Blog (October 2010)
By Clint Kalan
Chances are, if you’ve owned a television in the last fifteen years or so, you’ve probably watched, or at least heard of the television show “ER”. Not only did the show portray young, good looking doctors, bringing back patients from the brink of death, but it also portrayed those patients as real people, with real stories. What “ER” did not show us, however, is how unglamorous trauma care is for a hospital’s finances. In 2005, Georgia’s then 15 trauma centers– hospitals that have certain dedicated surgeons, emergency room doctors, and nurses on site or on call for accidents– lost $210 million dollars on unpaid medical care1. Expanding trauma care in urban areas, or bringing trauma centers to the estimated 47% of Georgia2 that lives more than an hour away from level I and II trauma centers, is a money losing prospect for hospitals and one they are most likely not able to do without additional financial support3. Even maintaining the current level of trauma care for some north Georgia hospitals.
Why do we need to expand trauma care? Like those patients on ER, the citizens of Georgia who get into horrific accidents all have their own stories to tell. They are our mothers, fathers, daughters, sons, and loved ones. Unfortunately, a disturbing percentage of them will not live to keep telling those stories because Georgia’s trauma death rate, per capita, is 20% higher than the national average.4 An estimated 700 Georgians die each year because our state is not up to par on trauma care4. If this situation is not remedied, maybe you will one day know one of those men, women, or children. Maybe you did know a person who was one of those 700.
This November, the citizens of Georgia have the opportunity to put the money in the hands of just the right people to fix this problem: medical professionals. Approving Georgia Ballot Measure 2 would deliver $80 million dollars to the Georgia Trauma Network Comission5, a group of composed of some of the state’s leading trauma surgeons, paramedics, ER doctors, and nurses whose charge it is to fix what is broken about Georgia’s trauma system. This money would be constitutionally bound to this task and given to this group who already has a track record for using their limited resources to make sure those trauma centers that we do have are as strong as possible. Or, we can say no, and hope against hope that the only ambulances and emergency rooms we have to see are those on television.
To learn more, check out the Yes 2 Save Lives Campaign.
Clint Kalan is a former Emergency Medical Technician and is currently a Physician Assistant student at Emory University School of Medicine as well as a member of HealthSTAT.
1. Code Blue for Georgia’s Trauma System. In: Team GSTA, ed. Vol 2010. Atlanta: Georgia Statewise Trauma Action Team; 2007.
2. 2009 Maps of Trauma Center Access. CML.Web 2009; Georgia Level I/II Trauma Center Coverage. Available at:http://tramah.cml.upenn.edu/CML.TraumaCenters.Web/statepage.aspx?state=13&responseTime=60&transportMethod=DOF&year=2009. Accessed 10/17/2010, 2010.
3. McConnell KJ, Johnson LA, Arab N, Richards CF, Newgard CD, Edlund T. The on-call crisis: a statewide assessment of the costs of providing on-call specialist coverage. Ann Emerg Med. Jun 2007;49(6):727-733, 733 e721-718.
4. Report from the Joint Comprehensive State Trauma Studies Comittee. Report from the Joint Comprehensive State Trauma Studies Comittee. Atlanta, GA: 2006 Legislative Session of the Georgia General Assembly; 2006.
5. Ashley DW. The quest for sustainable trauma funding: the Georgia Story. Bulletin of the American College of Surgeons: The American College of Surgeons; October 2010:5.
By Cindy Zeldin and Joann Yoon
On Election Day, Georgia voters will head to the polls to elect our state’s policymakers. Most voters are familiar with certain elected offices, like that of Governor, but many Georgians may be unaware of the importance, or perhaps even the existence, of the Office of State Insurance Commissioner.
The Insurance Commissioner runs the Georgia Department of Insurance and is elected every four years in a statewide vote. Among the core functions the Department of Insurance performs is the regulation of health insurance in Georgia. The Insurance Commissioner ensures that companies selling individual and small group policies in Georgia are financially solvent and enforces consumer protections and state laws regarding benefits that private insurers must include in policies sold in Georgia.
With the recent enactment of the Affordable Care Act, the new health care law, the role of the Insurance Commissioner has expanded. Our next Insurance Commissioner’s decisions will play an important role in shaping Georgia’s health insurance system for consumers in 2011 and well into the future.
Guest Blog By Brittany Freeman
Director, Health Policy
American Cancer Society South Atlantic Division
During the 2010 National Breast Cancer Awareness Month, we can all celebrate the significant progress that is being made to save lives from breast cancer. Today, more women are surviving this terrible disease than ever before. The 5-year relative survival rate is 98 percent when breast cancer is detected at an early stage.
