Political Heavyweights Debate Health Care

Four political heavyweights sparred on Wednesday over whether creation of a government-run health care program would drive down skyrocketing costs. But they agreed that some overhaul of the nation's health system would make its way through the Democratic-led Congress.

Republicans Karl Rove, a former top adviser to President George W. Bush, and ex-Senate Majority Leader Bill Frist warned that a public health care plan could have a huge price tag and quash private-sector innovation. But former Democratic National Committee Chairman Howard Dean and one-time Senate Majority Leader Tom Daschle said a public plan could help bring down costs and insure more Americans. Dean proposed a 10 cent carbon tax on gasoline to pay for the costly overhaul, expected to cost at least $1.2 trillion.

The four debated the virtues of government-run health care at the 2009 BIO International Conference in Atlanta on Wednesday. The faceoff came as the battle over health care heats up in Washington.

Majority Democrats are aiming to bring health care overhaul bills to the floor of the House and Senate by August. It's a priority for President Barack Obama, a promise he made during his campaign.

Rove predicted that if the final bill contained a public health care system "it will pass with little or no Republican support."

I"m for choice," Rove said. "There is no reason you have to have a public plan to have competition and choice."

Frist, a heart surgeon before his election to the U.S. Senate, acknowledged that if the government comes to the table with a public plan it would bring costs down. But he said the bill for taxpayers would eventually swell as companies abandon private coverage for their employees and dump them on the government rolls.

But Dean said the GOP was missing the impact health care reform would have on America's ability to compete in the global marketplace.

"This is a business proposition," he said. "What are we going to do to make American businesses more competitive? Driving down the cost of health care will help."

Daschle said too much is paid on administrative costs in health care plans and any reform needs to look at how "to wring inefficiencies out of the system." He said the trick would be to strike the right balance between public and private coverage. Daschle had once been expected to lead the charge for health care reform in Washington as Obama's choice to lead the U.S. Department of Health and Human Services. He withdrew from consideration amid questions about unpaid taxes.

Sparks flew at one point Wednesday as Rove jokingly referred to Dean's home state of Vermont as "dinky," smaller than some ranches in his own state of Texas. That led to Dean to chide Rove for years of budget deficits under Bush. Rove countered that Obama was only making matters
worse.

(Associated Press)

Health care pros: Grady broke its promise

Health care advocates met in Atlanta today to address the widening health care disparities in minority populations. Of particular concern to some – how politics have shaped the allocation of medical services at one high profile hospital.

According to Dr. George Rust, the ratio of poor African Americans unable to access adequate and affordable health care has remained unchanged for nearly half a century. Rust directs the National Center for Primary Care at the Morehouse School of Medicine. All Morehouse medical students are required to do some clinical work at nearby Grady Memorial Hospital. But, Rust says Grady isn't delivering on its promise made in the 1890s. Namely, to serve the poor.

"We segregate health care for the poor and then we under fund it. We say we're going to create a separate system of care for the uninsured and then we're not going to adequately fund it. And what we're seeing is that when deliver care separately you get separate health outcomes and worse health outcomes."

Today it’s estimated that annually so-called segregated health care means 83,000 African Americans die at earlier ages of treatable and preventable diseases. Most experts agree lifestyle choices may be the root causes of treatable diseases like diabetes and obesity. But add, the lack of culturally sensitive medical personnel unfairly burdens some minority communities.

Health care group launches campaign

A health care advocacy group launched a multi-million dollar campaign in Atlanta today to press for reforming the American health care system.

Health Care for America Now is a coalition of more than 100, primarily left-of-center groups calling for cheaper and more comprehensive health insurance and health care.

Larry Pellegrini of the Georgia Rural Urban Summit, says the coalition plans to invest $40 million dollars to get their point across nationwide:

"…which would actually make it one of the largest, if not the largest campaign on a single issue that's ever been formed. The funding is already obtained, and we intend to make it an investment in reforms that will satisfy the needs of the people."

The group is touting a 10-point plan they want to see on the national agenda, including universal health care, a choice of private or public coverage, and equal access to treatment.

Organizers say their supporters include labor unions, women's and minority groups, medical practitioners, and small-business associations.

