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Perry sidesteps uninsured issue, reiterates state’s rights

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Sep 3, 2005
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Perry sidesteps uninsured issue, but reiterates state’s rights

Posted on October 20, 2011 at 10:05 pm by Dana Thompson in Campaign 2012, Gov. Rick Perry, Healthcare


The question from GOP debate moderator Anderson Cooper on Tuesday night was about health care, specifically the high number of uninsured children in Texas. Gov. Rick Perry’s answer decidedly was not.

After alluding to Houston’s Medical Center, Perry pivoted to illegal immigration and a 5-year-old charge that his chief rival for the GOP presidential nomination had hired undocumented immigrants to do his yard work.

It was not the first time the governor had ducked a question about the number of uninsured in Texas. Larry Kudlow asked him about it last week on MSNBC’s Kudlow Report.

“Every person in Texas has access to health care, and I think that’s an issue that all too often gets lost in the debate,” Perry said. “The states have the decisions to make, whether or not they’re going to have a wide-sweeping insurance program …”

Perry’s answer got to the heart of the matter as far as the governor is concerned. State’s rights, he explained, trumps comprehensive health care.

“If a state wants to have a huge, expensive, all-encompassing Cadillac plan, that ought to be their call,” he said. “But if a state like Texas decides we want to have the program that is less costly, has less coverage out there, but everyone in our state has access to health care, that ought to be our call, not somebody in Washington, D.C., making it.”

Texas, through its elected leaders, has decided during Perry’s tenure as governor to take the less costly, less coverage approach. The result is a dismal list of health-care rankings that hardly would seem to be a model for the nation.

Opposing arguments

Defenders of the governor’s small-government approach to health care in Texas argue that extenuating factors, including large numbers of illegal immigrants, account for the high number of uninsured.

“Governor Perry supports private-sector solutions and has signed legislation to make insurance more affordable,” Perry spokeswoman Katherine Cesinger said. She listed a health-care cooperative that single-employee businesses can join and legislation the governor signed that allows consumer-choice health plans to exclude mandates that can drive up costs. Cesinger also mentioned Healthy Texas, a new plan to encourage small businesses to offer health insurance.

“Every Texan has access to health care,” she said. “Further, Texas has a strong safety net for children in the state.”

Robert Sanborn, president of Houston-based Children at Risk, disagreed.

“The fact of the matter is that the number of Texas children not covered by health insurance is something to be ashamed of,” Sanborn said. “It shows the lack of leadership and political will to say, ‘We are going to take care of our children.’?”

In all, 1.3 million Texas children, or 18 percent, were without health insurance in 2010, the latest year for which statistics are available. The national figure is 10 percent.

Texas leads the nation in the number of uninsured residents overall. Texas also has the third-lowest percentage of people covered by their employers.

An estimated 6.2 million people — 26 percent of the state’s population, according to the Census Bureau, live without health insurance.

Approximately 49.2 percent of Texans got insurance through their jobs in 2010. That is 6.1 percentage points below the national average of 55.3 and nearly 8 percentage points lower than when Perry took office.

Almost two out of three uninsured Texans have jobs, although most of them make less than $25,000 a year, according to the left-leaning Center for Public Policy Priorities.

A Texas Children’s Hospital study this month found that in the past three years, 400,000 Houston-area children lost coverage through their parents’ work plans. During the same period, the Children’s Health Insurance Program (CHIP) and Medicaid health coverage for children doubled.

Perry famously supported legislation in 2003 to privatize the applications and management process for CHIP, the joint federal-state health insurance program for poor children. The effort left more than 200,000 children — 40 percent of those enrolled — without coverage. It was not until this year that CHIP funding was restored to pre-2003 levels.

Low-income residents

Access to health care and health coverage is especially dire for low-income residents. The state spends less per capita on Medicaid than all but one other state.

The number of Texans who qualify for Medicaid has grown 80 percent since 2001. Yet, lawmakers earlier this year cut $805 million from doctors serving Medicaid patients. They also postponed $4 billion in Medicaid costs for payment, a gimmick to squeeze the state budget into balance. Meanwhile, the state added 4 million residents in the past decade.

Spencer Harris, a policy analyst for the Texas Public Policy Foundation, a conservative think tank, contends that the state’s high rate of uninsured has little to do with the state’s small-government approach, unavailability of private coverage or restrictive Medicaid eligibility rules.

“It’s a combination of things,” he said. “The biggest problem is the cost of Medicaid. Plus, we have a large illegal immigrant population and a growing one, and that inflates our uninsured rate.”

Harris also contends that a significant number of Texans who could afford insurance coverage decide to do without.

The problem, as Harris sees it, is not as critical as it has been portrayed, but he acknowledged Texas can improve. His solution involves eliminating unnecessary regulations, permitting nurse practitioners to practice independently, allowing state employees the option of health savings accounts and — as Perry has advocated — seeking a federal waiver for Medicaid funding block grants.

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Crisis in care: Hospital ERs are strained. Threats of epidemics, natural disasters and terrorism compound the worry.

Copyright 2006 Houston Chronicle

Published 05:30 a.m., Wednesday, June 28, 2006

Medical professionals in the Houston area have been sounding the alarm for years that local hospital emergency rooms are strained to the breaking point. The crush of uninsured patients who have no other health care options aggravates the problem. Now, a new report warns that the country's stressed emergency rooms would be overwhelmed in the event of a terrorist attack, epidemic or natural disaster.

The report by the National Academy of Sciences' Institute of Medicine is chilling in the portrait it draws of today's emergency room misery: People can wait two days to see a physician, ambulances are forced to drive critically ill patients to distant hospitals, while many ERs operate with too few nurses and no neurosurgeon or other specialists.

Though the broad outlines of the problem have been understood for years, the report reveals that the situation is worsening. Emergency room visits increased by 26 percent from 1993 to 2003. Hospitals responded by curtailing trauma care to stem the spiraling cost of treating ever larger numbers of poor, uninsured patients. According to the report, hospitals closed 425 emergency departments and shut down 198,000 beds over 10 years.

Representatives of the city of Houston, Harris County, professional medical groups and the Greater Houston Chamber of Commerce have been working together to lessen the burden on local trauma care facilities. One remedy is to make treatment and preventative care more widely available to the poor and uninsured and closer to where they live. Only then will emergency rooms be free to perform their duty to gravely ill or injured patients.

Last year, a Harris County public health task force recommended consolidating public health and medical services; increasing access to clinics for preventative, primary and specialty care; and improving access to health insurance. The state would make strides toward the latter by removing barriers to and broadening eligibility for coverage under the Children's Health Insurance Program for children of the working poor.

Some place primary blame for trauma care overuse on illegal immigrants, who often are uninsured. But Texas has the largest percentage of uninsured residents in the country, making lack of coverage a problem that affects millions of citizens and legal residents. Focusing emergency room relief efforts on the undocumented will do little to solve the problem of uninsured Texans and swamped hospital emergency rooms.

Preparing ERs to deal with the press of patients that an act of terrorism, the next hurricane or an outbreak of disease could bring will take extraordinary efforts, from increased Homeland Security outlays for disaster-related care to coordination of EMS, public health and public safety agencies.

Emergency room crowding is not new. But new threats make finding solutions more urgent than ever.



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Apr 12, 2008
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real world
“Every person in Texas has access to health care, and I think that’s an issue that all too often gets lost in the debate,” Perry said. “The states have the decisions to make, whether or not they’re going to have a wide-sweeping insurance program …”


I didn't think he did that well in the debates, but thanks to flounder, I see he did pretty good.

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