ATHENS, Ga. — The coming session of the General Assembly could include a protracted battle between hospitals on one side and on the other, physicians and out-of-state corporations interested in setting up cheaper treatment centers.

That was the conclusion lawmakers drew Tuesday from a panel discussion at a conference at the University of Georgia previewing issues before the General Assembly.

A lawyer for physicians and the companies argued that a 1979 state law reducing competition between health providers is outdated and results in monopolies that keep prices artificially high.

“The problem is that if we force all the business to go to that one provider, all of us are paying more money,” said Victor L. Moldovan of McGuire Woods.

Hospital executives say they depend on the law that requires a state certificate of need before any health facility can open. Removing it would jeopardize an estimated 19 rural hospitals that are on the verge of closing, such as Putnam General Hospital in Eatonton.

“You take all the requirements off of hospitals to be open 24/7 and never being able to turn away a patient like these treatment centers enjoy, then our costs will go down,” said Gregory Hearn, CEO of Ty Cobb Healthcare System in Royston.

Hearn and his colleagues complain that doctors and corporations establish outpatient treatment centers that skim off the most lucrative business, leaving the hospitals to care for the uninsured and those covered by government plans that only pay 80 percent of the cost of procedures.

There’s no specific recommendation to repeal or make wholesale revisions to the requirement for a certificate of need. They would likely come up if lawmakers consider a minor change to allow rural hospitals to downgrade their emergency rooms to save money.

The emergency room proposal never got a hearing in the last legislative session although the Board of Community Health did make some administrative changes to address some of its provisions after the session ended.

The hospitals like the idea and say it would allow them to shed requirements for expensive, round-the-clock staffing. They just don’t want the discussion to expand to include the possible repeal of provisions that keep competitors at a distance.

The physicians and companies don’t want to let the opportunity slip by to get the greater freedoms they want. ┬áLegislators are stuck in the middle.

“Healthcare is changing, and hospitals are going to have to change, and physicians are going to have to change,” said Rep. Sharon Cooper, chairwoman of the House Health and Human Services Committee.

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