Click here for more GPB News coverage of state health-care issues.

Boost for ailing minority health care

Minority health care in several southwest Georgia counties gets failing marks according to a new report. The 2008 Health Disparities Report (.pdf download) says that while racial and ethnic minorities make up about a third of Georgia's population, they are much more likely to have health problems.

The Office of Minority Health, which put out the report is working to equalize health care access for minority and non-minority populations in Georgia.

Kristal Ammons of the Department of Community Health says Muscogee County's grade was among the lowest statewide:

“...particularly in the overall report card -- they received a grade of 'F' for prenatal care and maternal health outcomes.”

Representatives met with local officials in Columbus on Thursday to discuss ways of improving minority health care.

Ammons says a matrix of poor education, poverty and economic hardship are a big part of the problem, but adds that many other counties received higher ratings.

The group plans to distribute $1.5 million in improvement grants statewide. The funds will also cover other health issues including cardiovascular disease, cancer, diabetes and HIV/AIDS.

The group plans to set up coalitions with local officials and health care providers in Fort Valley, Valdosta and Brunswick, among others statewide.

Click here for more GPB coverage of health issues in Georgia.

Bill would create web-based health care supermarket

The Georgia Senate has passed a measure that would create a statewide agency designed to promote and market a consumer-driven health insurance superstore. The plan has the backing of the Lt. Governor, who called the proposed Georgia Health Marketplace Authority a "free market solution based option for consumers." The plan would allow individuals to buy health care coverage directly from a doctor or hospital. Insurers and health care companies would pay a fee to be included on a web-based list from which people choose products and services. The bill's sponsor, Tommie Williams (R-Lyons) says buying health care coverage should be like shopping for any other product. "They can buy just any kind of car they want, that they can afford. That's what we're trying to do, is offer alot of different products out there," says Williams. Cagle, says the program is designed to help some of the 1.7 million uninsured Georgians. The web-based site would be allowed to market high-deductible health care plans to Georgians ages 18 to 25. Participants in those plans pay out-of-pocket up to a certain ceiling but have coverage for "catastrophic" events, such as cancer. Democratic critics of the plan say it excludes the poorest of Georgians because of an an inability to pay for items excluded from coverage, including STD screening, pregnancy complications, and birth control. The measure passed 42-12.

High risk topic of Senate health care committee

Pictured: Senators Don Thomas (left) R-Dalton and Committee Chair Judson Hill (right) R-Marietta at a meeting of the Senate Healthcare Transformation Study Committee. (Not pictured: Senators Don Balfour (R-Snelville) and Horacena Tate (D-Atlanta).


The Senate Healthcare Transformation Study Committee met today in Atlanta, hoping to build on legislation passed in 2008, which reformed health coverage in Georgia by turning it into an incentive based commodity. Today insurance companies have the option to refund premiums to patients who stay healthy. States around the country are looking at Georgia's free market health coverage as a model, which rewards healthy lifestyles with insurance premium refunds.

However, lawmakers it's now time to tackle the lack of health care for the middle class, uninsured workers. Those who have been turned down for health coverage because of a pre-existing or catastrophic condition.

Marietta Republican Judson Hill heads the Senate Health Care Transformation Committee.

"These are for working Georgians, someone who may have had a heart attack, or may have diabetes or a lot of different health that are not uninsurable. They're working, they're out here making 50, 150 thousand dollars a year, but they've got ongoing health issues that may cost them thousands or tens of thousands of month in health care."

Georgia is one of 4 states which does not have a high risk pool. And, it's estimated there are 10-thousand high risk working Georgians, left with one very expensive option when catastrophic illness hits.

"When a guy gores to the hospital with some heart condition and he doesn't have insurance because he wasn't able to purchase it, then he comes under the indigent care trust fund and the government kick ins money to partially refund the hospital for the free services that they're giving to that individual. Those monies come from taxpayers."

The Committee --- working with the state Department of Insurance -- hopes to present a draft of its proposal prior to the '09 legislative session.

University grant aimed at Hispanic women

As Georgia lawmakers prepare for hearings on the critical shortage of health care workers, Brenau University hopes a $250,000 grant from The Wal-Mart Foundation, will attract female health care majors in one of the state's fastest growing Spanish-speaking communities.

