By Jack Bernard
The (Macon, Ga.) Telegraph, September 20, 2018
Georgians self-report poor/fair health at a much higher rate than Americans in general, 19 percent to 16 percent. Georgians are correct based on objective morbidity factors (University of Wisconsin “County Health Rankings and Roadmaps”) as shown below. Even more important to a Telegraph reader, Bibb County is significantly worse than the rest of the state, ranking 143 out of 159 counties on statistical health outcomes and 98 on general health factors.
A major reason for Georgia’s poor health status is that our rate of medically uninsured (younger than 65) is 16 percent, much higher than the national average of 11 percent. This dismal situation was caused by the failure of our state leaders to accept Medicaid expansion via the Affordable Care Act (Obamacare), although 90 percent of the cost of expansion is paid by the federal government. But, the long-term solution is Medicare expansion, not Medicaid.
I’ve pulled two indicators to illustrate how our state falls short: (a) Premature deaths for the U.S. as a whole are 6,600 per 100,000 versus 7,500 per 100,000 for Georgia. The low birth weight rate for the USA is 8 percent versus 10 percent for Georgia.
On the provider end, The Medical Center of Central Georgia and other hospitals that serve a disproportionate number of medically uninsured have high levels of bad debt, causing medical price increases for Bibb’s private pay patients. Also, due to indigent care, many of Georgia’s public hospitals are asking for increased subsidies paid for from local taxes.
The bottom line is that Georgia is a less healthy state, and Bibb is even more unhealthy. Clearly, providing health insurance to more Georgians will have a greater positive impact on Bibb citizens versus the state as a whole. And that is the reason that single payer (Medicare for All) should be supported by all Bibb taxpayers. But it is not because of deliberate misinformation, some of it by health professionals.
Medicare is one of the nation’s most efficient and popular programs, having an overhead of just 2 percent versus an average of 12 percent for private insurance. Few conservative Americans older than 65 believe that their Medicare represents socialism. All providers are private, as will be the case when it is finally expanded.
Countries with single payer and similar systems all provide universal care at a fraction of the cost here while covering everyone.
All have better healthcare outcomes. Some of this is undoubtedly due to a healthier lifestyle. But, I doubt that all my distant relatives in Naples and Paris turn down second helpings of food while bicycling to work daily.
It is a real pity that the word “socialism” scares politicians who would otherwise endorse Medicare for All. Trump repeatedly endorsed single payer until he became a politician.
Health coverage and cost are not problems that will resolve themselves via minor changes. Thirty million folks are still uninsured. Since my time as director of health planning for Georgia, national expenditures on health care as a percent of GDP has risen from 8 percent to over 18 percent. This situation has meant less money for infrastructure and education.
But, there is hope long term. The majority of Democrats now supports single payer. Someday, so will the GOP. If for no other reason than cost, change will inevitably come. At that point, hopefully health status for Bibb residents will improve.
Jack Bernard, the first director of health planning for Georgia, has been an executive with several national health care firms. A Republican, he’s a former chairman of the Jasper County Commission.