Saturday, March 20, 2004

As feared this past week Georgia Medicaid briefly ran out of money:

Georgia's health care program for the poor has run out of money, but that fact didn't bring legislative leaders to an agreement Thursday on a plan to bail out Medicaid.

The program's money dried up late Wednesday afternoon, stopping payments to doctors, hospitals and other medical providers who care for the 1.4 million Georgians on Medicaid. Payments for PeachCare, which covers uninsured children, also were suspended.

Doctors and other medical providers were frustrated, saying the holdup will persuade more physicians to limit the number of Medicaid patients they see --- or drop them altogether.

"Even if this is fixed, physicians will look at whether they will continue to provide Medicaid services," said Dr. Michael Greene, a family physician in Macon who is president of the Medical Association of Georgia.

Steve Barber, chief financial officer of Royston-based Ty Cobb Healthcare System, said: "It's incredible to me they let it get this far. It's not as if they didn't see it coming."

And the finger-pointing is proceeding at a rapid pace:

It's the House's fault," said Senate Majority Leader Bill Stephens, R-Canton. "They're picking politics over people."

House Speaker Pro Tem DuBose Porter, D-Dublin, laid the blame on the Senate. "Obviously, the Medicaid payments do not matter to the Senate," he said.

This isn't like Blue Cross running late on some payments. Physicians who have a high number of Medicaid patients in their practice cannot withstand a prolonged freeze on payments. Anything past a few days and there will be a problem meeting payroll. Nursing homes could also be hard hit:

It will pose "an immediate danger to the patients and the employees of Georgia's nursing homes," said Fred Watson, president of the association. "Many facilities will be trying to make payrolls tomorrow and next Friday. Some will have to make loans, and we suggest the state borrow short-term funds to get us through this crisis."

And while the money was found yesterday to fund the program, the pork projects that had been holding things up got passed as well:

Gov. Sonny Perdue and legislative leaders moved Friday to get the state's massive health care program for the poor and elderly back in business. Perdue released $57 million to Medicaid to allow the Department of Community Affairs to process health care claims over the weekend. The program, which provides health care to 1.4 million Georgians, ran out of money to pay claims late Wednesday.

The governor announced the transfer of money from the Department of Human Resources to Medicaid just after House and Senate leaders agreed on a mid-year budget adjustment that will provide an extra $171 million to the program. The spending plan, which also would provide more than $100 million in additional funding for fast-growing schools, will go to the full House and Senate for a vote Monday......Perdue blamed the budget roadblock on "silly, partisan political differences."

"A child needing insulin doesn't really care who's fault it is," the governor said. "A lot of this revolved around the trade-off for special projects and trying to take home pork to our districts when we didn't want to provide medicine for those who can't afford it. That's what offends me so much about this."

The mid-year plan approved Friday includes about $40 million in local projects using bond money from a West Georgia reservoir that was never built. The House and Senate split the money.

Among the projects are a park/museum in the hometown of Senate President Pro Tem Eric Johnson (R-Savannah), a golf course in the district of Senate Appropriations Chairman Jack Hill (R-Reidsville), and a dam project in the district of Sen. Don Cheeks (D-Augusta), one of the budget negotiators. Another $15 million would go for a land conservation program being pushed by Perdue.

This is one of the things about a state-sponsored single-payer system that concerns me. Do the physicians out there want their reimbursements conditional upon whether a legislator gets a golf course or dam in their district? Would anyone want the funds for their healthcare be the subject to political whim? Your representative displeases the party in power, and now the health budget in your district is cut, is this what we want?
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