Prepared Remarks at the Georgia Press Association Newsmakers Luncheon August 23, 2007

It is good to be here today to share with you a little bit of my vision for the future of health insurance in Georgia. Since my first election as a state senator 12 years ago, I have seen more and more that consumers in our state have lost control of their healthcare decisions. Because of government mandates and regulation, consumers have been pushed aside. They have become lost in the maze of a complex and unfriendly system. Many shrug their shoulders and just give up.

This maze of complex and skyrocketing costs has made health insurance unaffordable for many of Georgia’s small businesses as well. They are starting to give up, too. The inability of small businesses to offer coverage has fueled this alarming rise in the number of uninsured people in our state. It is the cycle of crisis and it must be broken. To do so, our vision for the future of healthcare in Georgia must put consumers back in charge of their healthcare decisions.

The healthcare crisis in Georgia is certainly not new. And although the problems have been articulated before, they are worth mentioning again. In our state right now there are 1.7 million uninsured people. That figure represents one fifth of Georgia’s population. Between 2004 and 2005 we saw a 13% increase in the number of uninsured Georgians.

Probably more alarming than the number itself is who makes up that 1.7 million. These are not just indigent people. Seventy one percent of the uninsured in Georgia are either working adults or the dependents of working adults. This means that almost three fourths of the uninsured in our state are people out there working hard every day - just like you and me - to provide for their families. And still can’t afford insurance. Or they work for a small business that cannot afford to insure their employees. These are unfair statistics. And in a state as great as Georgia, there is no excuse for hard-working people not to be able to afford at least a basic level of insurance.

The figures are staggering. Georgia ranks 6^th in the nation in the increase of uninsured residents. And if we don’t do something to address this crisis head on, it is only going to get much worse.

A lack of insurance is not just a problem for the uninsured. Everybody pays. We pay through higher premiums. We pay through higher taxes. And we pay through greater out-of-pocket expenses - as hospitals and physicians pass along the cost of treating the uninsured to the rest of us. An average family of three with private coverage pays about $969 per year to pay for the costs of treating the uninsured. That is almost $100 per month!

It is safe to say that the present state of healthcare in Georgia is pretty grim. So what about the future? There are many particular steps that we can take, but the bottom line is that meaningful health care reform can only take place when we put consumers back in charge of their healthcare and we find ways to provide basic services to those in need.

As more and more Georgians fall into the ranks of the uninsured, these patients become more dependent on the emergency room as their primary source of health care. This is creating a greater strain on our already burdened emergency rooms. And it is driving up our healthcare costs.

Many times people go to the emergency room with ailments that are not emergencies. Often it is just a headache, or an earache, or a stomach ache. Over 20,000 Georgians visited the emergency room last year with dental problems. The top condition treated in Georgia’s emergency rooms last year was an upper respiratory infection…mainly just a cold. The cost for this so-called emergency treatment? $33 million dollars! That is $33 million dollars gone. Not to mention the amount of time that doctors and nurses in the emergency room have to spend on treating these patients. Time that could be better spent handling true emergencies.

When you combine all of these facts you can see that emergency rooms are getting overwhelmed with cases that can be better treated somewhere else. All of those additional costs make health insurance more expensive for the rest of us, which causes more businesses to drop that coverage for their employees. Which further increases the number of uninsured working Georgians. This downward spiral must be broken.

In order to break the cycle, we have to find alternatives for these indigent patients and provide them access to affordable, basic care. Our proposal is the creation of what we call Safety Net Clinics. These clinics, established around the state through a grant program, will provide a range of basic services. These services will be selected by the Department of Community Health from among the most common conditions that we see in emergency rooms...like colds. They will also provide chronic disease treatment and prevention services, as well as a range of immunizations and lab testing.

The plan here is for these Safety Net clinics to replace the emergency room in the role of primary care facility for the indigent. To provide them with a place to get basic healthcare services. Clinics will be open seven days a week and will be staffed by a combination of nurses and physician assistants, supervised by physicians. They will be funded through a combination of state grants and private donations. Physicians would be encouraged to volunteer their time at the clinics through income tax deductions. By bringing together doctors, care clinics and county health departments we can make a great difference for some of our neediest citizens.

There was a newspaper story recently about a lady up in Hall County named Suzy Harris. She recently received an award for her years of service to the indigent and uninsured in Gainesville.

Suzy saw the growing number of uninsured and indigent people up in northeast Georgia and knew something had to be done. And she knew it was going to take a collaborative effort to do it. So Suzy got together a group of doctors and clergy and with her never-fail attitude, she started the Good News Clinic in 1991. The clinic was established to provide basic treatment to those who might otherwise not get it.

