees and closed down its outpatient services, including Chickamauga Family Practice, cardiology, pulmonology, and some doctor’s offices….Workers are left scrambling for new jobs and wondering how they’ll pay their bills. Patients are left with no clear direction to obtain records or find replacement doctors.”
There are federal dollars available to Georgia, that would dually address the 300,000 folks without health insurance coverage and provide a huge boon to rural hospital’s bottom line.
The estimated economics of Medicaid expansion are hard to ignore: 56,000 jobs created statewide, $40 billion in economic impact over ten years, and, most importantly, critical health care infrastructure, like rural hospitals, could be kept open.
The math is clear. Even over a four year period, the state could see a net gain of $148 million. Yes, a net gain. The state spends $575 million over four years, but adds $723 to the budget from added sales and income tax revenue.
Medicaid expansion isn’t just some bleeding heart liberal dream of addressing our residents’ myriad of health problems, like Georgia’s painfully high maternal mortality rate, the second highest in the nation. Medicaid expansion is a sound economic development policy for Georgia and Georgia’s struggling rural communities.
The reality is that Georgia’s high uninsured rate and struggling rural hospitals are part of the same problem. Rural hospitals treat a lot of uninsured patients, who are, not surprisingly, unable to pay for care out-of-pocket. Meanwhile, hospitals are unable to get adequate reimbursements for the care they provide to these patients. Ensuring that all Georgians have health insurance, also ensures that rural hospitals are treating more folks who can pay their bills and keep hospitals running.
Dr. William Custer, health care economist for Georgia State University, spoke about the $2 billion we all already pay for folks who are uninsured:
Georgia already spends about $2.6 billion caring for the uninsured, he said. They pay about 20 percent of it themselves, about $520 million in self-pay. The other $2 billion or so is split between taxpayers, mostly state and local taxes, and other health care consumers who pay the cost in higher health care costs and higher premiums, “which means we all bear the cost,” Custer said.
Georgia has a straightforward policy solution to save rural hospitals. So, why have political leaders continued to place barrier after barrier in the way of Medicaid expansion?
It’s pure political shenanigans. But Georgia’s families can’t afford for politicians to play with their lives.
Overall, rural communities see higher rates of common diseases, like hypertension, diabetes and cancer, as well as higher morbidity and mortality rates.
“The biggest problem is acute emergencies,” Dr. Alluri Raju, a Richland physician, told Georgia Health News. “If you don’t have a hospital close by, it definitely affects the outcome.”
In other words, people in rural Georgia die from car accidents and heart attacks because the nearest hospital is over 30 miles away, even if their injury or disease is treatable.
When rural hospitals close — and families must travel even further to access emergency and critical care — there are real consequences for people’s health and wellness.
This is a health care crisis.
Georgia’s women are at particular risk, as Georgia has a significant shortage of OB/GYNs, and rural hospitals are often the only place they can go to give birth. The Georgia Obstetrics and Gynecology Society predicts that by 2020, 75 percent of the care areas outside Atlanta “will lack sufficient obstetric services.”
The Georgia Maternal and Infant Health Research Group reports that women who must drive over 45 minutes are “are 1.5 times more likely to deliver preterm than women who drive less than 15 minutes.”
Almost one in four pregnant women in Georgia are in the former category; that means lack of access to health care providers is putting nearly a quarter of pregnant Georgians at increased risk for preterm births.
Both for the health and wellness of Georgia’s rural communities, and their economic stability, Medicaid expansion is a common-sense proposal. The legislature’s refusal to act is unconscionable, and will continue to cost the state — in both lives and dollars.
>>>Add your voice to the conversation at SaveGeorgiaHospitals.org.