Meetings show health care not stuck in neutral

Two Atlanta gatherings Monday showed that health care isn’t waiting around for whatever happens to the 2010 reform law.

Gov. Nathan Deal’s committee on health exchanges met at the state Capitol for introductions and background on their task.

The federal law, officially known as the Affordable Care Act, requires states to have health exchanges running in January 2014. That’s when the law — if it’s upheld in the courts — is to be fully implemented. If Georgia or other states don’t create their own exchange mechanisms by then, the law says the federal government will run the operation in those states.

Health exchanges are online shopping malls where individuals can compare and buy insurance. Their purpose is to greatly enhance the insurance-buying power of individual consumers and employees of small businesses.

Ryan Teague, deputy executive counsel for the governor, said the health reform law is ‘’a heavyhanded approach to expanding Medicaid.’’ But he told the exchange committee that however undesirable the Affordable Care Act may be, ”we have to deal with reality’’ and not ignore the law’s existence.

The committee, Teague said, will have the opportunity to fashion something that “we would have done on our own.’’

States’ approaches vary widely

Consultant Cindy Gillespie of McKenna, Long & Aldridge told the panel that exchange work is going on across the country. Eleven states have declared they’re going to establish their own versions of exchanges, she said. A few states are considering private insurance for Medicaid beneficiaries, she added.

While Vermont is moving toward a government-run exchange, the discussion at the Georgia meeting Monday appeared to favor a more private market approach.

States such as Indiana, Mississippi and Oklahoma were mentioned as trying to make their exchanges as conservative as possible.

Teague also said the clock “is ticking fairly fast’’ as Georgia considers its options. The 2012 General Assembly will have a last shot at passing an exchange law next year before the federal government would decide to step in.

“We need to figure out what’s best for Georgia,’’ Teague said.

Deal told the committee Monday that that its effort to reshape the health insurance marketplace will be valuable. An insurance exchange is “a Republican-like idea,” he said. A goal is to make coverage more accessible and available, Deal said.

The governor added that Georgia is still vigorously pursuing its legal opposition to the Affordable Care Act. “We’re still hopeful we’ll get some court relief,’’ he said.

On Wednesday, the 11th U.S. Circuit Court of Appeals in Atlanta will hear the latest round of arguments in a suit by Georgia and 25 other states seeking to overturn the health reform law.

In January, federal Judge Roger Vinson in Pensacola, Fla., struck down the entire law, and the government will appeal that decision in the hearing this week.

Care that can kill you

Also Monday, a Carter Center roundtable discussion focused on how to improve the quality of health care.

More than 100,000 patients die annually from medical errors, and about 2 million infections occur in health care facilities, said Christine Bechtel of the Campaign for Better Care ( It’s a national organization seeking to improve health care for older patients with multiple medical conditions.

“We have a real problem on our hands, financially and in human terms,’’ Bechtel said. Patients and their families should be empowered to help create changes, she said.

The administrator of the federal Medicare and Medicaid agency struck a similar note, telling the Carter Center audience that ‘’too many Americans are being harmed’’ in the health care system.

Dr. Donald Berwick, of the Centers for Medicare and Medicaid Services, cited a study,  published in the journal Health Affairs in April, that found that on average, one in three patients admitted to hospitals suffer medical errors or adverse events.

Berwick pointed out that the public-private Partnership for Patients aims to reduce hospital-acquired infections by 40 percent over three years, and to cut hospital readmissions by 20 percent over that time. Some hospitals have essentially eliminated central-line associated bloodstream infections, pressure sores, and pneumonia from respirators, he noted.

“We know how to do it,’’ Berwick said. ‘’We know how to improve.’’

Medical errors cost the Medicare program $4 billion a year, Berwick added. Sharing the best medical practices among health care providers will reduce these costly failures, he said.

Panelist Yolanda Chancellor, a Georgia patient advocate, described errors and failures in the care that her grandmother and boyfriend received.

Knowing a hospital’s or doctor’s record on quality of care is vital for patients, she said.