What began as a small operation has today grown to the largest clinic in Georgia, seeing more than twenty thousand patients a year. That’s twenty thousand men, women and children who now have another choice besides the emergency room for care. Twenty thousand people who do not have to go without.

Imagine if there were more places like this throughout Georgia. Places that would provide basic services and preventative care in a more efficient, and cost-effective way. Places that would allow the poor to get treatments that they need while also freeing up emergency rooms to do what they were designed to do: treat true emergencies.

That’s the goal of the Safety Net clinics. They are not free clinics but more affordable alternatives. Patients will participate in their care through co-payments based upon their income. These clinics will be open to the indigent and the working poor to allow their basic needs to be met.

Getting the uninsured out of the emergency rooms is only part of the solution. We have to find ways to give more Georgians access to affordable health insurance. To do this, we need to create a consumer-based health care market - where individuals and businesses can get the information they need to make educated choices about their health insurance. By giving people more options, and by allowing them to purchase insurance directly from companies, we can lift the veil on the complex health insurance market creating a system that is affordable and accessible to every Georgian.

We are therefore proposing the creation of the Georgia Health Marketplace.

The Georgia Health Marketplace will be a clearinghouse for health insurance products - bringing together insurance providers and consumers in a streamlined, web-based system. Insurance companies and physician groups can use this website to market products directly to consumers, and individuals and business owners will be able to compare options and select their choice of insurance. People will once again be in control of their healthcare decisions.

Small businesses that qualify for Governor Perdue’s new HIP plan and individuals who qualify for PeachCare will be able to enroll for these programs through this marketplace. In addition, the Georgia Health Marketplace will offer two innovative new products that people may choose.

The first is a Catastrophic Health Insurance plan, a high deductible plan that would cover only truly catastrophic claims. This plan would ideally be coupled with a Health Savings Account or some other basic coverage plan.

The other option is a physician direct plan, which would allow hospitals and physician groups to market directly to consumers. They can offer a set array of services at a fixed annual cost. By directly linking healthcare providers with consumers, market forces and competition will drive down costs.

In order to oversee the operations of this new health insurance marketplace, we will establish an Authority composed of key stakeholders. Representatives from the Department of Community Health, the Insurance Commissioner’s office, as well as healthcare, insurance and consumer representatives chosen by myself, the Governor and the Speaker will all determine how products are listed on the website and will establish the rules and regulations for the day-to-day operation. Their mandate will be to make the marketplace as accessible as possible.

There are two key parts of the Georgia Health Marketplace that make it truly special. The main benefit is portability. A big problem with our current insurance model is that you can’t take your insurance coverage with you if you change jobs. So what you often run into is a situation of “job lock” where people feel stuck in their current job and can’t move on because of the change in benefits. Or if they change jobs they risk not being able to get new insurance because of pre-existing conditions. People are not in control of their own choices.

The Georgia Health Marketplace seeks to correct this problem by offering insurance products that are both affordable and portable. When you sign up for a policy through the marketplace, your coverage cannot be dropped, and you can renew coverage annually, regardless of where you are working. The consumer is in control.

Another key aspect of the Georgia Health Marketplace is that it will allow small businesses to purchase health insurance for their employees using pre-tax dollars, just like larger companies can do now. The Authority will determine the best ways for consumers to take advantage of pre tax dollars, but the idea is that this tax benefit will make getting insurance more affordable for small businesses. And once again, these small business owners will be in control. They will be able to choose the products that work best for them.

By directly connecting healthcare providers with healthcare consumers, we can allow the free market system to do what it does best. The Georgia Health Marketplace has tremendous potential to lower health insurance costs as well as the number of uninsured in our state by allowing people to make educated choices based on personal need.

What I have outlined here today is my vision for what healthcare in Georgia should look like. I have painted some broad strokes, and you should keep in mind that there is still work to be done on this plan. Over the next few months, we will be refining it and working to make sure that the final plan fulfills our vision of improved access to healthcare and a system centered on the consumer.

We intend to reach out to legislators and key stakeholders in an effort to hear everyone’s opinion. I encourage those of you who care about this issue to contact our office. Fixing healthcare in Georgia is going to take leadership…it is going to take vision. And it is going to take the commitment and collaboration of each one of us. And while we are the one taking the lead, at the end of the day this is not just our plan. It is a plan for every Georgian. And they deserve no less than the leadership and the dedication to get this right.

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