Jim Barco is primary fundraiser for the small, private, women's university in Gainesville. He says the need for bilingual medical professionals is essential in the state's fifth largest Hispanic community.

"The critical factor is, these women will help health care organizations become more effective, because there will not be the need for translators as much."

In the past decade, the state's Hispanic population has more than tripled.

Currently, less than 60 Hispanic women are health care majors at Brenau. Officials there say they hope its Nursing and Healthcare Scholars Program will add an additional 200 Spanish- speaking women by 2008.

Congress to vote on PeachCare expansion

Congress is about to vote on legislation to renew and expand Georgia's PeachCare and similar child health plans nationwide.

The House bill would increase spending on the Children's Health Insurance Program by $50 billion. In Georgia, supporters say, the expansion could provide health care for 210,000 more children who are eligible for PeachCare but are not enrolled. State officials have capped PeachCare's rolls at 295,000 children because of budget concerns.

The Senate bill is less ambitious, but still would increase spending by $35 billion. Higher tobacco taxes would fund the expansions. The House bill also would reduce payments to managed care companies that oversee some states' health plans, including Georgia's PeachCare and Medicare.

Sen. Johnny Isakson says he cannot support the Senate bill. He says expanding PeachCare would be a move towards universal health care.

"I think [universal health care] is problematic," he says. "It has never worked anywhere in the world. I don't know why we'd think it would work here."

Sen. Saxby Chambliss agrees. His spokeswoman adds that Chambliss will not support anything that includes tax increases.

President Bush has threatened to veto the proposals. Without a new law, however, the program will expire on September 30. Isakson predicts the debate will go down to the wire.

Flu shots available in W. Ga.

The Columbus Department of Public Health and the West Central Health District report that they have received supplies of influenza vaccine, for the winter flu season.

The flu shots will be restricted to Georgia residents of the following counties, and will be distributed at their local health departments this coming Monday, September 22 from 8:00 a.m. to 4:00 p.m:

Chattahoochee, Clay, Harris, Macon, Marion, Muscogee (Columbus), Quitman, Randolph, Schley, Stewart, Sumter, Talbot, Taylor, Webster.

The vaccine will be available on a walk-in basis to the general public and high-risk population for $23.00 apiece, and pneumonia vaccine will cost $14.00, according to a statement by the West Central Health District (WCHD).

The WCHD recommends vaccinations for the following high-risk populations:

• Adults age 65 years or older
• All children aged 6-23 months
• Residents of nursing homes and long-term care facilities
• Health-care workers involved in direct, hands-on, face-to-face patient care
• Pregnant women
• Children aged 6 months-18 years on chronic aspirin therapy
• Individuals who live with or care for one or more children less than 6 months of age
• Individuals with long-term health problems such as heart disease; kidney disease; lung diseases like asthma; metabolic diseases like diabetes, blood disorders like anemia; a weakened immune system caused, for example, by cancer or cancer treatment, HIV/AIDS, or steroid therapy; or certain conditions such as neuromuscular disorders that can cause breathing problems.

Click here for moore GPB News coverage of of health issues.

Athens Regional Looks To Cut Millions

One of the bigger hospitals in the state needs to cut millions of dollars from its budget in order to stay afloat. The financial struggles of Athens Regional Medical Center are much like other health care facilities across Georgia trying to hang-on.

Officials with Athens Regional are considering all options in trying to reduce costs, but yet spur new revenue. The Athens Banner-Herald says the hospital needs to cut $14-million from its budget, and layoffs may have to be part of the plan. The hospital employs 2,500 people full-time, with another 500 part-time.

The weak economy has affected hospitals and health care centers everywhere in Georgia, whether in large urban, or small rural areas.

Kevin Bloye is with the Georgia Hospital Association, which represents 170 hospitals and health care systems:

"We did a survey among our membership the first part of the year and we found three out of four hospitals in the state are experiencing pretty severe increases in bad debt and charity care since October of '08."

A spike in un-insured patients, and dramatic fall in money-generators like elective procedures are part of the equation.

