Geoff Duncan Releases Rural Health Care Plan Without Medicaid Expansion

Today, Geoff Duncan, Republican candidate for Lt. Governor of Georgia, released his rural health care plan. Duncan’s plan rejects Medicaid expansion as a “political solution that promises free health care in exchange for votes.”

Duncan states that “we have to get away from judging success by the size of the federal program. We should judge success by how successful we are.  In this case, better health outcomes come from local solutions.  Medicaid does not deliver the best health care.  Its appeal to the Left is that it delivers more power to government and more control over people’s lives.”

Duncan further stated that “when Congress founded Medicaid, it was a program to help poor women and their children and the disabled. But Medicaid’s huge expansion is now contributing to the national debt and straining Georgia’s budget. It has more waste, fraud and abuse than any health insurance program in the country.”

Duncan’s plan outlines four models:

  • Telehealth. From “seeing” a doctor on your smart phone to a specialist for a procedure via Skype at a local hospital, telehealth makes health care more accessible and affordable to Georgians as it reduces the cost of infrastructure and creates real-time interaction between doctors and patients. In rural communities, telehealth provides access to care where there is a tremendous shortage of primary care doctors and specialists. Our state should pursue available federal grants so telehealth sites can be set up in health clinics, physicians’ offices, fire stations and a host of other potential locations that can provide primary care and disease management.

 

  • Georgia’s Rural Hospital Tax Credit Program. Our state currently allows corporations and individuals to donate up to $60 million annually to a program to benefit rural hospitals. In exchange for the credit on their state income taxes, hospitals can use the funds to purchase equipment and make other improvements. Fifty-eight hospitals have generated an average of $600,000 to $1.4 million since the launch of the tax credit initiative — no strings attached.  Lawmakers should raise the cap to $100 million so hospitals can meet the unique health care needs of each community.

 

  • Charitable and community health care clinics. We have a network of charitable clinics that were founded by churches, charities and local physicians’ groups or hospitals and are staffed with doctors, nurses and other medical personnel who donate their time to treat the working poor. They charge patients on a sliding scale basis which benefits those who earn too little to afford health insurance but too much to qualify for Medicaid. In addition, we have federal-funded health clinics offering the same services in local communities. We need to do more to expand the scope and availability of these clinics so the uninsured have access to care.

 

  • Competition into the health care marketplace. Georgia needs to examine high-risk pools and association health plans so the uninsured have choices other than wildly expensive Obamacare plans. In addition, we need to require more price transparency in the health care marketplace so patients can shop and compare what hospitals and physicians charge for their services. We also need to explore whether Georgia should continue with its antiquated certificate of need law which allows one medical facility to shut out another in offering services such as heart procedures or delivering babies in an effort to monopolize revenue at the expense of patient access and increased costs.

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Dave BearseAndrew C. PopeMattMD_actualNoParty4Mebethebalance Recent comment authors
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Lea Thrace
Lea Thrace

sigh

thats all i can provide in response to this. a big heavy sigh.

Caroline
Caroline

The only thing he is saying that makes sense is the need law. However he’s not dealing with reality. The situation is that if one hospital offers heart surgery and the other one does not it’s unlikely that in a low income area that the other hospital is going to expand its heart department due to the cost of expansion.

Ellynn
Ellynn

So folks who can’t afford health care are going to use their Smartphones for care (until the GOP takes the that federal funding away in Tax Reform 2.0…)? My mom is legally blind. A smart phone is not going to cut it. And you need Broadband in rural areas first. Historically, a majority of church charities from the 1920’s until the 1960’s received local, state and/or federal funds for running their hospitals, orphan homes, work farms, and potters fields. Seriously, look it up. Even local charities now rely on federal funds of some sort, and most will lose some of… Read more »

Benevolus
Benevolus

“It’s appeal to the left”… kinda tells you where this is coming from and where it’s going right away. But I will state for the record, that I believe the attraction to “the left” is that Medicaid actually works pretty well, so who cares why it was founded. We are allowed to progress! Big things require our collective resources. Local communities can’t do everything by themselves. This isn’t Mayberry anymore. And if waste, fraud, and abuse are the problem, let’s work on fixing that. Every other industrialized country has massive centralized health care that is more efficient than our system.… Read more »

NoParty4Me
NoParty4Me

spot on!

