Health Costs

Many American baby boomers perceive tuberculosis to be a relic of the past, like polio.

In past centuries, the disease killed millions of Americans, including historical figures such as President James Monroe and Eleanor Roosevelt.

Then, in the 1940s and ’50s, effective drug therapies were developed, and experts predicted the eventual elimination of TB.

Yet TB remains a massive killer worldwide, accounting for 2 million deaths annually. And it’s the leading cause of death for people infected with HIV, including in the United States.

The U.S. rate of TB has been declining. Last year, a total of 10,521 new tuberculosis cases were reported in the U.S., an incidence of 3.4 cases per 100,000 people. That’s the lowest rate recorded since national reporting began in 1953, the CDC says.

But Georgia’s tuberculosis rate, though dropping, is still higher than the national average. Georgia reported 347 TB cases (3.5 cases per 100,000 population) in 2011, a 16 percent decrease from 2010.

The disease in the state is largely centered in three counties in metro Atlanta — DeKalb, Fulton and Gwinnett.

The state Department of Public Health reports that in 2010, the most recent year with available data for population estimates by race and ethnicity, the highest TB case rate was in Asians (24.1 per 100,000), followed by Hispanics (8.2 per 100,000), and non-Hispanic blacks (7.1 per 100,000).

The cost of containing a live outbreak can be ‘‘phenomenal,’’ says state Sen. Renee Unterman, who represents a Gwinnett district. Unterman’s advocacy helped inject an extra $350,000 in the state budget for treating TB in those three counties.

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For a person accustomed to grim health data, one prediction still tends to be jarring:

The current generation of American children may be the first not to live as long as their parents.

Much of this projection is linked to the increase in health conditions such as obesity.

These medical deficits in the U.S. health system were highlighted Thursday at an Atlanta conference and in national media reports.

Tyler Norris, a senior adviser on Total Health at Kaiser Permanente, cited the life expectancy warning as he spoke to an Atlanta audience about the burden of obesity and diabetes.

Kaiser is one of the sponsors of the upcoming HBO documentary “The Weight of the Nation,’’ in which experts such as the CDC director, Dr. Thomas Frieden, talk about the urgency of addressing the obesity problem. (Here’s a link to the trailer.) full story

Atlanta and Columbus are doing better on air quality, but both have a long way to go.

The two Georgia cities are rated among the worst metro areas for air pollution in the United States, according to the American Lung Association’s annual report on air quality, State of the Air 2012.

The report, released last week, found Atlanta/Sandy Springs/Gainesville 25th-worst on ozone, and in a tie for 24th-worst on soot. Columbus/Auburn, Ala./Opelika, Ala. tied for 17th-worst on soot.

Still, June Deen, the state director of the American Lung Association, says that in Atlanta, “we’ve had fewer and fewer bad air days’’ in terms of ozone and particulate pollution. Columbus has also improved, she says.

“We still get F’s in a number of categories,’’ Deen says. “We’re not out of the woods by any stretch.’’

Two Georgia coastal cities — Savannah/Hinesville/Fort Stewart and Brunswick — were among the cleanest U.S. cities for ozone, probably due mostly to their location near the Atlantic Ocean.

Ozone and particle pollution, or soot, are the most widespread air pollutants — and among the most dangerous. Ground-level ozone, a main ingredient of smog, has harmful effects, especially on children, older adults and people with respiratory illnesses.

Air pollution, including particulate matter, is linked to respiratory and heart diseases, cancer, premature death, and reduced lung function in children.

Tuesday, May 1, is World Asthma Day, and it also launches the start of smog season. The Fulton County Department of Health and Wellness is holding an asthma awareness event Tuesday, bringing together community leaders, medical experts and clean air advocates. full story

Georgia consumers will qualify for an estimated $30 million in health insurance rebates this year due to a newly implemented provision in the federal health reform law, according to an analysis released Thursday.

Nationwide, health insurers will have to pay an estimated $1.3 billion in rebates, said the report by the Kaiser Family Foundation.

Under the 2010 law, officially called the Affordable Care Act, insurers in a state are required to spend at least 80 percent of premium dollars on medical care costs, or pay rebates to consumers.

The U.S. Department of Health and Human Services, though, allowed Georgia health insurers to meet that level gradually for individual health policies, with a 70 percent mark in 2011, 75 percent in 2012 and 80 percent in 2013.

Insurance companies will be required to issue rebates by August if they did not meet those spending levels last year.

The Kaiser report said that 109,776 people in Georgia with individual plans will get rebates totaling $3.9 million, averaging $35.12 per enrollee. Almost one in three Georgians in individual plans will get rebates. full story

It was pitched as a way to provide cheaper health insurance for uninsured Georgians.

House Bill 47 would let health insurers in Georgia sell policies from states that have fewer coverage requirements.

Proponents said these out-of-state policies, stripped of Georgia’s mandates, would have lower premiums – and allow more people to afford individual health insurance coverage.

The high-profile legislation was passed by the Legislature last year and signed into law.

But a year later, nothing has happened. No insurer here has started selling a non-Georgia health plan.

The state Insurance Commissioner’s office says it fielded some inquiries as regulations were being written, but that nothing has yet been offered.

Experts speculate that health insurers, here and elsewhere, have their focus squarely on the pending Supreme Court decision on the 2010 federal health care law – and don’t want to offer a policy that may soon be extinct. full story