Georgia’s rural health care crisis just gets worse

February 19, 2012 

A relatively obscure observance no doubt passed unnoticed by most Georgians, especially those who didn’t read the Macon Telegraph. For all who missed it -- and that’s probably most of us -- Thursday was Rural Health Day in Georgia.

To call such an occasion “bittersweet” is perhaps too positive. Because about the only thing positive about the state of rural health care in this region is that it’s positively abysmal.

If most were unaware of Rural Health Day, they’re aware of the demographics of our neighbors in southwest and south Central Georgia -- among the poorest regions not just in the state, but in the nation.

As staff writer Maggie Lee reported in Thursday’s edition of the Telegraph, the plight of rural Georgians is a double whammy. The aging of the baby boomer generation is already a looming strain on health care resources, financial and human. But here, the rural population is even poorer and older than the rest of Georgia. People in those regions are among the most likely in the state, and probably nationwide, to have little or no health insurance. And even if they do, they might not have a doctor anywhere nearby to treat them.

According to Georgia Rural Health Association figures reported in the Telegraph, there is no practicing pediatrician in 65 of Georgia’s 159 counties, no obstetrician/gynecologist in 68. And Association Executive Director Matt Caseman estimates that up to a third of the state’s general practitioners will retire in the next 10 years.

The challenge of replacing them, and reversing those dreary rural health care trends, is daunting. Georgia’s Medicaid reimbursement rate has not been increased in a decade, which means it’s those poorer rural patients who are even more at risk because fewer doctors will accept Medicaid patients. Gov. Nathan Deal’s proposed budget does not include any Medicaid help, although it does increase funding for poor children’s health care: The budget includes $4.6 million more in reimbursement money for PeachCare, the state health insurance program for children who don’t qualify for public assistance.

One positive note is the recently announced collaboration involving Macon-based Mercer University and two Columbus hospitals for medical training here. Incentives for physicians, especially newly minted ones, to practice in areas desperately in need of medical services are an effective way to help underserved areas. Yet governments in such areas are in the classic double-bind: They need doctors and hospitals, yet the very poverty that creates the need is an obstacle to providing the incentives.

An alternative approach involves tuition or professional assistance for doctors who commit to a certain term of practice in medically underserved areas. We’d be surprised if such arrangements weren’t already being considered in the plans for medical training here. There’s certainly no debate about the need.

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