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Thomason sues state (Texas)
El Paso Times ^ | October 25, 2003 | Diana Washington Valdez

Posted on 10/25/2003 7:28:44 AM PDT by FITZ

Thomason Hospital District and other health-care providers filed a lawsuit Friday in U.S. District Court, alleging the state's new and reduced Medicaid reimbursement rates discriminate against El Paso's poor by denying them equal access to health care.

El Paso County Attorney José Rodríguez filed the suit against Albert Hawkins, chairman of the Texas Health and Human Services Commission, after the hospital board voted unanimously to proceed with legal action.

The county hospital stands to lose the most because it is the main health-care provider for low-income and indigent people, and could be forced to raise property taxes to offset the 2.5 percent reduction in Medicaid payments, Rodriguez said.

Kristie Zamrazil, spokeswoman for the commission in Austin, on Friday said that state officials could not comment because they had not seen the lawsuit yet.

Rodriguez said the lawsuit is about equal access to health care in a state where Medicaid reimbursement rates vary widely. The disparate rates contained in the new state budget that went into effect Sept. 1 "represent gross violations of federal laws and the U.S. Constitution," he said.

The lawsuit was filed to help protect El Paso patients such as Lucia Perez.

Perez said she is diabetic and completely reliant on Medicaid for her treatment.

"I am alone, and I could not be without the care I receive now if it weren't for Medicaid," she said. "It is important to keep medical care services available in our community, and this is especially important for our children."

Medicaid is a federal program that helps pay for health care for needy people and low-income families with children. States determine eligibility and the health services covered, and the federal government reimburses a percentage of the state's expenditures.

Without the support of Medicaid, the health of this community is in jeopardy, health officials said. El Paso's historically low Medicaid reimbursement rates also have contributed to the county's acute doctor shortage, Rodríguez and Thomason's board members said.

Over the years, El Paso doctors have moved to cities such as Austin or Houston, which are less dependent on Medicaid, and as a result, El Paso has 61 percent more patients per doctor than the statewide average. In 2001, El Paso had a ratio of one doctor per 1,048 patients, compared with the state average of one doctor per 641 patients.

"El Paso has a difficult time attracting and keeping doctors because of our lower Medicaid reimbursement rates when compared to other cities in Texas," Rodríguez said. "About 16 percent of our population is on Medicaid, and 35 percent are uninsured. In Travis County, which is comparable in size to El Paso, only 5 percent are on Medicaid, and only 18 percent are uninsured."

Patricia Duarte Melendez, one of the individual plaintiffs, is among the El Pasoans who depend on Medicaid for medical care.

In a statement, Melendez said she's had difficulty obtaining medical care for her son. The problem, she said, stems from a lack of doctors in El Paso, fewer doctors being willing to see Medicaid patients, long waiting lists to see doctors, and long waits at the doctor's office once patients get in the door.

El Paso had 135,392 Medicaid patients in 1998, and the average Medicaid expenditure then was $2,109, compared with the statewide average of $3,071.

"At an average difference of $962 per year, the loss to the El Paso community is over $130 million a year," Rodríguez said. "The 2.5 percent reduction will only make matters worse."

Dr. Carlos Gutierrez, a pediatrician who serves on the hospital board, said he had to close down his clinic because he could no longer afford to pay his bills with the Medicaid reimbursements he received.

"I wanted to stay in El Paso, and I was able to stay in practice by joining another group of doctors. But there are other doctors who've had to leave El Paso," Gutierrez said. "Unless the rates are adjusted, there is no way we are going to attract doctors and keep them here. The new medical school will help bring more doctors here, but we won't see the impact for another 10 to 15 years, and we need help now."

El Paso County hospital officials said a doctor in Houston receives $634 from Medicaid for delivering a baby, compared with $450 for a doctor in El Paso.

The current Medicaid reimbursement helps to explain why there is a lack of health-care specialists in El Paso and why people must travel to other cities to receive specialized treatment, Dr. Jose Luna Jr. said.

State officials are aware of the problem but they are ignoring it, Thomason CEO Pete Duarte said. Officials have a report with details on the disparate rates and their negative effects, but "that report is only collecting dust on a shelf in Austin."

But the state continues to use poor communities along the border, including El Paso, to attract certain federal funds, Rodriguez said.

The state "continues to allocate a disproportionate share of this funding to non-border counties."

El Paso County hospital officials said they are in contact with other Texas border communities that might have similar problems and might be interested in joining the lawsuit.

He also said the plaintiffs also are seeking an injunction to prevent the new rates from going into effect while the case is decided. The suit also represents El Pasoans who have had problems under the existing rates. Other plaintiffs include Equal Access for El Paso and El Paso First Health Plans Inc.

Diana Washington Valdez may be reached at dvaldez@elpasotimes.com


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events; US: Texas
KEYWORDS: freehealthcare; immigration; moresocialism; texas; texasbudgetcrisis
El Paso had 135,392 Medicaid patients in 1998

And a total population of about 600,000 ---- that's a lot of welfare.

1 posted on 10/25/2003 7:28:45 AM PDT by FITZ
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To: sarcasm
ping
2 posted on 10/25/2003 7:31:46 AM PDT by FITZ
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To: FITZ
Dr. Carlos Gutierrez, a pediatrician who serves on the hospital board, said he had to close down his clinic because he could no longer afford to pay his bills with the Medicaid reimbursements he received. "I wanted to stay in El Paso, and I was able to stay in practice by joining another group of doctors. But there are other doctors who've had to leave El Paso," Gutierrez said. "Unless the rates are adjusted, there is no way we are going to attract doctors and keep them here. The new medical school will help bring more doctors here, but we won't see the impact for another 10 to 15 years, and we need help now."

