In a roundtable discussion on health care reform held by The Augusta Chronicle on the eve of an important election, Augusta hospital CEOs and physician leaders said the current system and the cost of treating the large number of uninsured can't continue.
Though there are misgivings and questions about aspects of the Patient Protection and Afford- able Care Act passed this year, they think repealing it will be difficult and eliminating key parts while retaining others could make it worse.
Even places where the problem of treating the uninsured has historically not been a major problem are seeing a greater burden because of the economic downturn, said Jim Cruickshank, the CEO of Trinity Hospital of Augusta.
"You've got more folks out there that are not working, unemployed, their COBRA benefits have run out, unemployment has run out and they just don't have the wherewithal, the financial means to pay for that bill after they've incurred it," he said.
"We see probably double the charity and uninsured that we've seen over the past couple of years," said C. Shayne George, the CEO of Doctors Hospital. "Definitely, that is an indicator, I think, of the economy."
Even those with health insurance sometimes have deductibles as high as $2,500, which can make collecting difficult for a physician office, said Dr. Phillip Kennedy, the CEO of the Center for Primary Care and the president of the Primary Care Association.
"That is essentially uninsured when they walk into our office," he said.
Overall, the cost of treating the uninsured, who might have put off preventive care until the problem is worse and more expensive to treat, is affecting everyone, said Dr. Ricardo Azziz, the president of Medical College of Georgia and the CEO of MCG Health System.
"Regardless of who wins or loses (today), that looming problem of increasing health care burden, increasing number of uninsured that are helping to drive the cost of health care for all of us, that will have to be addressed," he said. "And neither party will be able to turn back and not face that problem."
Despite calls for repeal, it seems unlikely, at least until after the next presidential election, said Dr. Jacqueline Fincher, of McDuffie Medical Associates in Thomson and the governor-elect of the Georgia chapter of the American College of Physicians.
"You can't get past a veto from the president," she said. "But they could defund it. And I think that's the concern because obviously there are many good things that were in the bill. There was also a lot of other things that I think many of us around this table were concerned about."
If the bill goes away, hospitals are still stuck with $155 billion in cuts that will still be in place, said Jim Davis, the CEO of University Hospital.
"If we continue to have growing uninsured, still have the $155 billion in cuts, it is going to put tremendous strain on the hospitals in the country to continue to provide care," he said. "There's a lot at stake there."