What is more important to Georgia’s lawmakers — great access to great doctors and health care, or a cheap pack of cigarettes?
As a physician, I have asked myself that question for the last 12 years — the last time Georgia nudged the state tobacco tax from 12 cents per pack to a still-dismal 37 cents per pack, currently the 47th-lowest tobacco tax in the country.
We know cheap cigarettes are more accessible to kids and place a huge burden on our health care system. Numerous studies show 89 percent of adults who smoke today started before they turned 18. In other words, adults don’t start smoking; kids do. Kids are most likely to quit smoking, or never start, in response to a price increase.
According to the Centers for Disease Control and Prevention, Georgia spends more than $500 million per year in Medicaid funds treating tobacco-related disease.
Since the last increase in the tobacco tax, payment rates for doctors caring for Medicaid patients in Georgia haven’t budged, even as the cost to deliver that care has soared. These rates make it unaffordable for me and my primary care physician colleagues to accept more Medicaid patients, and make it very difficult for these low-income children, parents and elderly Medicaid enrollees to find a doctor.
If these people can’t find a doctor, they will go to the emergency room, the highest-cost center, for care that most likely could be handled in a primary care office at a much lower cost. For two years, the federal government equalized Medicaid rates to Medicare rates for primary care services, but that policy expired Dec. 31. Now, Georgia physicians are left holding the bag again trying to provide the same care with a 30 percent payment cut.
Rural areas like mine are disproportionately impacted by these low Medicaid and Medicare payment rates, in addition to the many poor and uninsured patients we treat at reduced rates. These issues, along with changing health care policies, are creating the perfect storm — causing the closure of at least four rural Georgia hospitals already, with another 15 to 20 hospitals on the critical list.
Just recently, a potential cure for all of these issues was discovered. It came in the form of a fiscal note requested by a state senator, indicating that Georgia could increase state revenue by $585 million per year by simply increasing our state tobacco tax to the national average. That’s right. Georgia can reduce youth smoking, improve Georgians’ access to high-quality, lower-cost primary care, and rescue our failing hospitals, just by having an “average” tobacco tax.
Perhaps one thing we can all agree on is that kids’ access to tobacco shouldn’t be easier than Georgians’ access to health care. A tobacco tax is just what this doctor is ordering. I hope our state lawmakers will “fill the prescription” so our state will get on the way to better health.
Dr. Jacqueline Fincher, an Atlanta native, practices in Thomson.
