In some ways, the spread of the coronavirus (COVID-19) has been like watching a slow-motion car wreck: You can see the impact and the damage coming a long way off, but it seems like a long time coming. Then again, the accelerating speed of the fallout is breathtaking: sporting events, schools and even the General Assembly are on indefinite hiatus.
Crises like a pandemic happen all at once, but the ability – or inability – to respond to them develops over time.
Which will it be for Georgia?
It’s hard to say for certain. But over the years – in some cases, decades – our state leaders have declined to enact some important policies that would have put us in a better position. Gov. Brian Kemp has a great deal of executive discretion now that the General Assembly has ratified his declaration of a public health emergency. His administration should consider executive actions to remedy this situation so that Georgia can begin catching up as soon as possible.
Just as flexible labor markets help American companies respond and rebound quickly from disruptions in their industries or the broader economy, flexibility and adaptability in healthcare are crucial as Americans face down the coronavirus. But as with labor markets, not all states are equally flexible or adaptable in this regard; some have better policies than others.
For example, the hardest-hit states are likely to face a shortage of hospital beds. This is especially true if they make it hard to add beds in the first place by maintaining obsolete, onerous “certificate of need” laws that drastically restrict providers’ freedom to open new facilities or expand existing ones. More than two-thirds of states still impose these CON laws, even though the federal government ended CON mandates and even recommended repeal. Sadly, Georgia is one of the states that still has CON laws.
Instead of letting private entrepreneurs and companies decide whether it’s worthwhile to invest in new hospital-bed capacity, our state effectively lets their competitors veto their plans through a long, expensive, litigious process. It’s as if Colonel Sanders had been able to block Truett Cathy from opening his first restaurant – and we needed “mor chikin.”
Georgia’s CON laws include provisions that providers “may” seek emergency approval for expansions during a crisis, and regulators “shall” decide in no more than 30 days. But why maintain all this hoop-jumping when manpower is stretched thin and time is of the essence? Kemp should follow the lead of states like Michigan and North Carolina and waive many CON restrictions for the duration of the crisis.
With a shortage of healthcare workers even before the pandemic, making more of them fall ill and exacerbating the problem, it also would be nice right about now if those we do have could practice medicine to the fullest extent of their training – their “scope of practice.”
Unfortunately, to name one example, Georgia is not one of the 22 states that have passed laws allowing nurse practitioners to ease more of the workload of doctors, who can then focus on advanced procedures. This includes evaluating patients, working with diagnostic tests, managing treatments and even prescribing some medications, according to the American Association of Nurse Practitioners.
Several states have loosened such restrictions for a variety of medical professionals. As another example, Florida just passed a bill allowing pharmacists to test and treat conditions such as strep throat, freeing up other practitioners to focus on the virus and other more acute needs. This is another area in which the Kemp administration should explore removing regulatory barriers.
There is some good news. Today, a doctor on the other end of a video connection can diagnose a number of health problems without an in-person consultation. Telemedicine can reduce exposure for patients (whether from the highly contagious coronavirus or another ailment) and medical workers alike. It could also allow doctors in unaffected areas to quickly help patients where there are outbreaks.
Thankfully, a bill authorizing physicians licensed by another state to practice telemedicine in Georgia was passed last year and took effect July 1. Georgia has also entered interstate compacts to recognize some health professionals’ licenses issued by another state, and President Donald Trump issued an executive order pre-empting such cross-state barriers.
Let us hope the measures we have already taken are enough this time – and resolve to take others as soon as possible.