Bloye says federal stimulus dollars in the state budget propping-up Medicaid is helping.

State fines managed care group for the poor

The state is fining one of its new Medicaid managed care organizations $3.7 million for failing to provide timely patient care.

An audit by the Georgia Department of Community Health found Peach State Health Plan was slow in granting Medicaid families and Peachcare kids permission to receive medical services.

Agency spokesperson Amanda Seals says DCH stands by its year-old privatized managed care program and will work with Peach State.

"The Department takes their obligations very seriously," says Seals. "But, we also still feel that these plans are doing a better job of managing health care and improving the health outcomes while getting a better value for the state dollar."

Peach State is appealing the fine. In the meantime, it has replaced its top executive. The company provides health services for nearly 280 thousand poor and working-class Georgians.

Southeast Ga. mental health provider lays off 63

Southeast Georgia's largest mental health care provider has laid off 63 employees.

Gateway Behavioral Health Services says, it's dealing with a $6 million budget hole. The company says, the main cause is shrinking payouts from state-run Medicaid.

So last week, Gateway gave pink slips to about 10% of its workforce. It's also cutting back to focus more on treating core and emergency services.

Underfunding means Gateway can't afford to address many preventable problems, according to Gateway C-E-O Frank Bonati.

"Prevention and early intervention become infinitely harder when we have to divert all of our attention to acute care and chronic care situations," Bonati says. "It's a question of pay me now or pay me later. The perfect example, of course, are jails."

The National Association for the Mentally Ill ranks Georgia 44th in mental health care funding. Gateway serves about 9,000 patients in eight southeast Georgia counties.

Cagle critical of DHR mental health management

A legislative committee Thursday agreed to transfer over five million dollars from a mental health program to other programs within the state's Department of Human Resources. However, the move angered some lawmakers who accused the Department of poor planning.

The committee voted 8-to-4 to allow the money transfer after DHR commissioner B.J. Walker said if they didn't approve it, the money would lapse. She says the five million is left-over from a program that provides mental health care for foster children. It will how help pay for case workers in the foster care system--federal money for that program was cut-off in March.

Lieutenant Governor Casey Cagle voted against the money transfer because he says there is a lack of leadership within the department.

"I have questions about the strategy of addressing mental health by the department. I have huge concerns relative to not being able to anticipate the funds that were coming from the change in federal policy".

Mental health care in Georgia in general is under scrutiny from the U.S Department of Justice. State officials say they are addressing those concerns.

Georgia gets near-failing grades in new emergency care report

A national report released today gives Georgia’s emergency medical care near-failing grades.

The American College of Emergency Physicians second National Report Card says Georgia’s got some serious medical homework to do: Georgia ranks 31st on the list, says ACEP President Dr. Nick Jouriles:

“The emergency care system is a ticking time bomb made worse by the financial crisis, and a failing nation’s healthcare system.”

Statewide, “failing” stands for an “F” in access to emergency care.

The report also gives the state C’s and D’s for too little disaster planning, and too few medical providers serving too many uninsured residents.

Doctor Matthew Watson is an emergency room physician at Atlanta’s Northside Hospital:

“By not having all of the different subtypes of physicians available, this limits our ability to care for the patients in a timely fashion.”

And in a bustling emergency room, that means,

"If patients come into the emergency department that we can’t provide the care for, then that’s going to slow down the next patient that needs to be seen, which is ‘domino effect,’ it’s just going to slow down the providing of care to all of the patients.

The report says more than 80 percent of the state’s residents live within an hour of a Level I or II trauma center.

Watson says, however, that part of the problem is getting doctors and other medical providers to work with limited equipment in many parts of the state:

“In rural areas, you simply don’t have the facilities that could support open-heart surgery, or any of the other specialties at a smaller rural hospital.”

The report has some bright spots: Georgia ranks first in the nation for patient access to substance abuse treatment services.

As well, liability reform laws also get high marks for limiting frivolous lawsuits and lowering medical liability insurance premiums.

The report, partly funded by The Blue Cross Blue Shield of Georgia Foundation, recommends training more emergency doctors and residents, critical medical specialists, registered nurses, and primary care providers.

Click here for more GPB News coverage of health care issues.

