Let's put Collin County's health care needs first

Let's put Collin County's health care needs first
08/08/2003
By BILL BAUMBACH

County-funded indigent care is the final safety net for our poorest citizens. Only those who cannot qualify for any other medical help are eligible. Indigent care helps the poorest of our poor and the sickest of our sick. So what happens when the indigent care benefits run out?

According to county documents, you stand a good chance of dying. Last year the 2002 Collin County health care annual report noted that a record number of patients ran out of benefits, and over a quarter of them died later that year. How many more died because they could not get benefits is uncounted and unknown.

Yes, right here in Collin County -- one of the richest counties in the state, people die without getting needed care. We are the largest county in Texas without a public hospital, we spend the least amount of taxes on health care -- and our people die.

A couple of weeks ago, The Dallas Morning News reported that Collin County's share of tax abatements for Texas Instruments' chip plant would exceed $84 million. Two months ago, commissioner Jerry Hoagland announced that Collin County promised the developers of a new soccer stadium $20 million in tax money. And then in a recent guest commentary, Mr. Hoagland, explaining why the county can't help its poorest citizens get decent health care, wrote, "We have to prioritize the spending of money we have."

Meanwhile, the Plano Area Interfaith puts forth a modest (many who have studied it say too modest) proposal for a low-cost clinic, staffed by volunteer doctors. Our commissioners are less than enthusiastic, and all reports indicate they will turn down the request. Just the TI and soccer tax breaks alone would finance over 400 of these Interfaith clinics.

As the letters to the editor in this paper show, the people of Collin County are starting to question their commissioners' priorities. I think we all deserve an understanding of the issues and an explanation of the policies.

Why is Mr. Hoagland saying that the trust fund's balance is falling quickly? According to the charter that established it, the trust fund is to be used only to provide health care services to the indigent. Mr. Hoagland implies that the fund's balance is falling rapidly, from $25 million down to $18 million. His claim is based on fuzzy math.

The $25 million includes $5 million in fixed assets such as buildings and land. The $18 million does not. In 2002, the county spent $2 million on indigent care, and 2003 was budgeted to be about the same. The balance at the end of 2002 was over $25 million. We should expect to go into fiscal 2003 with $23 million.

For the last four years, the county has benefited from the tobacco settlement. In the first year, all the money, over $4.5 million, went into the trust fund. Every year since, a smaller and smaller part of the proceeds from the settlement are allocated to the health care trust fund.

Last year, the fund received about 35 percent. Right now, the county has $93,000 in settlement funds that have not been allocated. Remember, the proposed Interfaith clinic's startup costs are about $100,000.

Yet if the trend continues, our commissioners will use only 20 percent, or under $20,000, to help the health care trust fund.

Correcting health care inequities on the scale that this county government has allowed to happen is not a Republican vs. Democrat issue. It's not a liberal vs. conservative issue either. It's all about simple human justice and compassion. As far back as 1919, the voters in this county recognized that public health care was important. That is why, from 1920 until 1968, we did have a county hospital. We need one again.

Many much smaller and much poorer counties than ours have recognized that Texans need not watch our neighbors die in the name of fiscal responsibility.It is about priorities.Most of us here in Collin County are fortunate enough to have insurance or Medicare. We do not see that there is real suffering right here in our towns and in our countryside. The fact is we have over 100,000 uninsured and over a 5 percent poverty rate. The truth is we can afford to help our fellow citizens. What we cannot afford is a continuation of zero budgeting of tax dollars to health care.

This is the time to question our priorities. The indigent hospitalization contract, which was written when the county hospital was sold, has expired. Interfaith has a plan on the table. The public is starting to realize that health care for our poor is important.

Please contact your commissioners, and ask them to rethink their priorities. If they hear from enough of their constituents, then maybe a real public debate will begin to seek the best solution, combining fiscal responsibility with justice.

Bill Baumbach is a resident of Wylie and one of six Voices of Collin County columnists. He can be reached at bill@baumbach.org. A different Voices columnist will appear every Friday.