June 12, 2006
I grew up in a hospital. My mother worked most of my life as a nurse in a hospital. I got the chance to work there too as an orderly. I loved being an orderly, even though the nurses were merciless in finding the nastiest things on earth for me to do.
I’m also passionate about health care. For very personal reasons.
I’m supposed to be dead. As many of you know, I’m a cancer survivor. I would be dead, but for access to excellent, early and frequent health care. I’m one of those people who did not die because I didn’t need more health care than I could afford.
I lost my mother Billye Watson to cancer when she was only 62. Daddy died because of cancer 13 months before her, when he was only 66.
But, both lived many years fighting that beast because of access to quality health care.
Each day, Liz, our son Preston, and I address the needs of that great kid who is basically on a life support system, working to control his Type 1 diabetes with at least 4 shots of insulin a day and blood tests that are no less frequent than 8-10 times a day.
So, I’m personally committed to assuring health care for Texans. It is a key reason I want to be in public service. And, I should also mention, I considered what Billye Watson did in that hospital every day to be a high calling of service.
As a former mayor and former chair of the local chamber of commerce, I can personally testify to the role that businesses like hospitals serve in our community in terms of jobs and impact on our local economies. Hospitals are a major employer in our state. They create hundreds of thousands of jobs and over $85 billion dollars in economic activity. Plus, they play a major quality of life role when it comes time to attract business and educated workforce. The truth is that the people we want to grow our economy in Texas want to live where there is quality hospital and health care.
Even so, you all know the problems with health care in our state better than I do. You know what our ongoing failure to treat our ailing friends, neighbors, and family members means to Texas’ physical, economic, and educational health.
You know Texas ranks at or near the bottom nationally in per capita health spending and the number of doctors and nurses. You know as well as anyone the stress this puts on the entire state when Texans need — I say again, when people will die without — more health care than they can afford.
You know Texas is near the top in the number of uninsured people and, most troublingly, uninsured children. You know the horribly pernicious effects this has on our state’s economy, its schools, and its image.
You know better than I do all of the frightening statistics that are far too high, as well as the reassuring ones that are so low it’s hard to sleep at night.
I’m sure you all are familiar with the Code Red Report, which was assembled by a distinguished task force and published by the University of Texas System this year. The report puts into tragic relief the deficiencies in the way Texas treats its sick, injured, and infirm.
But the Code Red Report is only the latest sign of something that you all already know — Texas’ failure to address this crisis is not just an issue for Democrats and Republicans to haggle over every two years.
It is, instead, a disease — a devastating disease of poor public policy that by itself takes the lives of 2,500 Texans who die every single year simply because they don’t have health insurance.
Fortunately, there are things we can do to treat this disease. They are relatively simple, common-sense strategies. And, I suspect, you probably already know what they are.
First, we must — absolutely must — cut down on trips to the Emergency Room. The ER is the most expensive place to get health care in most communities, particularly urban ones. It is also the only place that is forbidden to turn people away. And, unfortunately, it is the most popular.
If this were any other business — if executives refused to advertise or invest in efficient assets, or if they insisted on needlessly pouring critical resources into the very facilities that cost them the most money, then these leaders would be thrown to the lions. Yet, that is how we, as a state, collectively run the business of health care.
We have to do things differently, and we have to start with the emergency rooms. We have to invest in efficiencies that preserve health, prevent illness and avoid the ER.
Second, Texas has to start asking for its fair share of health care money from the federal government.
Now, folks, I know I’m just a simple Democrat. But I do hope that if I’m lucky enough to serve in the Texas Senate next year, someone will explain to me what’s so wrong with asking for money that someone in Washington D.C. wants to give us. And it’s ours.
It’s like Ed McMahon is standing at my door step with a giant pile of money that I gave him. I’m not going to tell him, “No thanks. Take it on down to Mrs. Massachusetts’ house.” I don’t get it. Why are we sending Texans’ hard-earned tax dollars to California?
Third, Texas has got to do a better job protecting its children. Right now, 1.4 million children in our state don’t have health insurance.
1.4 million kids. That’s like a city bigger than Dallas, populated only with innocent boys and girls who have done nothing wrong. They just got sick or hurt — and were unlucky enough to have parents who can’t afford, or refuse to buy, health insurance.
Now, Texas actually has a program that was doing a pretty good job protecting a lot of those kids. In 2003, over a half-million boys and girls were signed up in CHIP.
But then we cut the program to its marrow, made it much tougher to sign up, made it difficult for parents to find out it existed, and finally turned the whole thing over to a private company that, up to now, has utterly failed to do its job.
And so we have chiseled nearly 170,000 children out of CHIP — which is akin to the state descending on my hometown of Fort Worth and stripping every child there of health insurance. By the way, not one of those kids got well as a result of this activity. They still ended up in your emergency rooms. But now, with no way to pay.
Of course, it’s bad economics to not take care of the health of our fellow Texans. The cuts in Medicaid and CHIP funding in 2003 meant many bad things for our economy. They meant higher local taxes to compensate for the increase in emergency room visits; they meant more costly visits because people were forced to put off seeking health care until a later time; and they meant those who could afford health insurance faced increased premiums.
I’ve been doing a lot of economic development over the last decade, including offering tax incentives and urging government to do so.
And, I’m a big supporter of those incentive programs.
But, in every instance, every time we offered an incentive or a tax break to some company to locate here and create jobs, we were gambling. We gamble on whether the jobs will be created.
With investment in CHIP, the state is able to get a guaranteed return.
For every dollar invested (call that our “incentive”), the federal government assures $2.59. That’s a great return. And, that’s before the money is then used to compensate your hospital for services, which allows you to pay workers, create or preserve jobs, and see the money churn through our local economies. From a purely economic development standpoint, I’m hard pressed to think of a better investment program.
Finally, we have to be a lot more creative and innovative about the way we provide health care in Texas. This, I believe, is the area where you all can, and I hope will take the time to, teach me the most.
You know the technological developments in how medical records are kept and analyzed.
You know the cutting-edge advancements in disease management and multidisciplinary care.
You know almost
uitively what resources communities have and how they can work together.
You know the public- and private-sector innovations that are helping individuals and small businesses connect with insurance programs across the country.
And you all have tremendous ideas that haven’t even been tried yet.
Right now, I firmly believe that the most important thing we can do is admit that Texas can do better. Let’s admit we’re sick.
Unfortunately, this is not as easy as it sounds.
I don’t believe that Texans elect us to ignore or rationalize this problem as a growing population and rising health costs tear at the fabric of our health system. I believe they elect us with the expectation that we will work, experiment if we must, but ultimately meet our state’s challenges with something more than denial.
Once we admit that simple fact, that Texas can do better, then we can come together with our unique experiences and shared sense of mission to produce the marvelous system that our state deserves.
You are all here, in this profession and this room, because of your commitment to the health of our state and its people. That you are here is a tribute to your considerable talents and the way you’ve used them. I thank you and congratulate you for all that you’ve done for the public and its health.
But please know that I, the State Legislature, and the people of Texas have never needed you as much as we do now.
God bless you all, and thank you for all you do.