Perry shirks his duty on Texans’ health care

Austin American-Statesman, July 12, 2012

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It takes some kind of chutzpah for a governor of the state with the highest percentage of uninsured — 1 in 4, or about 6 million Texans — to draw a line in the sand and announce that nothing's going to change.

Gov. Rick Perry threw Texans under the bus Monday when he announced our state would not expand Medicaid, leaving $76 billion from the federal government on the table.

He also refused to create a health care exchange, an online market allowing the uninsured to shop for coverage.

You can just see him pounding his chest as he composed the letter to U.S. Health and Human Services Secretary Kathleen Sebelius: “Both represent brazen intrusions into the sovereignty of our state.”

He included the requisite talk of guns and the obligatory thrashing of the Medicaid program. He thanked God and the founders for his right to reject the federal “power grab.”

It takes some kind of chutzpah for a governor of the state with the highest percentage of uninsured — 1 in 4, or about 6 million Texans — to draw a line in the sand and announce that nothing’s going to change.

This cowboy swagger is amusing in an Austin City Limits ad, but in a letter from the head of a sovereign state to a member of the Cabinet?

Perry seems to be in a time warp, stuck somewhere between the American Revolution and the Wild West.

It would be humorous if it were not so disastrous.

In the 11-county Central Texas region, 360,000 people are uninsured.

Central Health, the Travis County hospital district, could have saved $7 million to $8 million a year, which could have been used to more effectively provide primary care.

People’s Community Clinic could have earned $1 million for primary care (more than 10 percent of its budget).

Some of the most frequent emergency room users will continue to be the mentally ill.

Costs will continue to be shifted to taxpayers and consumers through higher insurance premiums.

Expanding Medicaid would give us $76 billion between 2014 and 2019, with Texas putting up about $6 billion from the state budget for its share. That $6 billion is far less than Texas hospitals now spend in a single year for uncompensated care.

In the last paragraph of Perry’s letter to Sebelius, he wrote, “I look forward to implementing health care solutions that are right for the people of Texas. I urge you to support me in that effort.”

Really? For 12 years, public health care providers have waited for Perry to do something about health care.

All we’ve seen is a failed executive order to inject all sixth grade girls with a vaccine to protect against a sexually transmitted virus, an immunization made by the drug company for which Mike Toomey, his former chief of staff, lobbies.

Toomey also ran the pro-Perry super PAC during his failed presidential campaign.

In an interview Monday on Fox News, Perry said that the federal government doesn’t like us anyway and their data is just “fake and false on its face. The real issue here is freedom.” Really?

As a neonatal nurse, I’ve taken care of lots of sick and premature babies and their families, and I talk to plenty of Texans outside of work.

I have never once heard anyone express concern about Texas’ sovereignty.

I have, however, heard from a whole heckuvalot of Texans worried — make that panicked — that they might not be able to get insured, they lost their insurance with their job, they can’t find a primary care provider, they might go bankrupt with medical bills, or they will have an accident or illness in which they would have to come with the $10,000 they would owe before their deductible were to kick in.

There are babies at Dell Children’s Medical Center whose care may cost $4 million to $5 million in a year, yet their insurance coverage has a $1 million annual limit.

The hospital is out that money, and their parents are hopelessly in debt. Fortunately, by 2014, annual limits will be completely prohibited thanks to the law.

On any given day, the emergency room at University Medical Center Brackenridge — and every other public hospital in Texas — is full of people waiting to see a doctor for primary care. Without insurance, they can’t just pick up the phone and make an appointment.

I invite you to try doing that. It’s a real eye-opener.

Nurses see the tragedies every day of uninsured people who have put off seeking care until it’s too late.

Lives are shortened, quality of life is destroyed and hearts are broken.

Texas legislators must see this, too, because of the 254 counties they represent, 185 are considered medically underserved and parts of 46 others fall under the designation.

Maybe when the Legislature convenes in January, its members can turn this around and take the federal government up on its offer.

Without executive leadership, it will take real guts, but lawmakers could drag Texas off the bottom of the statistics heap and get their neighbors the medical care they need.

Toni Inglis, MSN, RN CNS (retired), FAAN, a lifelong Austin resident and retired neonatal intensive care nurse and editor of NursingNews, writes a monthly opinion column for the Austin American-Statesman editorial page.