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State of Health Care in Georgia. Is the Health Care system really broken? Here are few facts. You decide!!!!. State of Health Care in Georgia. 17% of Georgians are uninsured. State of Health Care in Georgia. 33 of 35 rural critical access hospitals no longer deliver babies!.
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State of Health Care in Georgia Is the Health Care system really broken? Here are few facts. You decide!!!!
State of Health Care in Georgia 17% of Georgians are uninsured
State of Health Care in Georgia 33 of 35 rural critical access hospitals no longer deliver babies!
State of Health Care in Georgia 12 hospitals have closed in Georgia since 1996. At least half dozen are at closures door today.
State of Health Care in Georgia At least a dozen times in the last two years rural hospitals came to within two days of not making payroll due to cash shortages!
State of Health Care in Georgia The state of Georgia only pays 85.6% of COST less interim payments adjustment and something complex called DRG rebasing so many hospitals only net 70%-75% of COST!!! Georgia added 2 ½ % to payments beginning July 1 2008. Medicaid typically represents 20%+ of hospital’s net revenue
State of Health Care in Georgia When the state pays at 85.6% of cost it cost shifts to the local population and the commercial insurance $250,000,000 worth of health care cost thus driving employer provided insurances off the scale
State of Health Care in Georgia Baby Boomer Bubble demands will out run capacity beyond any plan in place!
State of Health Care in Georgia Baby Boomer Bubble demands will out run capacity beyond any plan in place!
State of Health Care in Georgia Physicians are giving up hospital practices in droves creating a tremendous gap in health care continuity! Hospitalists replace admitting physicians.
State of Health Care in Georgia Physicians are significantly underpaid as well so they are closing their practices to new patients of certain categories – Medicaid etc or just retiring and getting out!
State of Health Care in Georgia Illegal Immigrants have stressed the system because Federal rules tell hospitals they must take them whether or not they can pay…… so hospitals go broke to no-pay patients with no way to get paid!
State of Health Care in Georgia Few hospitals have covered depreciation in the last 10-15 years so the capital infrastructure is wore out!
State of Health Care in Georgia The federal government is broke so it cannot pay Medicare and Medicaid at current rates – thus major cutting of payments – Cost Reduction Act of 2005
State of Health Care in Georgia Federal Government is privatizing Medicare and Georgia is privatizing Medicaid!
State of Health Care in Georgia Federal and State Governments are pushing health care to a local subsidy program. County’s either subsidize or lose to regionalization
State of Health Care in Georgia Local Business and employers cannot afford to pay health care for their employees creating a new category called underinsured
State of Health Care in Georgia Underinsured then become vulnerable to financial wipe out, bankruptcy or a lifetime of debt
State of Health Care in Georgia The list goes on, and on, and on, and on, and on, and on, and on, and on, and on, and on, …… You get the picture!!!!!
State of Health Care in Georgia So how did we get here?
State of Health Care in Georgia Several major contributors include but not limited to: Payment complexity Some hospitals now have to file claims into 20 different payor platforms with 20 different computer systems Gross Revenue concept is absurd State and federal government cutting what they setup
State of Health Care in Georgia Several major contributors include but not limited to: Entitlements for 1965 Great Society’s creation of Medicare Federal Gov. says if you take federal money you have to take all comers whether they can pay or not - EMTALA Politicians will not cut rolls due to bad voter response. Uncontrolled eligibility.
State of Health Care in Georgia Several major contributors include but not limited to: Technology Nobody wants to be treated with yesterday's technology so providers become capital competitors for Heart work, Imaging, Surgery at millions of dollars for a machine Software revolution – Digitizing – very expensive Electric Medicaid Record – Animal vs. human – Veterinarians do it right!
State of Health Care in Georgia Several major contributors include but not limited to: CYA Medicine Call for total package of tests every time just to make sure we are not sued Admit all chest pain whether we think its gas or not!
State of Health Care in Georgia So where does this lead?
State of Health Care in Georgia Bankrupt patients and employees. Assets wiped out. Become wards of the state where assets have to be exhausted before state will accept patient.
State of Health Care in Georgia Major productivity loss among employers and turnover due to no benefits
State of Health Care in Georgia • Employers go broke trying to fund health care – GM and Ford
State of Health Care in Georgia Demographic allocated health care prevails. Regionalized Health Care becomes norm. Medicaid within 35 minute drive or 40,000 population center to achieve 35% commercial patients
State of Health Care in Georgia Either – (depending on new president ) Universal Health Care that has no budget funding source other than tax or Higher deductible health much like house hold insurance.
State of Health Care in Georgia So what should the government and we as employers and or individuals do?
State of Health Care in Georgia • Government – Free Up EMTALA • Pay at cost of services/Tax increase • Allow full eligibility screening to reduce roles • Enact more TORT Reform to eliminate CYA Medicine • Simplify payment systems • Copy the Veterinarians
State of Health Care in Georgia Individuals Assume Responsibility for our own health care Adopt preventive measures Know that high deductibles are the way of the future Understand all alternatives to care Don’t use the ER as a primary care doc
State of Health Care in Georgia Employers Determine what it takes to be competitive for labor in the market place Adopt preventative and high deductible buy downs Implement HAS’s and high deductible plans Prepare for high subsidy support to offset uninsured
State of Health Care in Georgia Summary The Health Care Financing and access model in place is broke Medicare/Medicaid cannot be funded for recipients near the current age and rate A totally new delivery system will be in place tomorrow Wal-Mart Medicine Retail Regionalized HomeCare Digitized Patients will be forced to assume personal responsibility Employers will reduce their participation in health care OR go broke trying to provide it
State of Health Care in Georgia Summary The new medicine is “Do without Medicine!”