Lawmakers Have Packed Schedule With Two Days to Go

Wednesday marks Day 39 in this year’s legislative session. And both chambers have a packed schedule.

The big issue for House lawmakers is the transportation governance bill. The measure no longer includes the creation of a new state agency – a plan backed by Governor Sonny Perdue. Instead, legislators would have more power when it comes to managing Department of Transportation dollars.

And there’s also a measure to curb property taxes. The legislation would put a 3% cap on property assessment increases.

In the Senate, next year’s budget is the hot topic. And there's a plan to do away with both the sales tax and the so-called birthday tax on car purchases. Instead, every sale would be subject to a title fee of up to $1500. Some of that money would be set aside for trauma care.

Below is a list of the bills that are on tap for the second-to-last day of the 2009 session.

House:
SB 27 - Confederate Heritage/History Month; create; encourages observances/celebrations; provide statutory construction
SB 49 - Georgia Registered Professional Nurse Practice Act; nursing education program
requirements; revise certain provisions
SB 85 - Georgia Aviation Authority Act; create; provide for membership, governance,
operation, power, duties
SB 114 - Education; provide for transfer of students who are military dependents into a local school system
SB 128 - Motor Vehicles; option of owner; permanent license plates for boat, utility,
noncommercial cattle/livestock trailers; provide for fees
SB 133 - Health Share Volunteers in Medicine Act; provide certain compensation; health care provider; sovereign immunity protection
SB 144 - Insurance Agent License; applicant shall be appointed by an authorized insurer prior to issuance of the license; repeal requirement
SB 163 - Human Resources Commissioner; authorize to appoint a diabetes coordinator
SB 164 - State Highway System; signs and signals; height limitations; allow owners to obtain permits to remove vegetation from the viewing zones
SB 172 - Victim Compensation; provide for recovery for serious mental and emotional
trauma; change definitions; provisions
SB 178 - Education; advance funding, exceptional growth, low-wealth capital outlay grants; embed/extend a sunset date
SB 194 - State Purchasing; benefits based funding projects; revise provisions; change
membership of an oversight committee
SB 195 - Professions/Businesses; clarify applications submitted in prescribed form not necessarily written document; provisions
SB 200 - Transforming Transportation Investment Act; create State Transportation Agency; definitions; purposes; abolish State Road/Tollway Authority
SB 201 - Health; provide voluntary contributions through individual income tax returns for cancer research
SB 207 - Proceedings; admit general public to hearings in juvenile court with certain
exceptions
SB 246 - Courts; provide notice of the release of child from detention under certain
circumstances; definitions
SB 253 - Sparklers; provide a definition for the term "indoors"
SR 1 - Appropriations; provide for prioritized funding requirements regarding certain
supplementary appropriations Acts - CA
SR 153 - Education Improvement Districts; provide creation and comprehensive regulation - CA
SR 176 - James H. Chandler, Jr. Memorial Intersection; dedicate


