Proposition 1 would improve care now and in the future

Austin American-Statesman, October 26, 2012

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Nationally, the health care industry has thrived despite the economic downturn, so a medical school is a smart investment.

Opponents of Proposition 1 ask why the state doesn’t pay for a medical school here. If we wait for the state, we’ll grow old and die. Both the legislative and executive branches of our low-tax, low-service state have signaled clearly that the burden of health care costs will be shifted to hospitals and local property owners.

Last session, funding for Medicaid was cut — despite Texas having the highest percentage of uninsured and the lowest ranking for access to health care in the nation.

Legislators also cut graduate medical education (residency programs for doctors in training) — despite evidence that beginning in 2014, Texas won’t have enough residency slots to accommodate all of our medical school graduates. That means Texas is spending $168,000 per student to educate doctors for other states, because doctors tend to stay where they’re trained.

And in July, Gov. Rick Perry guaranteed a heavier burden on hospitals and local taxpayers by turning down a 9-to-1 federal match in health care dollars to expand Medicaid (in the name of state sovereignty).

Last year, the state announced a new, temporary Medicaid transformation waiver that could result in a windfall of federal dollars. Sen. Kirk Watson, D-Austin, went into action. This is personal to him. He’s had cancer, and he represents the only large urban area in Texas without a medical school. Austin’s also the biggest U.S. city home to a top-flight research university that doesn’t have a medical school.

He brought together three partners to make it happen — Central Health (the Travis County health care district), the University of Texas at Austin and the Seton Healthcare Family.

Central Health is asking voters for a 5-cent tax increase per $100 assessed property value. At about $10 million per penny, $50 million would be raised, which would be leveraged to pull down about $80 million from the feds, equaling $130 per year — $35 million to pay for medical school faculty and resident services and nearly $100 million to help pay for much-needed projects demonstrated to transform and improve care.

The University of Texas at Austin will pay $25 million per year to build, staff and operate the school, plus an additional $5 million for the school’s first eight years for equipment. But UT requires the Central Health share to proceed.

Seton plans to build a $250 million teaching hospital to anchor the school, replacing the aging University Medical Center Brackenridge, which Central Health owns and Seton has operated since 1995.

As a practicing nurse, I can tell you we desperately need Central Health to have an increased capacity.

In neonatal intensive care units, how many of our babies could have been carried to full-term had their mothers had easily accessible prenatal care? The NICUs have cutting-edge technology, yet after weeks of skilled care (and sometimes millions of dollars), for some families I hold my breath at discharge. Will they be able to get the baby’s sore throats and fevers treated as efficiently as its extreme prematurity?

We want the mentally ill to be cared for in offices and clinics — not the county jail. Partnering with Austin Travis County Integral Care, the capacity to treat people will significantly improve. Telemedicine will counter a shortage of psychiatric practitioners by bringing virtual face-to-face consultations in the ERs, clinics and offices and for returning vets at the new Veterans Administration outpatient clinic being built on Montopolis Drive — the largest freestanding VA outpatient clinic in the nation.

The community needs that medical school. A recent study found Central Texas would be 770 doctors short by 2016 because of a large number of retiring primary care doctors and a growing and aging population.

The school will create a synergy among UT’s prestigious schools of nursing, biomedical engineering, pharmacy, and others to create world-changing innovation. The math makes sense. The increase would amount to about $100 for the average home value of $215,000. Nationally, the health care industry has thrived despite the economic downturn, so a medical school is a smart investment. It could eventually pump $2 billion and 15,000 jobs into Austin.

Nurses want folks to get the right care, in the right amount, in the right setting. We want ERs to be places people go to for emergencies only.

Proposition 1 would allow for a substantial improvement in care for all of us, sustainable far into the future.

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.