Uninsured

The state’s waiting list for people with HIV to get government drug assistance is steadily growing — intensifying concerns that patients won’t get the medications they need.

More than 1,100 Georgians are on the waiting list for the state’s AIDS Drug Assistance Program (ADAP). That’s the second-longest list in the country behind Florida’s, says Jeff Graham of Georgia Equality, which runs an advocacy network for people with HIV.

Currently, the ADAP program, which serves more than 4,000 uninsured Georgians, gets about $12 million in state funding and $33 million in federal money. “It has saved lives,’’ Graham says.

The program needs about $5 million in additional state money, plus more federal funding, to eliminate the waiting list, Graham says.

But he says ADAP may face a $600,000 reduction in funding under a new state budget proposal.

A large majority of those on the ADAP waiting list are being helped by patient assistance programs run by pharmaceutical companies, Graham says. That corporate help with medications is not a long-term solution, he says.

The state Department of Community Health, which runs ADAP in Georgia, said Wednesday that by using anticipated federal funding,  the waiting list will be substantially reduced.

“Total alleviation of the waiting list will require time and resources at the state level as well as an estimated $13.5 million in funding,’’ the agency said in a statement. “While much of this funding is expected to be federal, continued financial commitment from the Georgia Legislature will be essential.’’ full story

The news that Grady is closing two neighborhood clinics and raising prescription co-pays shows how cutbacks in government funding can squeeze front-line medical services.

Grady Memorial Hospital has come back from the financial brink in just four years, aided by corporate and foundation support and new management. The safety-net hospital is an indispensable part of Georgia’s medical landscape, providing about $220 million annually in indigent care.

Uninsured patients stream into its doors every day.

Grady also has operated Atlanta’s only Level 1 trauma center for years, runs the largest publicly funded infectious disease clinic on the East Coast and trains one in four Georgia doctors.

Now Fulton and DeKalb counties are lowering their funding to Grady by $3 million each, on top of a $27  million decrease in Indigent Care Trust Fund dollars from the federal government.

The reduction in Grady’s government funding coincides with an uptick in uninsured patients and the constant increase in medical costs, said Matt Gove, a Grady spokesman.

So it’s not surprising that two of the Grady satellite clinics – one in Decatur, the other in Southwest Atlanta – are closing. The two have the lowest patient volume among Grady’s satellite clinics, and patients will be directed to centers that have more specialty services, Gove said. full story

Insurance ‘’mandates.’’

Many conservatives use the term disparagingly in describing the health insurance coverages required by state or federal law. The mandates are criticized for being costly and limiting consumer choice.

But consumer advocacy groups say mandated benefits such as cancer screenings protect people from policies that don’t cover important tests and services.

The issue of mandates has erupted again in the Georgia General Assembly with the introduction of House Bill 47. The legislation would allow insurance companies to sell any policy in Georgia that they now offer in other states. Thus, an insurer could skirt Georgia’s required coverages with barer policies sold in states with fewer consumer protections. An out-of-state plan could lower the sticker price of insurance for uninsured Georgians, the bill’s proponents say.

The bill, proposed by state Rep. Matt Ramsey (R-Peachtree City), was approved by a House Insurance subcommittee Tuesday. It’s supported by the Georgia Chamber of Commerce and the National Federation of Independent Business.

A similar bill cleared the House last year but stalled in the state Senate.

Ramsey has said the legislation would reduce the price of insurance and thus get more people covered. The bill’s supporters argue that a single man, for example, would not need a policy that covers mammograms and shouldn’t have to pay for that coverage.

Georgia’s insurance mandates include requirements for health policies to cover screenings for cervical, prostate and colorectal cancer, along with mammograms. Consumer groups and legislators in the past fought long, hard battles to get these coverages approved by the General Assembly.

The American Cancer Society opposes the House bill. It would allow insurance policies to not cover essential cancer screenings, said Brittany Freeman, the director of health policy for the organization’s South Atlantic division. “Early detection not only saves lives but also saves money,’’ she said. “It’s more expensive to treat later,’’ Freeman said, adding that the extra cost would be borne by other policyholders. full story

The Good News Clinics began treating low-income patients in a community center at a Gainesville housing project in 1992.

Now, in a location that resembles a regular doctor’s office, Good News is the largest full-service free clinic in Georgia, handling more than 1,500 medical and dental visits every month.

The rise in the number of uninsured Hall County residents brings many new patients to Good News, where the visits are  free, and the work supported by medical volunteers, charities, churches and private giving.

The area’s high jobless rate keeps the clinic filled, says Good News’ executive director, Cheryl Christian.

Good News is one of several nonprofits and ministries designated by Nathan Deal’s transition team for its Jan. 8 day of service prior to his Jan. 10 inauguration as governor. Other health care services are included among the sites for volunteers to give back to their communities, in Deal’s “With a Servant’s Heart’’ initiative. full story

The executive director of Georgia’s largest physicians organization has been picked to head the state Department of Community Health.

David Cook, an attorney and longtime head of the Medical Association of Georgia, was rumored to be at the top of Gov.-elect Nathan Deal’s list for the DCH job.

As Dave Williams of the Atlanta Business Chronicle points out, the two go way back. Cook was chief of staff for Deal when the latter was in Congress and also worked for Deal in the Georgia General Assembly.

Cook will replace current DCH Commissioner Clyde Reese, who will move to the top position at the Department of Human Services.

Georgia Health News will try to interview Cook soon to flesh out his views on the state’s health care challenges. Cook  becomes Community Health commissioner in January.