Gov. Sonny Perdue wants the state to stop accepting additional federal matching funds to help poor folks pay medical bills. He wants the lame, the old and the destitute to dig a little deeper.
That must mean the governor is at the end of his rope. Georgia is running out of money and time to straighten out the lingering Medicaid mess. The feds have been paying Georgia $1.53 for every $1 the state spends on Medicaid. Looks like a good deal -unless you don't have any more dollar bills to put up.
Or unless federal investigators are breathing down your neck and asking embarrassing questions about why Georgia can't seem to get its act together. And why the Medicaid books don't balance.
This is no small matter. At last count, 1.5 million poor and disabled Georgians depended on Medicaid to pay for doctors, hospitals and medicine.
Three years ago, the governor promised a new day for Medicaid. Perdue vowed that he would bring in a managed-care outfit to dispense help and get the ledgers in order.
Nothing much has happened since. The state has cut funds for many old folks in nursing homes. It also has removed some needy kids from PeachCare, the insurance program for the working poor. (PeachCare is not Medicaid, by the way.)
The feds want more action. Washington seems to think it would be a good idea to give Georgia a lump sum for Medicaid and forget about new matching money for each recipient. Good idea for the feds. Bad idea for Georgia.
The state population is soaring. Many newcomers are indigent. The Medicaid rolls also are increasing as factories close and joblessness goes up. When the new poor get hurt or sick, they apply for Medicaid. A federal grants program would run out of steam quickly as thousands of fresh Medicaid recipients enter emergency rooms all over the state.
Perdue's way out of the predicament: Charge the poor more. For instance, a Medicaid recipient now pays a maximum of $3 per prescription. Perdue's people would like to increase substantially the patient's share of pharmacy costs. (An average prescription in Georgia costs $57.24.) In fact, there would be across-the-board increases in copayments for medical help. The state also would provide incentives for more home care for the elderly and the crippled to replace hospitalization and nursing-home care.
The governor says that under his secretly-devised plan recipients would have greater choice of doctors and healthcare providers. He also says the state would grade Medicaid providers on the quality of their services. Leaders of the Georgia medical community expressed shock and indignation at that idea. They say the plan may cause even fewer docs to accept high-risk Medicaid patients.
To some, the Perdue proposals sound like a Catch-22. If a Medicaid recipient has enough wherewithal for adequate home care or extra cash for higher co-payments, he or she probably wouldn't qualify for Medicaid in the first place. They would be too rich, in relative terms, for the program. Besides, they could likely find a better deal with a private insurer.
On the other hand, if these folks living on the edge can't take care of a sick mom or pop at home and don't have enough funds for higher copayments, then they probably will not get Medicaid help.
Said Lt. Gov. Mark Taylor, "These massive, unprecedented cuts will toss people out of nursing homes, cause doctors to abandon rural and other underserved areas of the state, and throw hard-working families into bankruptcy. Our state government cuts families' heath care while spending taxpayers' money to remodel offices for big shots in the state Capitol. Something is very wrong here. What is Gov. Perdue thinking?"
To be sure, Gov. Perdue apparently is thinking that he has a terrible problem on his hands. We want to be helpful. The governor may have overlooked calling on some of the greatest experts in the healthcare field -men who could show him the way on Medicaid. These wizards are right here in our congressional delegation, just a phone call or an e-mail message away.
What other state can boast of having two medical doctors and two trained dentists among its representatives? Dr. Tom Price, R-Roswell, came from one of the best-known orthopedic groups in the South. Dr. Phil Gingrey, R-Marietta, said he delivered 2,500 babies in his pre-politics career. Former dentists John Linder, R-Duluth, and Charlie Norwood, R-Evans, must have pulled, filled or replaced a million teeth.
Because of their experience, these fellows have to be among the most knowledgeable experts in the land. They know the score on Medicaid from the reception room up. They may even know more than former Speaker Newt Gingrich, whom the governor did consult.
Undoubtedly, Georgia's congressional medics would be happy to help Perdue find a less painful remedy for the Medicaid malady, just to pass the time. It might break up the awful drag of leaving an exciting medical/dental career only to find yourself reduced to rubber-stamping White House directives over and over -on everything from fighting the war in Iraq to combating stem-cell research at home.
Syndicated columnist Bill Shipp writes on Georgia politics. Write him at P.O. Box 440755, Kennesaw, GA, 30160 or e-mail firstname.lastname@example.org. His Web site is www.billshipp.com. His column appears on Wednesday and Sunday.