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Health Care Reform:

Health Insurance & Affordable Care Act

In Southwest Georgia, Insurance Costs Run High

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"If you look at the Georgia health indices for cancer, obesity, diabetes or pre-metabolic diseases, asthma, stroke,  or heart disease, there are many counties that are worse than some Third World countries," said David Hefner, CEO of Georgia Regents Medical Center.

The lowest premiums in the country are around Minneapolis, known for its healthy population. Yet other parts of the country face the same kinds of health challenges as southern Georgia and have significantly lower insurance premiums. In a cluster of five South Carolina counties that the University of Wisconsin data show have demographics similar to Southwest Georgia, the lowest price silver plan is 39 percent less expensive.

Many insurance brokers and residents place the blame for high premiums on the expanding Phoebe Putney Health System, the nonprofit that runs six hospitals in Southwest Georgia.  The Federal Trade Commission and Georgia's attorney general unsuccessfully tried to reverse Phoebe's 2012 acquisition of Palmyra Park Hospital in Albany because it made the system so dominant that they said Phoebe could essentially dictate prices. In a settlement, Phoebe was allowed to hold on to Palmyra, giving it 86 percent of the regional health care market.

Phoebe's dominance has also grown as it has purchased more physician practices. "Doctors you thought would never work for Phoebe are now Phoebe employees," said Sue Luckie, an insurance agent in nearby Leesburg. 

Mullins, the swimming pool contractor, is not surprised. "Some of the surgeons I have built pools for have moved from Jacksonville," across the state border in Florida, he said. "I have said, 'What would you possess you to move here, this isn't a resort area?' They said, 'We get paid twice as much as in Jacksonville.' "

Fair Health, a New York group that assesses customary charges around the country, examined five common outpatient procedures and exams in Albany, Georgia—the largest city in the nation’s  second most expensive marketplace. For Kaiser Health News, Fair Health compared the Albany physician charges to the South Carolina counties that had similar health demographics. All were about the same except for chemotherapy, where Albany doctors charged around $500 for the first hour and South Carolina doctors charged between $200 and $300 less. Real price information about Phoebe Putney Health Systems, the dominant hospital group, are not available.

Fri, Jan 31 2014

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