From: Metroplex Health System

(May 13, 2008) – The president and CEO of the Texas Hospital Association said today that the state’s uninsured crisis is the most pressing problem facing Texas’ health care delivery system.

In a speech to Metroplex Health System board members, physicians and administrators, THA President/CEO Dan Stultz, M.D., FACP, FACHE, stressed the need to reduce the number of uninsured Texans and encouraged local business and community leaders to get involved and to help make Texas’ uninsured crisis a state legislative priority for 2009.

Texas has the highest rate of residents without health insurance in the nation. Currently, one in four Texans – or nearly 5.7 million residents – has no health insurance coverage, and in Texas’ large cities one in three is uninsured.

There are nearly as many Texans without health care coverage as there are people living in the entire Dallas-Fort Worth Metroplex.

Stultz said that because the rate is so high, every Texan, including those with health insurance, is affected by the crisis.

“Not only do those with health care coverage pay higher premiums to offset a portion of the cost of the uninsured, but more importantly, overcrowded emergency rooms and a shortage of specialty physicians in ERs means that you may not be able to access the help you need, even if you have health insurance,” Stultz said. “The bottom line is, even if you and your family currently have health care coverage, you are hurt by this growing problem.”

Stultz explained that low income families who cannot afford to buy health care insurance and therefore do not have a family doctor, often turn to hospital emergency rooms for non-critical care.

This clogs hospital waiting rooms as these patients receive health care that could have been provided faster and more cost effectively in a clinic or outpatient setting.

Stultz pointed out that a surprising 82 percent of the uninsured are from working families, and only 53 percent of Texas employers provide health coverage to their employees.

Employer-sponsored insurance decreased 5.5 percent in Texas from 2000 to 2004.

“Unfortunately, in order to compete in a global economy, Texas businesses have no choice but to continue to drop health benefits or pass the costs on to employees, who often can’t afford the premiums,” Stultz said.

While Stultz acknowledges that there is no “silver bullet” that will fix health care, he said there are a number of steps the state can take to begin to address the uninsured problem.

“No one piece of legislation, no magic policy or program will fix all the problems, but reducing the state’s uninsured population will help relieve some of the pressure.”

During the 2007 legislative session, THA began advancing a series of proposals to address the uninsured rate.

Several of these proposals will be studied by legislators during the next year for possible consideration during the next legislative session, which starts in January 2009. These proposals include:

 Creating access to a new, more affordable minimum benefits package that provides preventive and primary care health coverage with a low deductible for Texans and their families;

 Making health insurance products affordable and accessible to regional or statewide pools and cooperatives of individuals and small employers;

 Providing incentives for businesses – including hospitals – to pay a reasonable percentage of an employee’s health insurance premium or pay into a state pool providing health care coverage for uninsured individuals;

 Requiring that companies receiving state enterprise fund assistance or local tax rebates, as well as those companies that do business with local and state government, provide adequate and affordable health insurance to their employees;

 Establishing a personal mandate – similar to auto insurance – that requires individuals to have at least a minimal level of health insurance coverage, with premium assistance for certain low-income populations and the disabled;

 Allowing parents to cover adult children on their health insurance policy, regardless of age or student status;

 Funding state Medicaid and the Children’s Health Insurance Program (CHIP) adequately so that the working poor and disabled have access to health care coverage;

 Leveraging federal matching funds for Medicaid more effectively and efficiently at the state and local levels; and

 Allowing adult family members of children enrolled in government insurance programs like CHIP, to buy into these programs and become insured, based on their ability to pay.

“Texas hospitals strongly believe that health care coverage needs to be accessible and affordable, so that all Texans have access to basic health care services,” Stultz said. “Every child should receive appropriate preventive and primary care, and mental health resources must be available for those who need them. Money should be directed first to expand existing programs that impact the people who have chronic illness and are already very sick. At the same time, we can pilot new programs to test various models.”

“The time to act is upon us,” Stultz said. “Texas’ health care crisis is real and is getting worse every day. We know that if we wait for federal action, it will not address the unique needs of our state’s population – and most certainly – it will be too late. ”

On the Web: www.gettexascovered.com

Founded in 1930, the Texas Hospital Association is the leadership organization and principal advocate for the state’s hospitals and health care systems. Based in Austin, THA enhances its members’ abilities to improve accessibility, quality and cost-effectiveness of health care for all Texans. One of the largest hospital associations in the country, THA represents more than 85 percent of the state’s hospitals and health care systems, which employ some 340,000 health care professionals statewide.