Augusta needs Medicaid expansion, and so does Georgia

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According to a Georgia State University report released recently, there is a relatively painless way to add 3,843 jobs in the greater Augusta region: expand Medicaid using predominantly federal dollars. But Georgia is one of a number of “red” states that are holding off doing so for primarily political rather than economic reasons.

According to a Kaiser poll, the majority of the country, 56 percent, wants the Republican party – my party – to get out of the way and permit the 2009 Affordable Care Act (Obamacare) to be smoothly implemented at long last. The voters are rightly tired of the constant bickering and partisanship that typified the last election and Congress.

VOTER DISILLUSIONMENT with political theater is why the 31st vote for repeal in the Republican House last year was counterproductive – as were Gov. Nathan Deal’s announcement at the Republican National Convention that he would not endorse the expansion of Medicaid in Georgia, and his more recent pronouncement that he would not set up a state insurance exchange. The feds will just set up the exchange, but Medicaid is another story.

Per a recent Supreme Court ruling, the Medicaid expansion provision of the Obamacare is now voluntary for each state. The feds cover 100 percent of the expansion expense for the first three years, falling to 90 percent permanently after a few more years.

Not surprisingly, expansion is being resisted by many GOP-controlled states where many of our poorest citizens without coverage reside. These are the very areas that need expanded coverage the most. Georgia, for example, has 22 percent of its population uninsured. Nearly half of our 1.5 million currently uninsured Georgians would be covered if we accept the federal government’s money to expand Medicaid.

The head of health policy for the Georgia Budget and Policy Institute said that Georgia’s $19 billion budget would only increase 2 percent by expanding Medicaid coverage under Obamacare.

Is this too much of an expense? Not when you consider that our hospital’s expensive emergency rooms already are seeing many of these lower income patients for free.

Well, not really for “free” – the expense is just transferred to those of us with insurance who do pay the hospital bills, and to Georgia’s taxpayers who pay for indigent care at their local public hospitals through their ever-increasing county property taxes. But when did fiscal rationality enter into politics?

MANY GOVERNORS turning down the Medicaid money are simply ideologues. They were so self-deceived that before the election they predicted an imminent Republican health-care revolution through Medicare vouchers and Medicaid block grants.

Medicare vouchers, promoted by Republican U.S. Rep. Paul Ryan of Wisconsin, just dump the cost increases onto the patient versus the government. There is no systemic change.

Medicaid block grants, still advocated by a Deal spokesperson, simply provide a way for states to cut services and beneficiaries, negatively affecting health-care delivery to the elderly and the poor who already have the worst health status of all Americans. For example, 55 percent of the patients served by Children’s Healthcare of Atlanta are on Medicaid. Do you really want to see them suffer because of fiscal shenanigans?

Because of the election, there is virtually no chance that Obamacare will be repealed or dramatically changed. So it is high time that we get with the program and evaluate the true costs and benefits of Medicaid expansion in Georgia.

Bill Cutler of Georgia State University did just that in his recent report. Dr. Cutler found that from 2014 to 2043 our state would get more than $40 billion in federal funds through Medicaid expansion. The economic activity related to the expansion would generate $275 million each year in local and state sales taxes. This is understandable when you examine the new jobs created – more than 70,000 statewide. And these are permanent private-sector jobs, not government, jobs.

GOV. DEAL SAYS that our share of the Medicaid expansion averages $400 million a year over time. Understandably, this upsets the single-issue “no new taxes for any reason” Tea Partiers. And that entails a political risk. But when you look at the benefits, the money coming into our state, the jobs created and the taxes brought in, the right choice should be obvious to our governor. Let’s hope he does the right thing.

(The writer, a former director of health planning for the state of Georgia, is a retired senior vice-president of a publicly held health-care company. He lives in Monticello.)

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ymnbde
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ymnbde 03/24/13 - 06:59 am
4
4
who needs a doctor when you can get access to a bureaucrat?

People go to emergency rooms because our education system doesn't teach them skills to get a decent job. The federal government will do to health care what they did to education. We don't educate enough doctors. It's that simple.
Oh, and i thought we were having a fire drill, but then i realized it was just the "conflict of interest" siren.

Bodhisattva
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Bodhisattva 03/24/13 - 07:49 am
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A perfect world. Everyone has

A perfect world. Everyone has an advanced degree and seeks a high paying job with a great benefit package. Who picks up the garbage? Who serves you at a restaurant? It has never happened and it never will happen. It has nothing to do with the education system. Who pays when hospitals care for uninsured patients that can't pay? We do with increased insurance costs and increased health care costs. The hospitals aren't generous enough to just eat the losses. Many rural hospitals will be history without the Medicaid expansion. I would say the old saying, "You can pay now or pay later." holds true here but, like it or not, the Affordable Care Act is law and we'll be paying now and paying later. The taxes are paid whether Georgia joins the system or not and we'll also have higher health care cost to cover non-reimbursed care. A lose-lose situation thanks to political theater by "Honest" Nathan.

ymnbde
11483
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ymnbde 03/24/13 - 08:11 am
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the main liberal problem

is that "good" is the enemy of perfect. Our health care system can absorb a certain amount of free care, but the current amount is unsustainable. It is unsustainable because our education system isn't educating, and people are simple herds of votes to be supported by taxpayers.
Oh, Bodhisvatta, surely you can see. We don't need a total takeover.
We just need more doctors and more competence. Saying anything less than perfection is bad is... well, not supportable.

deestafford
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deestafford 03/24/13 - 08:54 am
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1
When will the phrase, "We ain't got no money" sink in?

