I shake a lot of hands on the job. It is a routine part of my day. Today, the usual hand shaking routine was interrupted.
"It's the flu."
The woman refusing to shake my hand gave me a short nod instead, as if she had just washed her hands and they were still wet. Yes, the interaction was awkward, but it is stuck in my head for a second reason. As this woman and I awkwardly exchanged small talk about the flu epidemic sweeping Georgia right now, I could not help but notice in her expression a subtle but unmistakable trace of fear.
I recognize this fear because I feel it myself. The flu has been the center of a lot of conversations lately. Meetings have been cancelled. Work has been missed. Influenza is in the news each morning. Flu-related deaths in Georgia have doubled. Again. Hundreds are in hospitals. Now Grady is opening a mobile ER to handle the overflow.
Maybe you are like me, and you wonder if your number is about to come up. This morning, for example, I woke up with a tickle in my throat. Probably I just need to get more sleep. Then again, I wonder. Is it the flu?
How bad will it be? How much work will I miss? Will my friends and family get sick now too?
Eventually, I tell myself everything will be fine. My health is generally okay. And what are the odds that I would get sick anyway? Even if I do get sick, I may miss some time at work, but I will most likely heal. I always have before. I will probably even survive the medical bills. I have health insurance after all. Yes, everything will be fine. I have health insurance.
That is when I remember that more than 1.3 million Georgians do not have health insurance. I wonder how these Georgians feel about the flu. What is the fear like for them? Or is fear over the flu just another privilege they cannot afford because there are more pressing concerns, like how to put food on the table, and how to pay rent?
I have an educated guess about how uninsured people feel about the flu. It is based on a recent visit to a friend in the hospital. He has a chronic illness, and he had major complications just days before he lost his health insurance due to a career move his wife was making. He was lucky. Now, he cannot afford health insurance as his wife gets her startup off the ground. He may feel fear, but he really cannot afford that either. Instead, he relies on hope. He has hope the flu will pass him over. He has hope his chronic illness will not flare up. He has hope that his wife's startup will be successful. He has hope he will be able to find help if his luck runs out.
But I wonder if Georgia can support this kind of hope. Georgia is currently in a crisis mode when it comes to health care for low-income people. This is despite the fact that the U.S. Congress and the Trump administration are currently offering Georgia nine dollars for every single dollar the state invests in health insurance for low-income adults like my friend. If it sounds like a good deal, that is because it is. In fact, economists say Georgia would even get its small portion of the investment back through the economic activity generated by accepting the federal money. The money would come through the Medicaid program, which is largely privately managed in Georgia, and the Trump administration would even allow Georgia to place work requirements on beneficiaries if we wish to do so (my friend works two jobs, so as with most people on Medicaid, this would not matter, outside of the hassle with bureaucracy and red tape).
While people initially had concerns over accepting federal money, those concerns have been steadily addressed and resolved over the past several years through economic analyses and studies of other states that have accepted the offer. It has also become apparent that the federal money would go a long way toward helping Georgia's struggling hospitals by bringing in more paying patients, patients who are currently being served without compensation, or not at all.
The main question on the table now is: why are we still waiting? Georgia has a real opportunity to request the added federal Medicaid dollars during the current legislative session. But whether we do an expansion (Democrats) or a waiver (Republicans), it is going to take decisive action in in capitol as well as the support of citizens of all backgrounds across the state.
Most importantly, in order to move forward, we are going to have to put aside our fears. Precisely because the problem is so real, now is the time to show that Georgia will not be a place of fear. We need to show that Georgia will be a place of hope.
Dr. Lanford is a postdoctoral research fellow affiliated with Georgia State University and Emory University. His research focuses on the politics of health policy and the consequences of health policy for population health.