Speaking to a conference of hospital administrators in Savannah, Deal announced the names of 15 appointees — a mix of doctors, health care managers, lawmakers and local officials — he chose to sit on a new committee tasked with helping rural hospitals deal with high-cost issues such as treating uninsured patients. He also said the state Department of Community Health board will vote next Tuesday on policy changes that would allow rural hospitals to save money by downsizing, in some cases to the point where they serve only as emergency rooms.
Afterward, Deal acknowledged as cash-strapped hospitals shrink the amount of services they offer, they will also shed jobs in rural communities where they tend to be among the largest employers.
“If we can keep some form of health care alive and well in these communities as opposed to having them totally close, we’re still ahead of the game,” Deal told The Associated Press in an interview. “We may lose jobs, and obviously we will as you downsize, but at least you have some of the front-end, essential health care available.”
The governor spoke Friday to hospital administrators for HomeTown Health LLC, a network of roughly 50 rural Georgia hospitals. The group closed its meeting to reporters, but Deal’s office provided copies of his prepared remarks. HomeTown Health CEO Jimmy Lewis did not immediately return a call to his cellphone seeking comment on Deal’s plans. Lewis was among those the governor named to his new Rural Hospital Stabilization Committee.
Critics have faulted Deal, a Republican seeking re-election this year, for refusing to expand Medicaid eligibility for Georgians who can’t afford subsidized health insurance plans on government exchanges. Deal says the cost burden to the state would be too high. Many Democrats argue a Medicaid expansion would help solve one of rural hospital’s greatest cost burdens: treating uninsured patients who can’t afford to pay for care.
Deal said adding Georgians to the Medicaid roles won’t help rural hospitals enough because the program tends to pay medical providers less than the cost of the treatments they administer.
“So if you’re expanding a population base where the reimbursement is less than your cost, I think simple mathematics say that doesn’t necessarily help,” Deal said. “To the extent those are totally uninsured people, even inadequate reimbursement is better than nothing. But the big problem I have is Medicaid is an entitlement program. It is broken. Almost everybody will tell you there are major flaws in the system.”