Andrew C. Pope
Andrew C. Pope

You know what would make Obamacare plans less expensive? Expanding Medicaid in Georgia and taking a portion of the population that is more likely to have healthcare needs out of the risk pools for the Obamacare plans. Expanding state programs and federal programs offering nutrition assistance. Expanding free lunch programs in local school districts so children can get adequate nutrition. Increasing state funding for county health departments. Supporting a public option at the national level that provides lower cost options in rural and undeserved areas. Supporting a lowering of the Medicare enrollment age to take older, and statistically higher cost,… Read more »

Caroline
Caroline

I actually know someone who ran a community health care clinic and I will tell you it was constant begging for money, constantly trying to raise money, not getting enough money to run the operation at times. Again, he has no idea what he is talking about.

bethebalance
bethebalance

Yeah, I went and reread (re-read?) what Duncan sd abt the clinics, after Party’s comment below, and I was trying to figure out if Duncan was implying the solution involved more doctors donating time. It seems that’s exactly what he’s implying, which of course, would be one of the dumbest things I’ve heard. Aren’t Repubs supposed to like market-based ideas? If docs are donating time- and there’s still unmet needs- that means there is way more demand than supply. So, where’s the supply-side economics now? There are already some solutions out there, esp for rural hospitals, stuff like med school… Read more »

Caroline
Caroline

From what she said doctors donating time was the least of their problems. The only problem with the doctor donating time theory is that if someone needs a cardiologist, the cardiologist might only come one day a month. According to her the demand far exceeded the supply. They had more people than they could service most of the time and then there’s the issue of limited funds.

bethebalance
bethebalance

Yeah, I’ve had some experience working with a clinic. And specialists– including dentists- are in extremely short supply. But even if there are docs that donate time, that’s far from optimal for all involved. Charity can help fill in small gaps, but not Grand Canyons of supply and funding deficits.

MattMD_actual
MattMD_actual

The idea is complete nonsense. Community clinics help in some instances but where is the continuity of care? What are patients with more severe, chronic conditions going to do? I’ll tell you what, go to the hospital which will GET ZERO REIMBURSEMENT.

bethebalance
bethebalance

I have more problems with the politics of the press release than I do with the substance. The four “reforms” he proposes aren’t awful at all, although his ideas on improving the insurance marketplace are weak. But the concepts of getting more cost transparency, increasing clinics, etc. aren’t the worst. But it all comes off as defensive against Medicaid expansion. And it is never noted that none of these reforms is mutually exclusive from Medicaid expansion. Maybe you need new waiver programs, but those can be effective. And the rest of the politics: — “a political solution that promises free… Read more »

Caroline
Caroline

I fact checked the waste and fraud statement when debating a conservative at one point. The waste and fraud in the private insurance industry was something like 96 times what it is in public healthcare.

bethebalance
bethebalance

That sounds more plausible. For waste, admin and marketing costs are easy targets. For fraud- there’s much more money to be had from unnecessary expensive testing, etc, etc.

NoParty4Me
NoParty4Me

” Its appeal to the Left is that it delivers more power to government and more control over people’s lives.” OMG! what a stupid statement. People that get so desperate as to need Medicaid are hardly able to choose any options. Medicare and Medicaid have lots of fraud, but there is not enough oversight, investigation or enforcement to control the fraud. A bit of staff could save billions in lost funds. Medicaid is hardly outpacing trillion dollar tax giveaways and massive spending from the rubes in your party. (https://www.forbes.com/sites/stancollender/2018/04/15/on-the-deficit-gop-has-been-playing-us-all-for-suckers/#66be606a4694) Charitable and community health care clinics “staffed with doctors, nurses and… Read more »

MattMD_actual
MattMD_actual

“But Medicaid’s huge expansion is now contributing to the national debt and straining Georgia’s budget. It has more waste, fraud and abuse than any health insurance program in the country.” Where is the proof for this? How could he possibly even know this? Is it Medicaid’s fault that some doctors and administrators defraud it? Why is he talking about he national debt? Republicans pay lip service to that when a democrat is president, otherwise it’s no biggie. Tax cuts and two simultaneous wars? In the US, you can do that! Cut taxes and build up the defense department? Hey man,… Read more »

Andrew C. Pope
Andrew C. Pope

“we have to get away from judging success by the size of the federal program.”
.
Except when the goal is to increase the number of Americans with access to healthcare. Does a food bank go “we have to get away from judging success by the number of people we feed.”

Dave Bearse
Dave Bearse

Telehealth. Cool. Another use for Obama phones. . Duncan evidently didn’t get the memo that the Trump’s tax cuts for the rich legislation is likely to eliminate the federal deductibility of state tax credits for the hospital program. Considering that no one would participate in the state program except for it being a 100% tax credit, the program will be useless. . Charity. Because we can always count on all charities to serve the public without regard to client’s circumstances and beliefs. . Competition is indeed working wonders. The competitive US healthcare system spends twice as much per capita as… Read more »