A Subtle Hint To Sonny From Casey, And A Not So Subtle Response - Sort Of

(Updated overnight with reply to Teilhet by Eric Johnson. New material highlighted.)

By Dick Pettys
InsiderAdvantage Georgia

(8/23/07) There seemed to be a whiff of tit-for-tat in the air on Thursday between Lt. Gov. Casey Cagle and Gov. Sonny Perdue as Cagle unveiled two new health care initiatives (which we’ll detail in just a moment), roughly two weeks after Perdue unveiled his.

We'll have to set this up with a little background:

If you’ll think back to the early part of August, there was a lot of grumbling from key lawmakers that Perdue hadn’t adequately briefed them before publicly announcing his proposal to help small businesses provide coverage for uninsured workers. (Among the criticism: the briefing, in some cases, came only minutes before the public rollout, and/or was delivered by junior level staffers or by information packet.)

Fast-forward now to Thursday, when Cagle rolled out his proposal before the Atlanta Press Club. Asked if the governor was on board with it, he said:

“The governor and I have not sat down face to face to talk about this, but he was sent the briefing package just like we were on Georgia HIP (the Perdue program).”

We thought we caught a mischievous glint in Cagle’s eyes when he said that, but then again maybe not.

A few hours later, another shoe dropped when a Democratic legislator - Rep. Rob Teilhet - sent out an e-mailed statement calling the proposal "a transparent attempt to give the appearance of leadership, without the substance." That was followed a few hours later by a curt retort, also e-mailed, from Senate President Pro Tem Eric Johnson.

Nothing unusual in Democrats criticizing Republicans and Republicans returning the salvo, of course, and heaven forbid we should be accused of over-analyzing this - - but Rob's wife, Heather, is the governor's communications director.

Now, as far as the new health care proposals. Cagle called for:

1. A system of “safety net clinics” as an alternative to expensive emergency room treatment, open seven days a week and staffed by nurses and physicians assistants but supervised by physicians, and funded through a combination of state grants and private donations. Physicians would be encouraged to volunteer their time through the promise of income tax deductions.

Treatment would not be free. Co-payments would be assessed based on income. Patients would be required to sign a document certifying their income was less than 300 percent of federal poverty level.

Cagle proposes to start the program in a pilot program of five clinics.

2. Creation of something called the Georgia Health Marketplace, a kind of web-based clearinghouse through which employers and consumers could access information about health insurance options in Georgia and make informed decisions about what best suits their needs.

There are several wrinkles to this:

* The program would help consumers choose between competing policies and enable them to purchase them with pre-tax dollars, and guarantee their portability if they change jobs.

* Two new health care plans would be offered: a high-deductible plan covering only truly catastrophic claims, and a physician-direct plan, through which hospitals and physician groups could market directly to consumers.

The marketplace would be overseens by a new authority which Cagle proposes to create. It would include representatives from the Department of Community Health and the Insurance Commissioner's office, along with appointees of the governor, the lieutenant governor and the Speaker.

Cagle said his initiatives accomplish a couple of goals: freeing hospital emergency rooms to provide true emergency care rather than serving to handle colds and sniffles for the uninsured, and putting consumers more in control of their own care.

He sketched only the broad outline of the two proposals, leaving much of the detail to be filled in later.

The state already is doing some of what he proposed. Through an appropriation last session of $1 million, the state is preparing a “Health Care Quality and Cost Transparency Web Site” featuring cost and quality information about hospitals, pharmacies, ambulatory surgery centers, long-term care services and health insurers. It is designed to be used by consumers. It’s not up yet, but it’s in the works.

In addition, there already are clinics, authorized under a 2005 law which grants sovereign immunity to uncompensated health care professionals when they provide donated care to eligible patients. Cagle said the existing clinics would mesh easily with the plan he is advancing.

The official comment from the administration, delivered by Perdue spokesman Bert Brantley: "Governor Perdue shares the lieutenant governor's concerns for the high price we pay when uninsured Georgians use overcrowded emergency rooms for primary care services. We look forward to working with the lieutenant governor to find ways to coordinate his ideas with Governor Perdue's long-stated goal of creating a healthier Georgia."

Teilhet wrote in his e-mail: "A million and a half Georgians and their families can't see a doctor when they're sick. The overwhelming majority of these Georgians work full-time. Respectfully, a proposal to deal with this issue by starting five small public health clinics and re-working a website that already exists is like putting a band-aid over a severed jugular."

Eric Johnson replied: ""Rep. Teilhet has a responsibility to tell the truth. He doesn't. Every single Georgian can walk into an ER and see a doctor. That system is going broke. Democrats need to defend the status quo or propose a plan to improve health care. He can't do the former and won't do the later. The Governor and Lt. Governor have real plans on the table. The best the Democrats like Teilhet can do, while enjoying taxpayer subsidized government health care, is whine. That won't cut it, son. We eagerly await an alternative.........Hello?"