JACK BERNARD
Bernard is a retired corporate executive

A major reason for Georgia’s poor health status is that our rate of medically uninsured (under 65) is 16 percent, much higher than the national average of 11 percent. 

This dismal situation was caused by the failure of our former governor to accept any Medicaid Expansion via the ACA (Obamacare), although 90 percent of the cost of expansion is paid by the federal government. But some expansion of Medicaid is now possible under Gov. Kemp, using a limited waiver. It’s a good short-term move, if not all that’s needed as I describe below.

Georgians self-reported poor/fair health at a 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. 

Troup County’s health status is even worse than the state as a whole. Of the 159 Georgia counties, it ranks 80th in health outcomes, 90th in health behaviors and 91st in length of life, quite possibly due to these behaviors. These factors include smoking, obesity, inactivity, drinking, STDs and teen births. But Troup is not alone.

The closest large city is Columbus in Muscogee County, which is significantly worse than both Troup and the rest of the state, ranking 100 out of 159 counties on statistical health outcomes and 99 on general health factors contributing to quality of life. I’ve pulled two indicators to illustrate how our state and this region fall short: A. Premature deaths for the US are 6,600/100,000… versus 7,500 for the state and 9,700 for both Troup and Muscogee Counties;  B.  The low birth weight rate for the USA is 8 percent versus 10 percent in Troup, 11 percent in Muscogee County and 10 percent for Georgia. 

Hospitals in the SW region of the state, which serve a disproportionately high number of medically uninsured have high levels of bad debt, causing medical price increases for the area’s private pay patients. Also, due to indigent care, many of Georgia’s rural hospitals are asking for increased subsidies paid for from local taxes; seven have closed.

Clearly, providing health insurance to more lower income Georgians will have a greater positive impact on Troup versus the state as a whole. 

And, that is the reason that maximum Medicaid expansion should be supported by all Troup County taxpayers, which means going beyond the parameters of the waiver. Medicaid expansion will have to do for now, at least in the short-run until Medicare for All or something similar is enacted, which I believe to be inevitable.