Senate:
HB 2 updates and clarifies many existing provisions in Georgia law related to illegal immigration.
HB 16 prohibits the use of an electronic tracking device to determine the location or movement of another person without that person’s consent, with several exceptions.
HB 56 revises provisions relating to distribution of proceeds and renegotiation of distribution certifications.
HB 63 deletes the chapter governing the Redevelopment Powers Law and replaces with some existing and new language. It also adds new language regarding the Payment in Lieu of Taxes (PILOT) Restriction Act.
HB 64 specifies that a funeral director must file a death certificate within 72 hours.
HB 69 allows a physician to issue a Do Not Resuscitate (DNR) order without the concurrence of another physician so long as there is oral or written consent from an authorized health care agent operating under a durable power of attorney or pursuant to an advance directive.
HB 86 allows that absentee ballots must be counted by precinct, and separate returns must be made showing the results by each precinct.
HB 101 allows that a transit agency may authorize the placement, erection, and maintenance of commercial advertisements on or in transit vehicles or facilities owned or operated by that transit agency.
HB 119 makes and provides appropriations for the State Fiscal Year beginning July 1, 2009, and ending June 30, 2010.
HB 120 authorizes the annual sales tax holiday for school supplies and energy efficient appliances.
HB 141 is the annual housekeeping bill for the Department of Banking and Finance (the Department), which addresses the regulation of financial institutions and commercial paper in Georgia.
HB 147 relates to proceedings for forfeiture of bonds or recognizances, so as to relieve a surety from liability under certain circumstances.
HB 169 provides a notice of new or revised flood elevations to Georgia property owners affected.
HB 173 permits non-compete and non-solicitation clauses in employment and business contracts.
HB 184 directs the Department of Human Resources to prepare information for public dissemination on the department’s website describing the importance of obtaining a blood test for sickle cell disease.
HB 186 extends the income tax credit for teleworking through FY2012. It also increases the available credit to $2.5 million for Fiscal Years 2011 and 2012.
HB 189 revises the applicability of the Georgia Arbitration Code because the General Assembly finds that entities need to cooperate with each other to ensure parents with better options on child support obligations.
HB 217 sets forth the requirements for influenza vaccine protocol agreements between physicians and pharmacists or nurses.
HB 221 amends two statutes to require that writs of mandamus and writs of prohibition to compel the removal of a judge cannot be issued if a motion to recuse has not been filed first, nor where a motion to recuse has been denied after assignment to a different judge.
HB 243 provides conditions of employment of certificated personnel in elementary and secondary education for salary increase for persons receiving certification from the National Board for Professional Teaching Standards.
HB 258: Driver's license; minor of disabled guardian; restricted learner's permit; provisions
HB 278 allows local school system to waive the expenditure control requirements under the Quality Basic Education Act
HB 304 revises the rights of county appraisers and tax assessors and authorized agents of the county to go onto property to conduct official business.
HB 310 provides that the statewide recycling program for state agencies.
HB 318 defines several terms relating to the place of return for tax purposes of motor vehicles and mobile homes.
HB 321 relates to "group accident and sickness insurance" defined and "true association" defined, so as to provide for changes in the definitions of the terms.
HB 344 Probation; Department of Corrections; collections of additional fees; authorize
HB 349 Sales and use tax exemption; new construction of civil rights museum; provide
HB 371 Public Retirement Systems Investment Authority Law; increase in allowable fund investment; provisions
HB 379 Income tax; certain real estate investment trusts; disallow expenses paid
HB 388 The Option of Adoption Act
HB 395 Sales and use tax; personal property; construction of certain symphony halls; extend exemption
HB 406 Service delivery strategies; certain drinking water projects; funding limitation; provide exemption
HB 438 Income tax; tax credits for qualified jobs and projects; comprehensive revision
HB 439 Income tax; credits; business enterprises
HB 453 Superior courts; sunset dates for property filing fees; change
HB 455 Elementary and secondary education; annual contracts for certified personnel; extend certain deadlines
HB 473 Community Affairs, Department of; grants for clean energy property
HB 477 Retirement and pensions; creditable service; application requirement
HB 480 Taxation of motor vehicles; comprehensive revision
HB 483 Ad valorem tax; modernization and revisions of certain provisions
HB 485 Income tax; alternative credits for base year port traffic
HB 487 Superior Court Clerks' Retirement Fund of Georgia; employee contribution
HB 488 Superior Court Clerks' Retirement Fund of Georgia; eligibility criteria for creditable service
HB 492 Time-share projects and programs; private residence clubs
HB 493 Georgia Youth Conservation Corps; creation and purposes of the corps;
HB 509 Professions and businesses; regulation; change provisions.
HB 514 Judicial system; assignment of senior judges;
HB 528 Specialized land transactions; developers provide audits to homeowners
HB 549 Driver Services, Department of; information for purposes of creating juror lists
HB 568 Public Service Commission; members shall represent entire state
HB 575 Kidnapping; change certain provisions
HB 608 Time-share projects; estate shall include certain interests
HB 639 Special license plates; protect wild dolphins in Georgia
HR 161 White, Mr. John Jerome; compensate
HR 336 CPL Jonathan Ryan Ayers Memorial Interchange; dedicate

Obama Names New CDC Chief

President Barack Obama has appointed Dr. Thomas Frieden as director of the Centers for Disease Control and Prevention, turning to New York City's health commissioner to deal with the swine flu outbreak and other major health issues.

