This week’s Courier Herald Column:
With the holiday season upon us, the thoughts of most will turn away from politics and on to things that actually matter. And yet, when the presents have been opened and the calendar turns to 2014, there will be less than 2 weeks before the start of Georgia’s General Assembly session. Thus, while most of us are celebrating and spending time with loved ones, some have already been preparing for what will likely be a short and speedy session of making laws.
The Affordable Care Act, now generally referred to as “Obamacare” in most GOP circles, has dominated political conversation and will be the rallying cry to try to pass at least some state level legislation. A group formed under the name “Taxpayers For A Healthy Georgia” has been spending time and money in an attempt to reform medical malpractice cases for months.
At least two glossy direct mail pieces have been mailed to select voters targeting legislators that will consider eliminating the ability to sue doctors in favor of a claims system similar to the workers compensation process. Senate Bill 141 – The Patients’ Compensation Act – would provide for a patient compensation system where appointees of the Governor, Lt. Governor, and Speaker of the House would adjudicate claims against doctors without the patient ever seeing a court room.
Supporters claim the plan “lowers premiums, saves tax dollars, and pays injured patients quicker”. Critics such as Senator Fran Millar of Dunwoody openly question the legality of the bill, wondering if the courts would uphold the state taking away the patient’s right to sue. The bill is opposed by both the Medical Association of Georgia and the Trial Lawyers Association.
This may be the signature bill of this session of the General assembly, as the money already being spent on lobbying and informing the general public is significant. The deep pockets of those in opposition virtually ensure this bill will become a lobbyist full employment program.
Despite the use of campaign materials citing the bill as a way to fight the premium increases associated with the ACA, the bigger picture question is whether Georgians will support the creation of another government bureaucracy in an effort to bend the medical cost curve. That aspect, at least on the surface, makes this bill seem like it may have more in common with Obamacare than not.
Another proposal, however, seems to fall closer to the talking points of those in opposition to the ACA. A proposed “Cancer Treatment Fairness Act” seeks to put patients in better control of the treatment options available to those suffering from various cancers that can be treated with oral medication.
In the last five years, oral cancer treatments have expanded from about 10% of available cancer treatments to approximately 25% of treatment options. The problem is that oral treatments are generally treated as pharmacy expenses, which are often more expensive and carry higher out of pocket expenses than the customary IV treatments.
Supporters claim oral medications require fewer doctor visits, improved quality of life, and the ability to treat cancer like a chronic condition such as diabetes or high blood pressure. The proposal would not mandate that insurance companies cover oral cancer treatments, but would require those who cover cancer treatments to make the out of pocket costs equal for either IV or oral medications.
It would seem that of the two proposals, the Cancer Treatment Fairness Act has the easier path to become law. It doesn’t take away existing patients’ rights, nor does it have the powerful lobbies of the trial lawyers and the Medical Association of Georgia against it.
Instead, it offers a solution to the themes that have been lost that originally sold the ACA: That of the patient being able to choose his or her own medical care. The bill sets out to level the playing field – and the associated costs – for the emerging market of advanced oral cancer treatments. With that leveling will of course come a cost, as the additional expenses incurred by insurance companies will have to be absorbed by premiums paid by the insured.
When put to public opinion, however, the added incremental cost associated with being able to choose your own treatment – like choosing your own medical insurance or your own doctor – is likely to be supported. The lack of a right to sue in the Patient’s Compensation Act – despite the promise of lower premiums – will be a much tougher sell.