Posted on 03/24/2003 5:46:57 PM PST by FITZ
Supporters of medical malpractice/lawsuit reform routinely cite the plight of high medical malpractice insurance for border doctors in making their case.
No one disputes the problem.
But addressing medical malpractice is not likely to fix a bigger problem facing border doctors: too many Medicaid and CHIP patients and not enough commercial or private pay patients.
In El Paso, the patient mix runs heavy on uninsured and government-sponsored health insurance programs, such as Medicaid (for low income), CHIP (for children) and Medicare (seniors). According to a Community Scholars study using government data, the 2000 insurance mix for El Paso was 35 percent uninsured; 33 percent government programs; 32 percent commercial or private pay.
The patient mix was similar in Hidalgo County in the Lower Rio Grande Valley.
In Austin, the insurance mix (for 2000) was 18 percent, uninsured; 13 percent government programs; 69 percent commercial or private pay.
Because commercial insurance pays higher rates than CHIP or Medicaid, El Paso and other border doctors end up seeing many more patients each day -- for far less compensation.
El Paso would need nearly 300 more physicians to reach the statewide average of 152 per 100,000 people.
House freshmen Republicans summoned the Capitol media last week to talk about their unified support for House Bill 4, which is the massive medical malpractice/lawsuit reform. They mentioned the problem of medical malpractice insurance for border doctors.
But they declined to offer solutions for the bigger problem.
"We're not here to address that today. But I will tell you that it's a big concern," Rep. Dan Gattis, R-Georgetown, said.
Poverty of the mind
Here's a clue to underscore the desperation of state lawmakers looking for budget cuts: They're thinking about cutting school-dropout prevention programs.
The school dropout rate in the mid-1980s hovered around 33 percent, and today it's about 39 percent, Sen. Gonzalo Barrientos, D-Austin, told his colleagues last week.
Among Hispanic students, the dropout rate approaches 50 percent, he said.
Nearly 2 million Texas students have dropped out of school in the past 15 years, carrying an estimated economic cost of $468 billion, Barrientos said. That's billion, with a "b," he repeated.
Close to 90 percent of the inmates in state prisons never finished high school.
"If we don't do prevention programs for humanitarian reasons, let's do them for our pockets," he said.
Poverty triggers a primary reason for students dropping out, Barrientos said: "Poverty of the mind as well as poverty of the pocket."
Premise dropout information is difficult to get, but consider the numbers for El Paso's largest school district. For the El Paso Independent School District, 5,876 students enrolled in the ninth-grade class, but only 3,269 were remaining in that class four years later. That's an attrition rate of 44.4 percent.
A better prescription
Three El Paso pharmacists joined with colleagues around the state last week to lobby lawmakers about prompt pay measures and reimbursement rates for Medicaid prescriptions.
Barry Coleman, David Owen and Emmanuel Obi represented El Paso pharmacists.
Pharmacists lose money every time they fill a Medicaid or Children's Health Insurance Program prescription, said Coleman, who would like to retire one of these years.
"We're all busy, even if it's filling prescriptions below cost. It's crazy," Coleman said. "I'm trying to sell my stores. One reason I can't sell my stores is because so much business in done with Medicaid and CHIP."
Pharmacists order drugs every day and get billed every 15 days, Obi said. But it takes 40 to 50 days for insurance companies to pay the pharmacists, he said, which creates a cash-flow problem.
"We could live with 21 days," Obi said.
Gov. Rick Perry vetoed legislation last session that would have required insurance companies to make prompt payments.
When less than one-third must pay for their own and everyone else's health care, there is a big problem.
And obviously when millions of dollars are thrown at dropout prevention programs and the dropout rate goves from 33% to 39%, the programs aren't working and the money shouldn't be spent.
Guess which portion most of the illegals fall into? Very few are purchasing their own medical insurance plans because free health care for non-citizens has become some kind of "right" they believe they have. The line between legal and illegal can be very thing though ---many of those getting government programs are legally here because they were "sponsored" by relatives who never intended to pay for their costs.
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