health care

The bad economy and high unemployment are affecting hospitals in small towns like Millen. With so many people out of work, few people there have insurance. Jenkins County Hospital is increasingly treating poor people who can’t afford care, absorbing the costs and causing thousands of dollars in shortfalls. "The hospital is a vital part of the community, and a vital part of helping draw new industry and we need to keep it there and keep it strong," says King Rocker, the mayor of Millen. "Really and truly the only thing that can help that is some new industry to help put people back to work." The small hospital already can’t afford to do procedures such as colonoscopies or minor surgery. Full-time employees have a bigger workload since the hospital laid off all part-time staff a couple of years ago. Funding from the Jenkins County commission has helped plugged the hospital's shortfalls. Hospital officials, however, say they'll make another request for more dollars sometime during the current fiscal year due to the budget woes. Rocker estimates that only half of Millen's residents have health insurance. Hospital officials say the number of people with full-coverage private health insurance is far smaller, with most of them being teachers or state employees. The unemployment rate in Jenkins County in January was 21.8 percent, one of the highest in the state.

As Congress nears a possible health care vote two Georgia Congressmen, Sanford Bishop and John Barrow, are still in the undecided category. The margin is razor thin and the lobbying intense on both sides. In Bishop's Second Congressional District the constituent's opinions are as diverse as the population. In Byron 72-year old Marshall Scott sees plenty wrong with the Senate bill and he doesn’t want it. He’s called and emailed Bishop's office and he’s not alone. “All my friends and associates at church and so forth, I’m an assistant Sunday school teacher at our church, most all the men in there, they’re against it.” Scott says if Bishop votes yes he’ll work to get him out of office. About 89-thousand people in the Second Congressional District Are uninsured. Johnnie Zanders lives in Fort Valley and puts on community health fairs. She’s hoping for a yes vote from Bishop “I think this would be a positive step because everybody seem to be included and I know there’s some issues that some people don’t want to be included, but sometimes it’s a trade off.” Some Republican candidates are getting ready to challenge Bishop should he support President Obama’s health care bill.

Today Georgia Democrats in the Senate defeated a Republican move to send a message to the Obama administration against healthcare. Georgia is one of 38 states where Republicans are pushing a constitutional amendment that would allow the state to opt out of any federal health care mandate. Republican Senator Judson Hill says Republicans in the Georgia Senate want freedom of choice. "We stand united at least within the Republican Caucus to say your health care and your health care freedoms of choice are critically important. " But the amendment was defeated because Democrats voted against it and prevented the needed two-thirds majority. Senate Minority Leader Robert Brown says the amendment was only meant to poke the eye of the federal government and would end up in court. He says Democrats stuck together. "It was a very clear message. Let's focus on the things that are important to the people of Georgia...and let's not get distracted by this frivolous kind of legislation. " But Republicans aren't giving up. They're pushing a bill with similar implications. And that bill would only need a simple majority.

Another sobering day for committee lawmakers is ahead Tuesday at the state Capitol as budget hearings continue. In front of the microscope today will be education and health care in Georgia. Meetings of the joint House and Senate Appropriations committee began Monday as Georgia House and Senate leaders try to balance the state’s spending plan. It’s an unprecedented move to hold the joint House and Senate committee hearings as lawmakers joined forces to question agency heads this week. They are nitpicking budget line items as they try to deal with a more than $1 billion shortfall. Representative Chuck Martin, co-chair of the committee, had this warning for agency heads before their testimony. “This is not personal, this is not anybody questioning your professionalism, but we're in a very difficult time here in Georgia. We are frankly in a position where we have to do more for the same or less money." One political observer noted that budget writers look like they're haggling over crumbs and may need to bite the bullet and raise taxes if the state's revenue numbers don't improve soon.