Frieden has served as NYC's commissioner for the past seven years, where he led a campaign to ban smoking in restaurants and bars, boosted the number of New Yorkers getting HIV tests and helped to distribute millions of free condoms.

In a statement announcing Frieden's appointment, Obama said the new CDC chief had been a "leader in the fight for health care reform, and his experiences confronting public health challenges in our country and abroad will be essential in this new role."

Frieden will inherit a looming decision on how best to manage a swine flu outbreak, including whether or how to produce a swine flu vaccine. The virus has infected more than 66-hundred people in 35 countries.

Health experts say the CDC needs to make immediate improvements in employee morale and organization as the Obama administration works to overhaul the national health care system.

The 48-year-old Frieden is expected to take office next month. His appointment does not require Senate confirmation. He will succeed Dr. Julie Gerberding, who resigned in January.

Dr. Richard Besser has served as acting head of the Atlanta-based CDC in recent months.

(Associated Press)

Patient advocates: the doctor will see you. Now.

After three surgeries, Judy Sherer still had chronic pain in her left shoulder. She'd lost faith in her doctors, and in despair tried a new health benefit offered by her employer.

The service, Health Advocate, is a call-in center that helps customers find the right doctor, haggle over insurance coverage and manage other medical system headaches.

An advocate helped Sherer find a new surgeon — one who found metal shavings left in her shoulder by a previous doctor. The advocate also negotiated the charge for her physical therapy down to $40 per visit from the $200 she was told initially.

"It saved me a ton of money," said Sherer, 63, of Norcross, Ga. "I'm very, very pleased."

Health Advocate is one of a growing number of U.S. companies offering some form of advocacy services to medical consumers.

Currently, the health advocacy business is an industry with about $50 million to $75 million in annual revenue but only about a half-dozen companies of any significant size, said Richard Rakowski of Intersection LLC, a Connecticut-based investment and development firm that has researched the field.

More than ever, people need help negotiating the medical system, said Jessica Greene, a University of Oregon health policy analyst.

"We're asking consumers to make more complicated decisions, but the numeracy and health literacy skills of many consumers are not at the level needed to handle this new responsibility," Greene said.

Though some consumers are savvy enough to beat a billing overcharge or probe doctors' litigation histories, they don't have the time for such labors, experts said.

Indeed, the largest customers of health advocacy services are companies, not individuals. "The employers are interested because it means their employees are not on the phone taking care of doctor's visits" during work hours, Fischer said.

Some other companies have always focused on individuals, especially rich ones.

One example is $10,000-a-year PinnacleCare, founded in 2002 by John Hutchins, who created a concierge-like service at the Cleveland Clinic. He later used his connections to build a national network of doctors for his private health advisory start-up.

The Baltimore-based company is essentially a club for millionaires and billionaires that puts nurses and social workers in touch with members. Not only will they help members find top-level care, they will get them moved to the head of the line. PinnacleCare advisers will even meet the patient at a doctor's office or hospital.

PinnacleCare has about 1,700 member-families. One satisfied customer is Kirk Posmantur, 45, the founder and chairman of Axcess Luxury & Lifestyle. His Atlanta-based company markets handmade watches, private jets and other luxury items to the affluent.

"It's a no-brainer for those who've got net worth of $5 million or more," he said. "You've got people who advise you on your taxes. You've got people who advise you on how to manage your money. But what's more important than your health?"

(The Associated Press)

Click here for more GPB News coverage of health issues.

U.S. Secretary of Veterans Affairs visits Augusta

Dr. James Peake, the U.S. Secretary of Veterans Affairs, says he’s talked with officials at hospitals here about the possibility of expanding medical care for wounded veterans returning home from the wars in Iraq and Afghanistan.

Peake toured the Charlie Norwood VA Medical Center and the Eisenhower Army Medical Center in Augusta today.

He praised community efforts on the expansion, but stopped short of giving specifics on what role his agency would play, suggesting there may be other priorities to consider.

"We’re always re-assessing what we have as a mission requirement," Peake told reporters. "We’re talking about space issues today…about how to expand our primary care space to provide a separate portal for women. We’ve brought a gynecologist on board in the VA hospital, so that’s shifting and adjusting our mission to meet the need of our veterans."