The important decline in death rates from breast cancer – nearly two percent per year during the 1990s – has been attributed in large part to the benefits of screening. For women under 50, the drop has been particularly strong, at more than 3 percent per year. A woman’s risk of dying of breast cancer has now dropped 29 percent since mortality rates peaked in 1989.
But breast cancer is still taking the lives of too many women. Despite great advances, it is estimated that more than 4,900 women in Georgia will be diagnosed with breast cancer this year. Across the country, more than 192,000 women will be diagnosed, and 40,000 will die from the breast cancer, making it the second-leading cause of cancer death in women and the most commonly diagnosed cancer in women (other than skin cancer)..
Much of this is attributed to lack of access to health care and to important screenings like mammography.
Only 35 percent of women aged 40 and over who are uninsured or underinsured received a mammogram in the past year, compared with 60 percent of adequately insured women. For women with commercial health insurance or Medicare, even relatively small out-of-pocket costs can significantly reduce mammography rates, particularly for underserved populations.
The American Cancer Society and our advocacy affiliate, the ACS Cancer Action Network, and our many partners have been working to improve access and coverage to mammography through state and federal legislation. Georgia law now requires all insurance companies to cover mammography. State law now also requires insurers to also cover mastectomy and inpatient hospitalization after reconstructive surgery.
In 1991, Congress established a federal program, the National Breast and Cervical Cancer Early Detection Program, to help reduce breast and cervical cancer deaths among medically underserved women. In Georgia, this program, called the Cancer Screening Program, provides free pap tests to women aged 21-64 and mammograms to women 40-64 who are uninsured, underinsured, and have income below the 200% federal poverty line. If cancer is found, women can access treatment through the Georgia Women’s Medicaid Program.
Each year, the American Cancer Society, our volunteers and advocates and our partner organizations work to protect these laws and funding for these programs to ensure that woman continue to have this access.
At the federal level, the Patient Protection and Affordable Care Act will extend access to more women in the coming years.
The law requires that all commercial health insurance plans provide first-dollar coverage for mammograms for women starting at age 40. This applies to new plans now, but will apply to almost all plans by 2014.
Beginning in 2011, the law eliminates out-of-pocket costs for preventive services such as mammograms under the Medicare program
As well, the law creates public health investment fund to expand and sustain national investment in prevention and public health programs, including health screenings, and establishes education campaigns for the public and health care professionals regarding young women’s breast health.
Please help us all continue to advocate for these and other programs that provide access to screenings and treatment for breast cancer. For more information on breast cancer, please visit http://www.cancer.org/Cancer/BreastCancer/. To become involved in the advocacy efforts of the American Cancer Society Cancer Action Network, please visit www.acscan.org.
Guest Blog By Joann Yoon
Associate Policy Director for Child Health
Voices for Georgia’s Children
As the November 2 elections draw closer and as the rhetoric among the candidates becomes more heated, Georgians may start to feel “voter fatigue” and may begin to wonder if any common ground exists among the candidates. Thankfully, we do have an example of how the two leading candidates for Governor each has demonstrated leadership and support for a program that is helping many working families in Georgia—PeachCare for Kids. PeachCare is our state’s Children’s Health Insurance Program (CHIP), which was created by federal legislation in 1997 and was implemented in Georgia in 1998. Although the initial creation of CHIP was through the work of federal legislators on Capitol Hill, it was our leaders here in the state who put it to work for Georgians. Governor Barnes was in office at the time that the PeachCare program was off and running, and Congressman Deal was one of the federal representatives who boldly spoke out about the importance of PeachCare when the program was threatened with extinction in 2008.
The conversations may become more heated. The tv ads and mailers seemingly may be caked in mud. BUT we have seen how each of these men has stepped up in the past to make sure that Georgia’s PeachCare program was not only effective for kids and families but also cost-effective for the state.
We can only hope that the success of PeachCare’s creation is eclipsed by even greater policies to benefit kids and families in Georgia throughout the next four years.
Nearly 934,000 People in Georgia Will Be Eligible for Health Care Premium Tax Credits in 2014
As Part of the Huge and Unprecedented Middle-Income Tax Cut, Georgians’ Taxes Will Be Reduced by $3.6 Billion in 2014
Today, in partnership with Families USA we are co-releasing a new report, “Lower Taxes, Lower Premiums: The New Health Insurance Tax Credit in Georgia,” that quantifies the impact on Georgia consumers of the tax credits authorized through the new health care law.