Tell me any prediction agency/group that has made a forecast of lower cost coming as a result of some policy or legislation be correct? I venture the answer is never.
As far as the state not taking the feds up on their paying for medicaid intitially and decreasing its share over time is concerned. It will sink the states in the future. Medicare is beginning to push the state's finances under water and jumping in with Washington on an additional expansion is ludicrious.
It would have been so simple to "fix" our medical problems. Just eliminate the restriction of buying health insurance across state lines; eliminate mandatory coverages and let the people pick what they need ala carte; institute looser pays tort reform; and establish tax-free health savings accounts (HSA). Of course, none of that was discussed by the liberals because it would reduce much of its power and ability to get more people dependent on the government's teat. Don't forget that they think we are stupid and can't take care of ourselves.

dichotomy
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dichotomy 03/24/13 - 10:39 am
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This idea that a 2% increase

This idea that a 2% increase in our budget...and consequently an increase in OUR taxes.....is okay is the kind of thinking that is killing those of us who PAY the taxes. "Oh, it will create jobs" is always the answer but somehow it never does, and the welfare, SSI, food stamp, and Medicaid rolls keep growing because we keep offering them a better deal. Meanwhile the taxPAYERS are stuck with the 2% increase for this, and a 4.9% increase for that, and a sales tax increase for the roads, and, if you actually PAY you medical bills a 3% increase on your medical devices. This line of thinking that federal or state budget increases, more taxes, and more spending on give away programs are somehow good for the economy....good for the taxpayer.....is simply crap. Everyone, even the Democrats and the CBO, are already admitting that Obamacare is a BUST at controlling or lowering the cost of medical care. They already know that the federal government is not going to be able to afford even the 90% that they promised and many of the states know that they cannot afford the 10% and that the feds will most likely figure out how to get out of paying their 90%.

And as for the "created job" projections......I don't believe a bit of it. ALL of those people are getting some kind of medical care now, even if does begin in the Emergency Room. Expanding Medicaid will not create a noticeable amount of jobs compared to the additional cost to the state budget and the TAX INCREASE the rest of us would have to suffer to pay for it.

Obamacare has ALREADY FAILED at every promise it made and things just go downhill from here. Mainly, it's already proven that the costs will NOT BE REDUCED and that the CARE WILL GET WORSE. Obamacare has tuned into a monster nightmare. I'm glad Deal decided to keep the monkey on the fed's back instead of the GA taxPAYERS.

Little Lamb
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Little Lamb 03/24/13 - 11:28 am
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Selfish

My, my, aren't we self-serving today, Mr. Bernard? Your generous pension is being paid by a health-care company which presumably gets money from Medicaid reimbursements. Of course you want to see an expansion. Most of us working stiffs want to see a contraction in Medicaid benefits and especially in Medicaid beneficiaries.

rmwhitley
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rmwhitley 03/24/13 - 12:57 pm
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Where do these
Unpublished

"idiots" come up with the idea it's "federal money"? Don't they have a clue these funds come from the hard working 53% that don't suck the life out of America? This nanny state, (pushed by the likes of the naacp, obama, biden, pelosi, reid, sharpton, jackson, clyburn ad nauseam) teaches welfare families that work is disgraceful. Why not have these slackers, who haven't had a working member in their families since lyndon baines johnson gave them a free ride in 1964, clean highways, disaster sites and the like to earn their welfare checks? Minorities, who disproportionately represent the most welfare recipients per capita, are constantly told and say themselves that they deserve these "reparations" due to the injustices committed against them. To them I say, Get a Job.

carcraft
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carcraft 03/24/13 - 02:57 pm
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3
Taxes going up, health

Taxes going up, health insurance premiums going up, cost of medicine and medical devices going up along with increase in federal deficits related to health care! Well it was ok for Obama to lie and we stuck paying for his lie! Doctors are refusing Medicare patients now because the compensation is so low so I am sure if we add more patients Doctors will treat them and they won't show up in the ER right?

carcraft
31252
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carcraft 03/24/13 - 03:05 pm
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The writer of this editorial

The writer of this editorial acts like federal dollars are grown in a secret garden in DC and have no impact on any thing else going on! The only way the US government gets dollars is by first taking them from some one else and doling them out or printing them! This isn't "free " money it cost some one. 40% of every dollar spent is barrowed and added to our debt!

DanK
820
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DanK 03/25/13 - 12:44 pm
1
1
Tax dollars

Georgia (like most states controlled by conservatives) receives significantly more money from federal funds than Georgians pay in federal taxes. Deal's decision to pass on the federal dollars reduces the burden of Georgia on the wealthy/successful (liberal) states. Unfortunately, the ideological obstinance of Deal simply hurts the elderly and the poor of Georgia, who those liberals were willing to help with their tax dollars.

Bodhisattva
8803
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Bodhisattva 03/26/13 - 04:26 am
1
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Loser pay tort reform? A

Loser pay tort reform? A doctor botched your operation. You have a lawyer on contingency. They have 20 lawyers at $200 an hour each. They'll bill for about 16 hours a day, even if they're playing golf or at the club. You win, you get maybe enough to keep you living and cover additional medical care. Of course they'll tie up the settlement for years. They win, you lose everything. Why should only doctors and hospitals get an out for limits on negligence. Let's just have a total no-fault society. You can drive 100 mph and runs folks off the road. Start shooting a few hundred rounds in the air every day. No one is responsible. Grand idea. I'll get the AR ready and warm up the car.

Bodhisattva
8803
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Bodhisattva 03/26/13 - 04:52 am
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Total takeover? You're

Total takeover? You're joking, right? I'd love a single payer government system for all but this isn't it. Still have your private insurance through your private insurance company. Everyone is mandated to have some kind of insurance or pay a penalty. Private hospitals and private doctors get paid when everyone goes to the hospital whether from private insurance, Medicare, or Medicaid. Where's the takeover?

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