In the recent weeks, both Keisha Lance Bottoms and Rick Jackson have been discussing their plans for healthcare for Georgia. The goals appear to be similar, expanding healthcare access.
Some of the challenges rely on traditionalistic components to address healthcare access — get more doctors in the healthcare deserts and healthcare swamps in Georgia.
Healthcare deserts are areas lacking access to healthcare infrastructure — either pharmacies, primary care providers, hospital beds, trauma centers or community healthcare centers. Healthcare swamps are areas with, for example, dialysis clinics — treatment, not care.
Traditionally, healthcare deserts and swamps are also food deserts and food swamps, allowing for the challenges to persist upon each other. This means lack of healthy food options creates the need for more healthcare services and specialists to address preventable and chronic diseases. Yet, people need to eat so they continue to eat what is available, compounding healthcare concerns.
The food correlation to health is an example of a critical component of what neither candidate is discussing and, perhaps, what we all are missing … understanding the challenges holistically and developing creative solutions to address these pivotal challenges. We do not live in a vacuum, yet we discuss policy solutions as if we are.
This brings us to the traditionalistic responses to the healthcare challenges Georgians face: more doctors and more hospital beds.
The amount of time and money to educate and train more doctors and make more hospital beds available are the largest challenges with providing care to areas that desperately need such care.
For example, it can take a decade or more for someone to be a medical doctor. When one of the campaign promises is to increase the number of doctors, how soon can those doctors be in place? How quickly will areas in Georgia be able to get those healthcare providers? While more doctors should be part of an overall, long-term strategy, stopping at calling for more doctors is not going to provide a quicker solution to address the gap in available healthcare providers.
Another solution being discussed is increasing the number of in-patient hospital beds across varying segments of the healthcare sector.
Just as with increasing the number of doctors, this campaign promise to increase in-patient hospital beds does not move as quickly. To increase capacity of in-patient beds takes time. More physical beds would have to be added, plus staffing to tend to the additional patients or more hospitals would need to be opened.
Adding more in-patient hospital beds and doctors are notable ideas to help with the healthcare gaps in Georgia. Again, these efforts take time. Time that could go beyond the governor’s first term.
The Georgia Board of Health Care Workforce publishes reports of Georgia’s 159 counties without primary care providers. The most recent Georgia Board of Health Care Workforce report included 19 counties without a family medicine physician; 63 counties do not have a pediatrician; 82 counties do have an OB/GYN; 95 counties do not have a psychiatrist.
Fundamental observations arise after reading through Georgia Board of Health Care Workforce report: how can you have more in-patient hospital beds without having a healthcare provider to serve the patients? How can Georgia limit healthcare procedures such as abortion, yet do not have enough doctors to help during a pregnancy, let alone not enough to care for the born children? How can you want there to be more families with children in Georgia without family health providers to care for the entire family?
Another critical fundamental observation: how can candidates for office campaign on bringing more providers to Georgia while many of the people who need the care do not have or cannot afford health insurance to pay for such care?
It will not matter if more providers come to Georgia if those providers will not be paid for their efforts to help Georgians to be healthy.
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Additionally, the traditional view of only using medical doctors to have full authority and autonomy in Georgia is holding Georgia back from expanding healthcare access.
Georgia is one of 11 states who has restricted practice for nurse practitioners and one of 11 states with reduced practice for physician assistants. Georgia also restricts midwives and doulas.
Georgia can review and update the licensure, licensing board, and requirements allowing for nurse practitioners, physician assistants, midwives and doulas to be able to qualify to have autonomy to practice. This will alleviate the pressure on our residents in counties that do not have a medical provider for care.
Georgia can study other states who allow for their nurse practitioners, physician assistants, midwives and doulas to be able to be active providers and to understand what works and frame policy in Georgia to close the healthcare gap — to ensure all Georgians have access to healthcare.
Yet, is there political will to actually address the healthcare gap in Georgia, or is addressing this issue just another talking point for the campaign?
Since when did healthcare become a polarizing issue? Healthy people are able to add to the economics of our state. Healthy people ensure our communities can function at its highest peak. Healthy people are productive. Healthy people are an added plus to our society. So why is healthcare a polarizing issue? And, why are we picking and choosing who is able to have access to healthcare and who cannot?
If the argument is healthcare is expensive, yes it is. We heard many antidotes of the impact of increasing healthcare costs. And, while costs are increasing, value is decreasing.
What is the cost to Georgia of people getting sick prematurely or having chronic, preventable diseases? What is the cost to our economy, our communities, our families?
Arguments and scare tactics regarding “death panels” and tiered healthcare system already exist. It exists under the current system where people are unable to see a family care provider in 19 counties. Where children in 63 counties do not have a pediatrician. Where women in 82 counties have to travel to another county to have a provider to care for them during and post pregnancy.
It is time to do more than naming singular problems.
It is time to develop and implement interdependent solutions.
Tammy R. Greer has a PhD in Political Science and teaches public policy.
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