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Monday, August 27, 2007
Health care 101: Non-emergencies don’t belong in ER
The Atlanta Journal-Constitution
A place where reporters are assembled should ordinarily be a place to commit news. But Georgia Lt. Gov. Casey Cagle’s speech last Thursday to the Atlanta Press Club generated relatively little — page 5 in the local news section — for a health care proposal loaded with merit.
Most intriguing in his approach is that it does place the emphasis where it belongs: on the individual and in the private sector. Its promise, conceptually at least, is that a decade from now the momentum it spawns will be revolutionizing a consumer-driven health care system, not advancing the national creep toward HillaryCare. It’s a baby step, but a baby step in the right direction.
Components would be an effort to divert non-emergencies from emergency rooms, expanded information so that insurance consumers could make better, more appropriate purchasing choices, and competition.
“Over 20,000 Georgians visited the emergency room last year with dental problems,” said Cagle. “The top condition treated in Georgia’s emergency rooms last year was an upper respiratory infection — mainly just a cold.” Treating that cold at a doctor’s office could cost $100; at the emergency room, $1,400. Non-emergencies added $33 million to emergency room expenses last year, he said.
His proposal would be to create something he calls Safety Net Clinics for indigents, something similar to the clinics for paying patients now being added by chains such as Walgreens, Publix and CVS, which has 224 MinuteClinics across the nation and is opening 28 in the metro area.
Like any good conservative about to create a spending program with strong potential to grow, Cagle intends five pilots, staffed by physician-supervised nurses and physician assistants that would be open seven days a week. The Department of Community Health would draw up a list of the most common ailments inappropriately taken to emergency rooms, and those would be treated at the clinics, which are intended for indigents and the working poor who earn less than 300 percent of the federal poverty scale. That’s about $62,000 for a family of four. Treatment would not be free. Co-payments, based on income, would be required.
The clinics would be supported with a combination of charity, volunteers and taxpayer funding. Physicians would earn tax deductions for volunteering.
The model for Cagle’s proposal is not CVS, but the Good News Clinic in his hometown of Gainesville. Organized in 1991 by Suzy Hall, it’s since grown to the largest in Georgia, seeing 20,000 patients a year, he said.
While it’s not a part of Cagle’s proposal, emergency room fees for non-emergencies should be sufficiently high to direct the routine aches to the clinics.
A second part of his proposal is to expand the information through a Georgia Health Marketplace, an expanded state Web site that would allow insurance companies and physician groups to market their coverage options directly.
The state should gather and pour out tons of available information on the health care system, including costs, outcomes and every other bit of information that will drive competition by informing consumers, some of which it’s doing already.
The next step, then, is to increase affordability, by allowing consumers to shop for policies across state lines, free of mandates interest-groups have coerced state legislatures into adding on. Mandates add between 20 percent and 45 percent to the cost of policies, according to actuaries with the Council for Affordable Health Insurance. Allowing individuals to deduct health insurance premiums from their state and federal income taxes, as businesses can do, and making coverage portable is vital, too. But real reform here requires Congressional action.
Cagle does propose that policies sold here would be portable, meaning workers would own the policies and be able to take them to new jobs without being concerned about not being able to get complete coverage there because of pre-exising conditions.
The proposals, he said, allow “people to make educated choices based on personal need.”
Make no mistake.
We are in a race between HillaryCare and solutions like those Cagle proposes.
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Help the Dems find a bumper sticker
The Atlanta Journal-Constitution
Sometimes the best ideas come from people outside Washington, says Democratic political strategist James Carville. So help. Please.
“We need a turn of phrase that really jumps out and tells you right off the bat what this election is all about,” said Carville, who’s credited with providing Bill Clinton “It’s the Economy, Stupid.” The Democratic Senatorial Campaign Committee wants a bumper sticker phrase that describes the stakes in the ‘08 election. The bumper-sticker phrase would also appear on its literature.
The DSCC has four suggestions with a voting deadline of midnight tonight. Those include: “W is Out: Send the Right Wing With Him,” “No Republicans Left Behind in D.C.,” “What Have Republicans Done for You Lately?” and “2006 Was Just the Beginning: More Dems in ‘08.”
Having read Washington’s work effort, all of us should fully understand the call for the nation’s help. So let’s do it.
A colleague starts it off. His suggestion: “Death to America.” Another option: “George Was Right (McGovern Not Bush).”
I am more charitable. My suggestion, drawn from the Baptist hymnal: “I Surrender All” The song had such a powerful influence on the life of its author, Judson W. Van DeVenter, that he decided to change careers, becoming an evangelist. This bumper sticker could be career-changing for Senate Democrats, too, especially when it sinks in on the nation that this is their Iraqi policy.