A first-of-its-lind county-by-county look at national obesity rates finds a wide swath of Georgia with obesity rates exceeding 30%. The study from the Centers for Disease Control and Prevention is the first to give county-level snapshots of obesity across the country. It finds, the Southeast, Appalachia and tribal lands in the West have the nation's highest obesity rates. In Georgia, huge sections of East, Central and Southwest Georgia have obesity rates exceeding 30%. The mostly rural areas correspond with areas of high rates of diagnosed diabetes and high rates of poverty. The state's worst obesity rate is Terrell County's 34.9% percent. Metro Atlanta and the coast fare better. The lowest rate is Fulton County's 22.8% percent. The study suggests focusing diabetes prevention efforts on areas that need them most. To look up and compare your county's obesity rate to the rest of Georgia and the nation, click this link: http://apps.nccd.cdc.gov/ddtstrs/ To see how obesity relates to poverty, click this link: http://www.poverty.uga.edu/maps/

U.S. Senator Johnny Isakson says the health care bill passed in the House won't even be debated in the Senate. Isakson was in Macon to speak to a gathering of realtors. While still basking in the glow of his role in extending the home buyers tax credit he says the discussion is now shifting to health care. Democratic Senator and Majority Leader Harry Reid filed legislation this week that could allow the Senate to begin wrangling over health care legislation as early as next week. Isakson says he expects what he calls a, "long and loud debate." "They don't have the votes to even start the debate much less get a vote on final passage. So, it's going to make for an interesting Christmas holidays. I think the United States Senate will be in session the rest of the year." Isakson calls the House passage of health care legislation a rush to judgment. He says the Senate needs to step back and take a step by step approach before making any fundamental changes.

Georgia Congressman Jim Marshall says he will not support any of the current proposals to reform health care. According to the Macon Telegraph, Marshall is the first member of the Blue Dog Coalition to make such a definite statement. The 8th District Democratic congressman says none of the plans, currently under consideration, address the issue of rising costs. Speaking on Fox News Marshall said fundamental changes are needed in the way we pay for Medicaid and Medicare. He went on to say that systems that are centrally planned and paid for, like the Soviet Union's system, cannot address issues of waste and fraud. He said the current system will eventually bankrupt the government.

While about 300 Georgia physicians are gathing in Savannah this weekend, their attention will be on the national health care debate in Washington. The Medical Association of Georgia represents about 4,000 doctors and is one of the most vocal state medical associations that have come out against Democratic plans for health reform. M.A.G. President Todd Williamson says, the group opposes the public option and any individual or business mandate to buy health insurance. "The main way to control costs is to make sure that the patients is involved in their medical care decisions at every point and empowering the patient to direct their medical dollars," Williamson says. M.A.G. supports Republican ideas for health care reform. At least four Georgia Republican Congressmen are expected to attend, including U.S. Senator Johnny Isakson. Liberal groups protested an Isakson appearance in Atlanta on Wednesday because of his opposition to the public option. The doctor's meeting lasts through Saturday.

