Regardless of Georgia’s decision on Medicaid expansion, hundreds of thousands of Georgians will remain uninsured. One immediate way to help the uninsured (and save money) is to provide access to primary care clinics instead of expensive and unnecessary trips to emergency rooms. Thanks to leadership and private support, Georgia is a national leader in charity care. Leveraging this great asset should be the first step to helping the indigent and uninsured.
In 2004, the Sutherland Institute of Utah, a state-based think tank like the Georgia Public Policy Foundation, published a study titled, “To the Least of These – A Moral Case for Providing Authentic Charity Care.” The study, and a later study in 2008, outlined a charitable health care alternative to government programs like Medicaid. (The executive summary of the study is below.)
Georgia was ahead of Utah. In 2003, the Georgia Free Clinic Network (later renamed the Georgia Charitable Care Network) was founded, “to foster collaborative partnerships to deliver compassionate health care to low income Georgians.”
Today, Georgia leads the nation in free and charity clinics. In 2012, Georgia Charitable Care Network’s 96 clinics served 183,625 individuals and provided 463,922 patient encounters – and saved taxpayers more than $200 million.
Supporting the Georgia Charitable Care Network is something Georgia can do now to address its health care needs. Citizens should check to see if there is a clinic in their community. Encouraging private donations to existing clinics, volunteering or providing leadership to create additional clinics are steps any citizen may take. One way to incentivize these efforts is through a temporary tax credit that would enhance the capacty of the Georgia Charitable Care Network to support the replication of free clinics around the state.
The Sutherland Institute recommended a 2-for-1 non-refundable tax credit for any voluntary donation. For every dollar donated, a taxpayer, individual or business would receive a two-dollar non-refundable tax credit.
The Georgia Public Policy Foundation helped craft a similar charitable care tax credit proposal in 2012. Voluntary donations would receive a 1-to-1 tax credit of up to $1,000 for an individual and $2,500 for a married couple. A corporation or other entity could contribute up to 75 percent of the corporation’s Georgia income tax liability. The tax credit would be limited to $2 million per year for three years. The funds could be used be used for planning, expansion, development, outreach and technology support to help clinics serve the uninsured across the state.
Here is the Executive Summary of the Sutherland study:
The Sutherland Institute believes that Utah’s indigent and needy uninsured residents should receive health care even if they cannot afford it. How can we do this effectively without higher taxes, burdened state budgets and intrusive government involvement? A compelling answer is to provide universal health care to these neighbors in need using an entirely voluntary system of authentic charity care. By authentic charity care we mean a charitable system of health care that consists of individuals and institutions voluntarily giving of their time and resources to provide health care for those who need it.
However, charity care, as it now stands, is anything but charitable. What passes for poverty relief usually consists of such things as mandatory emergency room treatment, involuntary cost shifting, a myriad of government programs ranging from Medicaid to CHIP, and efforts on the part of health care providers to expand government- provided care. Today’s charity care typically fails to meet the real needs of those beneficiaries it pretends to serve and is a system fraught with eligibility requirements, inefficiencies, and unnecessary disincentives.
The good news is that our current system of charity care, to the degree it exists, can be fixed. This paper is one small step toward that end. In it, we stipulate ten principles on which to build a viable and long- lasting solution to effectively and efficiently provide for the health care needs of Utah’s indigent and needy uninsured.
Principle One: In a free society, voluntary charity is always more preferable than government welfare.
Principle Two: Health care is a commodity; charity care is a social imperative.
Principle Three: Civil society is obligated to care for the basic health care needs of the poor among them.
Principle Four: There exists no valid or legitimate right to medical care.
Principle Five: Providing “basic” care is not egalitarian and thus “the same level of care for all people” cannot be a goal of charity care.
Principle Six: All people should be eligible for charity care.
Principle Seven: All people are responsible to provide for their own health care.
Principle Eight: Reciprocity should apply to charity care.
Principle Nine: Health care providers engaged in authentic charity care should be protected from malpractice claims.
Principle Ten: Health care providers are obligated to provide charity care.
A system based on authentic charity care enables civil society to meet its obligation to care for the basic needs of the poor while avoiding the pitfalls associated with government programs. In fact, it totally eliminates government’s role in providing for the needy uninsured and indigent among us. Thus, it is voluntary, inclusive and reciprocal. It emphasizes the moral obligation but does not create a right, and it encourages the entire community to become involved in providing for their neighbors.
Our proposed system emphasizes private initiative and self-reliance as well as extensive community involvement. The experience of the 2002 Winter Olympics in Salt Lake City illustrates the powerful force that is available through harnessing volunteer efforts.
We propose that this new charity care program replace all government programs currently providing health care to the uninsured poor and needy among us. It relies purely on voluntary funding and the service of thousands of volunteers. It is designed to provide basic health care for those in need through a community health foundation, a system of dedicated charity care clinics, and associated providers including hospitals.
Once implemented, an authentic charity care system would meet the needs of all people requiring assistance through a purely volunteer program. It would bring the joy of helping those in need to all supporting the program, ensure that all in need receive basic health care, and allow recipients to become self-reliant while at the same time giving something back to their communities. And, it would do all of this without government involvement.
The Georgia Public Policy Foundation is a driving force for market-based solutions to policy challenges. The work done by this outstanding organization is making a real impact on the future of Georgia. I personally consider the Foundation a primary source for policy ideas. All Georgians are better off because the Foundation is helping lead the critical policy debates in our state.