In a perfect Texas, every child in the state would have access to healthcare, small businesses would not struggle financially to provide health insurance to their employees and proper healthcare and disease prevention would be stressed at every level of the education system.
But the grim reality is that the overall health condition of Texans is poor; the state has the highest percentage of the uninsured in the United States and far too many parents and children still lack the educational wherewithal to adequately address their health concerns. With those issues – and a host of other health-related concerns – serving as a framework, the Task Force for Access to Health Care in Texas is working toward finding practical solutions for improving the state of healthcare in Texas. As Task Force co-chairs, Neal Lane and Jack Stobo stated in the Code Red: The Critical Condition of Health in Texas report, “the Task Force is singular with regard to the importance and magnitude of the problem that inadequate health insurance poses, not only to the physical and mental health of the residents of Texas, but also to the financial well-being of the state.”
The Code Red Task Force convened an open meeting in October to discuss concerns raised in the report and hear a wide variety of perspectives about next steps. “We were very gratified that a standing-room-only audience participated in a series of panel discussions about access to healthcare. The comments were exceedingly valuable to the Task Force as it considers how best to move forward and build upon the momentum created by the Code Red report” said Dr. Kenneth I. Shine, UT System executive vice chancellor for health affairs. Four new members joined the Task Force, including Charles Begley (professor, Management and Policy Community, UT Health Science Center - Houston), Jodi Jiles (managing director, RBC Capital Markets), Bill Sage (vice provost for health affairs and James R. Dougherty chair, The University of Texas at Austin) and Patti Patterson (professor of community pediatrics, Texas Tech University Health Sciences Center). Lynne Kirk of Dallas has agreed to serve as senior consultant to the Task Force.
What’s next? After a productive meeting, the Task Force agreed to form work groups to assess progress made toward recommendations made in the report and issue an updated report next March.
Among the issues the Task Force will explore are challenges associated with paying for healthcare. The Task Force had been charged with thinking beyond traditional boundaries and constraints to develop innovative ways to fund healthcare such as a single-payer system that follows the employee rather than the employer.
A question that Task Force members raised was whether employer-based insurance works, particularly at the small-business level. More than 70 percent of all Texas businesses are small employers, and only 37 percent of those businesses offer health insurance to their employees. Even then, only 35 percent of those employees offered coverage actually enroll in insurance plans, primarily because the coverage they are offered is unaffordable. There is great variability in coverage rates when the cost of care burden is adjusted individually or only within a small group, which causes small businesses to pay more than large employers for similar coverage.
Another area of concern focuses on the information gap about healthcare that exists because many Texans lack the education necessary to seek and comprehend that information. The Task Force is looking at creating partnerships with the education community to create a plan for better educating the people of Texas about the importance of preventive heath care as well as what role the government can play in addressing this concern.
Equally troubling were findings that current trends of healthcare delivery in Texas could potentially make our existing problems worse. In the current system, overdependence on emergency rooms for accessing primary care for the uninsured is the most expensive means of delivering care. In addition, the current county-based approach to delivery of healthcare in Texas is inadequate and inequitable, the Code Red report found. Expansion of ambulatory (outpatient) services statewide is an essential, more cost-effective means of healthcare delivery. Additionally, Texas needs to focus more on dental care and mental and behavioral healthcare.
According to the Task Force, one conclusion is clear: Texas is getting poorer and less competitive economically because of the critical condition of healthcare statewide. Now is the time for bold, not incremental, steps to address the healthcare problems and assure the economic vitality and the health of the state. Strategies that both control the cost of health insurance and ensure the most cost-effective delivery of healthcare access for all Texans are needed.
The Task Force will review Code Red: The Critical Condition of Health in Texas report and attempt to be more specific in many areas of the report, refine the recommendations, engage the public and stakeholders and develop quantifiable measures, such as a scorecard for each recommendation for success in the updated report early next year.