The Senate Finance Committee has passed a health care bill relying heavily on membership cooperatives. A half million Georgians have electricity from member-coops. But some Georgia health providers say, extending health care isn't as easy as extending electricity. On a dusty stretch of road in rural Liberty County, Mike Foreman and his crew are installing a new electric line. It starts with lifting a 17-ton concrete pole with a crane and tipping it into a hole the width of a car. "Okay, we're going up with it," Foreman shouts, as the 100 foot pole dangles precariously above workers' heads. A lot can go wrong in the process. "A big crane like that sure makes it look easy," Foreman says. For Democrats, fixing health care is starting to seem like a precarious balance frought with heavy lifting. But if you want to take this power line image farthest, ask Mark Bolton how he thinks health care reform should go. Bolton is Vice President for Marketing for the company installing the electric line, Coastal Electric Membership Cooperative. "When I first heard the health care debate, I turned to my wife as we watched television and discussed politics," Bolton says. "And I said, 'The ideal solution to this is the cooperative business model.'" Electric Membership Cooperatives have electrified Georgia since the 1930's. They're basically small and non-profit electric companies. They serve rural areas. The Senate Finance Committee used them as a model for reform. Bolton says, the relevance of E.M.C.'s to health care is how they lower costs and extend coverage by forgoing profit. "We don't have to balance what is best for the customer with what is wanted by the stockholder," Bolton says. Bolton says, small E.M.C.'s also lower costs by joining forces on the state and national levels, to make power, for example. But whether health coops can lower health costs isn't a simple question. Many Georgia health providers say they're confused by health coops. Two Savannah hospitals and two Savannah doctors groups all passed on commenting for this story, saying, they had no clue what health coops are. Providers appear to be waiting to take their clues from industry spokesmen, like Kevin Bloye of Georgia Hospital Association. "There's just been so few details released," Bloye says. "It's really hard to comment." A Georgia doctors group, however, is openly skeptical. The Medical Association of Georgia's Todd Williamson says, he doubts coops get to any real means of cost containment. He supports Republican ideas for health care reform. "The main way to control costs is to make sure that patients are involved in the first dollar that's spent, and the last dollar that's spent, and all dollars in between," Williams says. Armstrong Atlantic State University professor Joey Crosby also doubts cooperatives can control costs. He's been following health care policy and prefers a more comprehensive change. He says, not even the public option goes far enough at bending the cost curve. "The 800 pound gorilla in the room is changing the culture of the way care is provided," Crosby says. It's still unclear if coops will be in a final bill. Democrats may push for the public option. If that happens, Georgia doctor and hospital lobbies say, they'll fight it with every kilowatt they have. Links to more information about Cooperatives: National Cooperative Business Association http://www.ncba.coop/ Letter to Senator John D. Rockefeller from NCBA http://commerce.senate.gov/public/_files/NCBACoopResponseLetter080509.pdf Senator John D. Rockefeller links to correspondence with his office http://rockefeller.senate.gov/press/record.cfm?id=317885 Senator Conrad Comments and Resources regarding Health Care and Health Care Coops http://conrad.senate.gov/issues/healthcare.cfm America’s Healthy Future Act of 2009 (Baucus) (Go to page 35) http://finance.senate.gov/sitepages/leg/LEG%202009/091609%20Americas_Healthy_Future_Act.pdf University of Wisconsin Center for Cooperatives http://www.uwcc.wisc.edu/info/i_pages/health.html Health Related Coops http://www.uwcc.wisc.edu/links/healthcarelinks.html Georgia Cooperative Development Center http://hosting.caes.uga.edu/gacoop/cooperatives.htm

A study by the Center for Medicare and Medicaid Services says the death rate for certain diseases at 14 hospitals in Georgia is higher than the national average. Three hospitals had a higher death rate for heart attacks while another three had a higher rate for heart failure, according to Hospital Compare, a Medicare website that allows people to compare the quality of up to three hospitals at a time. Nine hospitals had a higher death rate for pneumonia. The number includes a death rate higher than the national average for both heart attacks and pneumonia at the Medical College of Georgia Hospital and Clinics in Augusta. The survey only accounted for patients on Medicare, in their 60s or older. Kevin Bloye, a spokesman for the Georgia Hospital Association, says Georgia's rate of poverty and lack of education mean sicker patients. "That plays a major role when you talk about about patient care outcomes," says Bloye. "Those are sometimes factors that are outside the control of the hospital, and then of course there are some areas in hospitals that we need to do a better job." Bloye says hospitals across the state are working aggressively to improve patient care. While the hospitals are ranked low, that doesn't necessarily mean patient care is bad or dangerous. For instance at MCG, the death rates were higher, in part, because the health system accepts sicker patients, says Dr. David Snyder, a surgeon and vice president of patient care, quality and safety at MCG Health. Only about a third of the patients are on Medicaid as well. The hospital had 16,000 admissions last year. Meanwhile, the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality has rated hospitals and ambulatory care in Georgia as "weak," based on statistics from 2008. The report, meanwhile, ranked home health care as very strong. (Hear Dr. David Snyder discuss the Medicare study by clicking the audio link below.)