Thursday, November 14, 2013

A Sad State of Affairs in the Texas "Safety Net"

Being poor or uninsured in Texas means you get left behind to die...not that it should surprise anyone...a well-written article by a Texas doctor who is in the trenches daily trying to heal people with no support from our great state.

But UTMB is no longer the state-subsidized charity hospital it used to be. The changes began before Hurricane Ike in 2008. But after the storm, UTMB administrators drastically cut charity care and moved clinics to the mainland, where there are more paying patients. The old motto “Here for the Health of Texas” was replaced by “Working together to work wonders.” Among those wonders are a new surgical tower and a plan to capitalize on Galveston’s semi-tropical charm by attracting wealthy healthcare tourists from abroad. Medical care for the poor is not, apparently, among the wonders. Whereas UTMB accepted 77 percent of charity referrals in 2005, it was only taking 9 percent in 2011.
UTMB ascribes these changes to financial strain from Hurricane Ike, the county’s inability to negotiate a suitable indigent-care contract and loss of state funding. The state blames budget shortfalls. The Affordable Care Act, better known as Obamacare, could have been a huge relief. However, Gov. Rick Perry rejected billions of dollars in federal funding to expand Medicaid, funding that should have brought access to more than a million Texans, including many St. Vincent’s patients.
Perry’s refusal is catastrophic health policy. For patients, it means that seeking medical care will still require risking bankruptcy, and may lead nowhere. For doctors, the message was not only that our patients’ lives don’t matter, but also that medicine—our old profession, so full of people who genuinely want to help others—will continue to be part of the economic machine that entrenches poverty. When the poor seek our help, they often wind up with crippling debt.