Peake has previously pledged to improve health care for women veterans. The focus on women's care comes as a congressional report earlier this year said women don't get the same quality of outpatient care as men in several VA medical centers in the U.S. About 14 percent of veterans are women.

The Eisenhower and Charlie Norwood centers already treat many wounded troops. Medical personnel and community leaders want to build on that by increasing efforts in medical care and rehabilitation and subsequently bringing more wounded active duty troops here, making Augusta a hub for treating them.

They say coordinating medical services among all facilities here and getting federal dollars could potentially help relieve the Walter Reed Army Medical Center. That’s where many active duty troops go to recover from war injuries.

The Medical College of Georgia and the Joseph M. Still Burn Center are also among medical care facilities located in Augusta.

Perdue health plan draws critics

Gov. Sonny Perdue is encountering road bumps as he tries to build enthusiasm for a plan to use government funds to encourage small businesses to provide health-care benefits.

Most of Georgia's small businesses do not offer health coverage to their employees, but Mike Sullivan, owner of Conyers-based Southeast Sealing Inc., does. He says it is breaking his budget.

"There are a lot of guys and women in this state who have small companies and who are being absolutely ripped apart by high health-care costs," Sullivan says. He welcomes Perdue's proposal to create a voluntary, state-run, health-insurance program for small businesses.

"It will cost someone a lot of money," Sullivan says. "I just hope that someone is not me."

The money is proving to be the sticking point. Perdue wants to subsidize the $182 million program with federal Medicaid grants and $20 million of state funds. That amount of money could cover roughly 30,000 low-income workers out of a pool of about 380,000.

The idea of using government funds to pay for the plan is drawing criticism where Perdue needs support the most: under the Gold Dome.

"Entitlement plans are not the way to solve the problem," says House Rules Chairman Earl Ehrhart (R-Powder Springs). "If we really want to add something to this, let's have benefits for all taxpayers and let's do it through a tax credit, not through involuntary tax contributions."

Ehrhart says he doubts the General Assembly would approve Perdue's proposal without major changes.

Savannah's mental health hospital to remain open

The new director of a new state agency for mental health is wasting no time making his mark on the state's mental health system. Governor Sonny Perdue appointed Doctor Frank Shelp to head the new Department of Behavioral Health and Developmental Disabilities eight days ago. And today we learn that Shelp is reversing an unpopular decision to close a mental health hospital in Savannah

The decision last year to close Georgia Regional Hospital caused an uproar among local officials, who denouced the plan as a recipe for disaster. The plan would have left South Georgia without any place nearby to take the most seriously mentally ill patients. But that plan was made by the state Department of Human Resources. There's a new agency over mental health now, headed by Doctor Frank Shelp.

"I would say that it is a new course correction of about 35 to 40 degrees," says Shelp.

Shelp doesn't characterize the move to keep Georgia Regional open as a complete reversal because his vision for mental health keeps in place many aspects of D-H-R's proposal, known as "the game plan."

"The discussion became around closing a hospital or leaving a hospital open," says Shelp. "And that discussion reached such a level that it really precluded discussing other aspects of the game plan."

Shelp says, the plan was always to increase the continuum of care, such as with crisis stabilization programs, or C.S.P.'s, that promise more local services for most mentally ill patients, while none for the most seriously ill. Shelp says, a few patients might still be moved to the state's main mental health facility Milledgeville, but "the goal right now is to come up with a modification that will manage 95% plus of patient needs in their own region."

Shelp says, he's still developing plans for what to do with patients referred to the mental health system from the criminal justice system. He says, that part of the "game plan" was never fully explained. And just hearing that pleases advocates for the mentally ill. June Dipolito runs the Pineland mental health agency in Statesboro.

"I am excited beyond words," Dipolito says. "You cannot really run community mental health services without having the deep and intensive services of the acute psychiatric beds."

The new Commissioner of Behavioral Health and Developmental Disabilities currently works at Georgia Regional in Savannah. Frank Shelp is set to move to Atlanta by July.

Powered by Podbean.com