The docs want the advantage of receiving their price for their service. When the Peoples' representatives tell the docs what the People are willing to spend for those services, the docs sue for more money. So much for the humanitarian aspect to any physician protest argument.

3 posted on 10/25/2003 7:39:54 AM PDT by Sgt_Schultze
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To: FITZ
Now buzz word alert...henceforth both "illegal alien", and "undocumented migrant/worker/resident" shall be known as "low-income and idigent people" (as in 'it is the main health-care provider for low-income and indigent people').

Furthermore, "...and could be forced to raise property taxes to offset the 2.5 percent reduction in Medicaid payments," shall be known as "A cost of living increase forced upon us by mean spirited right wing politicians"

4 posted on 10/25/2003 7:43:06 AM PDT by norton
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To: norton
Yes ---- come to El Paso and take a look --- and welfare is one of the big attractants.
5 posted on 10/25/2003 7:44:14 AM PDT by FITZ
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To: Sgt_Schultze
Doctors don't mind the Socialized medicine --- they just want more of it so they make more money. The hospitals don't mind it either. The administrator of Thomason is very very well paid.
6 posted on 10/25/2003 7:45:33 AM PDT by FITZ
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To: FITZ
Correct-a-mundo! These doctors prefer the free enterprise system which allows them to make and exceptional income. But they want to derive that income by conscripting cash by the force of government. But when government force digs in its heels against their demands, they whine.

Sometimes it makes me wish we did have socialized medicine so they could feel the certain results of their greed. When medical care becomes free, demand will increase. There will not be enough money to pay for unlimited demand. Reimbursements will have to be cut, or waits will become longer. Medical schools will turn out fewer doctors because government will place the physicians where they are needed most.

This will include relocating prestige docs after the government is sued (successfully) to require quality physicians be placed in remote areas (equality of care doncha know). When the great docs are forced to relocate to undesireable locales, they will become specialists in unregulated diciplines like face-lifts and fat-sucking and veterinary. They will move back to their city high rises.

And the poor will continue to suffer from substandard medical care and the lefties will wonder why nobody wants to become a general practitioner. So they will require those seeking medical licenses to serve four years as a GP in a remote area as a requirement for licensure. But nobody will pursue the high risk specialties like OB because the liabilities go out into the scores of years. So government will regulate against lawsuits and the quality of doctor will degrade. The lawyer will complain. So government will embark on national law-care.....

7 posted on 10/25/2003 8:10:56 AM PDT by Sgt_Schultze
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To: Sgt_Schultze
"Rodríguez said. "About 16 percent of our population is on Medicaid......El Paso had 135,392 Medicaid patients in 1998.....

What gets me too is their poor ability to do basic math. 135,392 out of about a 600,000 population is a lot more than 16% of the population. Something is wrong when many more kids are being born to those on welfare and who cannot afford them or won't work than to those who have private insurance --- which has now gone down to about 33% of the population. El Paso is a good example of what happens when third world immigration is massive and completely unchecked. El Paso would collapse if federal and state money wasn't rolling in by the billions of dollars.

8 posted on 10/25/2003 8:24:10 AM PDT by FITZ
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Comment #9 Removed by Moderator

To: FITZ
El Paso is a good example of what happens when third world immigration is massive and completely unchecked. El Paso would collapse if federal and state money wasn't rolling in by the billions of dollars.

You can say the same for parts of New York City.

10 posted on 10/25/2003 9:18:11 AM PDT by sarcasm (Tancredo 2004)
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To: FITZ
Unbelievable... Why don't the citizens rise up and stop this? They must not be aware of these facts - and dollars slipping away. So much money they don't even miss it!
11 posted on 10/25/2003 9:20:10 AM PDT by Libertina
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To: FITZ
Good info at the following study......
http://www.morningsideresearch.com/HDComparisonAug29.pdf

Get ready as they are preparing the way for a property tax increase..... Currently the district assessment rate is 0.1854 and the maximun by state law is 0.75.

The maximum tax rate that a hospital district may levy is .75 and all of the hospital districts are well below that rate. The El Paso County Hospital District has the lowest tax rate and the lowest property tax revenue. The Bexar County Hospital District is the only entity shown in the table above that has an operating deficit, which is currently made up through reserve funds; the County Commissioners court has not approved a tax rate increase to address the deficit.
12 posted on 10/25/2003 9:42:23 AM PDT by deport
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To: deport
Except El Paso property taxes altogether are extremely high --- 4 times what they should be and it's one of the reason the middle class is leaving by the thousands. The working types are leaving town, the indigents from Mexico who must take welfare to survive are pouring in. One of the biggest immigrant groups moving in are the over 65 year old group --- not to work but to get on SSI and Medicaid --- and they are exempt from property taxes or have a very low rate.
13 posted on 10/25/2003 10:50:25 AM PDT by FITZ
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To: Libertina
The citizens are rising up but then moving out, high taxes are driving them away along with certain cultural issues. There is a crisis going on because as more of Mexico moves up into the US, the property taxes must go sky high and the middle class moves away. That's why the lawsuit ---- there is no way the local taxpayers can continue paying the free health care and education the citizens of Mexico have come to expect.
14 posted on 10/25/2003 10:55:04 AM PDT by FITZ
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To: DefCon2
The county hospital sets the property tax rate in Texas?

Yes --- their portion of it, schools set their portion, the college sets their portion, the county sets their portion --- it ends up being several thousands for a modest home by the time they all get finished. It'd be higher except the state and federal government send in a lot of grants and other money to routinely bail the town out. It's becoming a big Socialist nightmare.

15 posted on 10/25/2003 11:23:40 AM PDT by FITZ
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To: FITZ
I wish them success... we need to do the same in Washington.
16 posted on 10/25/2003 11:55:50 AM PDT by Libertina
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