Last month, new Census Data found that nearly 2 million Georgians were uninsured in 2009. In sheer numbers, only four states have more uninsured individuals than Georgia. As a state, we rank near the bottom of the pack on a range of health care indicators. Despite the complexity of the legislation and the contentiousness of the politics surrounding it, the new health care law is a huge opportunity for Georgia and its citizens to move the needle on these indicators.
Through a variety of pathways, the majority of Georgia’s uninsured will become insured when the major provisions of the new health care law kick in in 2014.
Beginning in 2014, more than 900,000 Georgians will become eligible for substantial health insurance premium tax credits, effectively pricing private health insurance within reach not only for Georgians who are currently uninsured but also for insured individuals who struggle with health care costs today. This will provide financial relief and protection against high medical expenses for hard-working individuals and families in Georgia.
These tax credits will be financed entirely with federal dollars and will be available to Georgians purchasing insurance through the new health insurance exchanges. The state of Georgia was just awarded a grant from the Department of Health and Human Services to begin planning for an exchange here in Georgia. This is an opportunity for our state to ensure this marketplace navigates consumers to the appropriate health insurance option, whether that be Medicaid, PeachCare for Kids, or private insurance that will now be made affordable through these hefty tax credits.
If we put politics aside and thoughtfully and carefully develop an implementation strategy for Georgia that makes the most of provisions like these new tax credits, our state and its citizens could benefit for generations to come.
By Cindy Zeldin
This column originally appeared in the Bryan County News.
Sept. 23 marked the six-month anniversary of the enactment of the Affordable Care Act, the new federal health care law. The bulk of the changes go into effect in 2014, giving state and local governments, insurers, providers and other key stakeholders time to translate and implement the new policies.
While the health reform legislation is complex and the politics contentious, the new health law is our best shot here in Georgia to expand insurance coverage, improve access to care and ultimately move the needle on many of our state’s lagging health outcome indicators.
Implementing the new health care law won’t necessarily be easy and doesn’t lend itself to a bumper sticker slogan. But with a coordinated effort and a collaborative spirit, we can leverage the new health law to build a healthier Georgia.
The new law is complex: a major reason for this is that our current health system is fragmented and complicated, and Congress made a concerted effort to preserve what was working well for most Americans while filling in the intractable gaps that simply left too many hard-working citizens without access to affordable, quality health care.
At the same time, insurers and the federal government are clashing over the details of how to carry out some of the provisions in the new law, and this back-and-forth has dominated the headlines. Add in a dose of pre-election politics, and it is no wonder consumers have some confusion.
Rather than use this confusion to impede the effectiveness of the new law, here in Georgia we should embrace the opportunity it presents, particularly since we have so much to gain.
Currently, nearly 2 million Georgians are uninsured. Despite the popular perception that the uninsured still get the medical care they need, the evidence is clear that they do not. The uninsured are nearly four times more likely than the insured to have gone without a recent routine check-up, and clinical outcomes are worse for uninsured patients across a range of health conditions.
If implemented properly, the new health law will cover the majority of Georgia’s uninsured by extending coverage to those who are denied, ineligible or for whom insurance is priced out of reach today.
The insured will benefit, too. While consumers in employment-based plans report high levels of satisfaction with their plans, the individual health insurance marketplace is a minefield, fraught with pre-existing condition exclusions and rescission policies that allow insurers to retroactively deny benefits to consumers who have purchased insurance in good faith, only to discover that it is pulled out from underneath them when they get sick. The new health care law will put a stop to these practices.
Perhaps most importantly for Georgia policymakers and consumers, however, is that while the basic architecture and the bulk of the financing for the new law are put into place federally, there is significant opportunity for the states to implement key policies in a way that is tailored to each state’s needs.
For example, the state of Georgia recently applied for and received a grant from the Department of Health and Human Services to begin planning for a Georgia health insurance exchange, which will serve as a one-stop shop for individual private health insurance policies and must coordinate with other state agencies to navigate consumers to programs like Medicaid for which they may be eligible.
The new health law also authorizes a $15 billion Prevention and Public Health Fund, and some of these dollars will be available for Georgia to draw down to implement wellness and prevention programs in communities throughout the state. There is also a significant investment in community health centers and grants to expand the provider workforce, all opportunities for Georgia.
Between now and 2014, if we put politics aside and instead thoughtfully and carefully develop a Georgia-specific implementation plan for the new law, the health of our state and its citizens could benefit for generations to come.