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Gov. Nathan Deal says rural hospitals a critical need

The governor says the state is in need of additional health professionals.

Gov. Nathan Deal visits WellStar Cobb Hospital last year. (Special photo: Andrea Briscoe)

Gov. Nathan Deal visits WellStar Cobb Hospital last year. (Special photo: Andrea Briscoe)

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Gov. Nathan Deal, shown speaking last week at a rural caucus meeting, says in a Q&A with Georgia Health News that rural hospitals are a critical need in the state. (Special photo)

ATLANTA — Nathan Deal has been involved in many high-profile decisions on health care while serving as Georgia’s governor.

Deal, who is running for re-election this year, has staked out his opposition to the Affordable Care Act (often called Obamacare) and to expanding the state’s Medicaid program. He has also supported changes to the health plan covering state employees and educators, following a wave of criticism that occurred after a new benefits framework debuted Jan. 1.

Georgia Health News recently emailed questions to Deal on a wide range of major health care issues in the state. We received his reply shortly before the scheduled close of the 2014 General Assembly.

In his answers, he discusses pending legislation, the federal law on ER care, the financial struggles of rural hospitals, and what he sees as ways the state can improve its health care system.

Here are GHN’s questions and Gov. Deal’s responses:

Q: What is your biggest accomplishment as governor in the field of health care?

A: When Washington tried to levy the huge taxpayer burden that is the Affordable Care Act on Georgians, I could not allow for billions of dollars of our state budget to be diverted from our schools and our citizens. By mitigating that disastrous impact on our state — an additional 620,000 people on Medicaid rolls and billions of dollars — we are keeping our budget balanced and protecting the people of Georgia.

Q: As governor, you have blocked Medicaid expansion in Georgia. House Bill 990 would require legislative approval for any such expansion in the state. Do you support this legislation?

A: Yes, just the expansion of Medicaid would cost Georgia an additional $2.5 billion over 10 years. This will have major budgetary impacts so it only makes sense to have our state legislature play a part in the decision making process.

Q: Do you foresee any circumstances under which you would support an expansion of Medicaid?

A: No, not under current conditions. I am doing everything in my power to rebuild our school funding as we come out of the Great Recession. We simply cannot afford the $2.5 billion in new spending that the expansion would require without a severe impact on public education. The federal administration needs to start acknowledging the Supreme Court ruling and look at other alternatives that don’t force new spending by the state. I have often discussed the advantages of a block grant. States need more flexibility in order to make their program work for their unique population rather than a one-size-fits-all Washington mandate. When I was a congressman, I served as chairman of the health subcommittee of Energy and Commerce. The need for flexibility is not new to me, but serving in my role as governor has only reinforced the notion that states can operate more efficiently with flexibility.

Q: You recently commented that changes to the federal EMTALA law (requiring hospitals to treat arriving ER patients) can help reduce health care costs. Can you expand on those comments?

A: I have always been a supporter of promoting primary care and preventative care as opposed to emergency room visits for non-emergency circumstances. In the case of a true medical emergency, people should always have access to emergency rooms. However, for non-emergency situations, we should encourage those people to seek treatment in a more cost-effective setting, thus opening beds and reserving resources for those in most critical need. Because there is some confusion on this issue, let me be clear: No one’s going to be denied service. None. This isn’t about blocking doors to health services. It’s about opening new doors that yield better health outcomes at a fraction of the price of emergency rooms. The onus is on us to make sure these non-emergency resources are available and convenient to the populations in need of service.

Q: Four rural hospitals have closed in Georgia over the past two years. Can the state of Georgia do anything to prevent more from closing?

A: I recognize the critical need for hospital infrastructure in rural Georgia, as they save lives and maintain our communities. Hospitals large and small have all felt the impact of the recent economic downturn. While support that these hospitals received has diminished, I am hopeful that as the economy improves, so does the flow of funding and contributions that keep our rural areas thriving. We will continue to monitor the situation with the Department of Community Health.

Q: The changes to the State Health Benefit Plan that began in January have sparked a wave of criticism from educators, state employees and retirees. Will the pending switch to a co-pay system alleviate the members’ concerns?

A: The intention of those changes was to lower out-of-pocket health care costs for state employees. The SHBP already covered 100 percent of preventative care visits, and these improvements give employees an additional layer of security so they can do the right things to stay healthy. I believe the changes address the core concerns of our employees, but the Department of Community Health will continue to monitor and evaluate the situation.

Q: What can be done to improve the health care system in Georgia?

A: Since taking office, I have focused on the need for additional health professionals in Georgia. We have been increasing the number of residency slots in hospitals across the state. Georgia taxpayers help fund a promising young Georgian’s pre-K, K-12, post-secondary and graduate-level medical education only to see them perform their residency outside of our state and not return. That doesn’t provide value for Georgians paying taxes. It doesn’t make sense for Georgians needing care and it isn’t fair to young Georgians looking to begin medical careers. We must ensure that no doctor trained in Georgia is forced to leave the state to complete his or her medical education. There is still work to be done, but we are making strides on this front. Individuals in Georgia can also play a major role in improving their own health by being active in their healthcare decisions. This means taking advantage of all the preventative care opportunities to improve the well-being of themselves and their families.

Andy Miller is editor and CEO of Georgia Health News.