County should address
its health care crisis
05/16/2003
BILL BAUMBACH
Six months before he died, my father was kicked out of the Veterans Affairs Hospital. He was a World War II vet, and he thought he had benefits for life. He had Medicare. He had a Medicare supplement policy. He thought he was covered.
We had to put Dad in a nursing home, and the VA told us that when the last of his money was spent on the nursing home bills, we could get him on Medicaid. We did, and he died broke.
His is not an unusual story. Anyone with elderly relations has seen those nursing homes filled with Medicaid patients. When they have spent every last bit of their money and assets, they get government help. Maybe that's a reasonable policy for the old at the end of life, but what about the younger people who finds they need expensive medical care in Collin County?
If a young person is one of the 80 percent who have insurance, he or she will find no lack of high-quality hospitals and physicians. But if that person is one of the estimated 25,000 county residents without insurance, or if the insurance runs out, it is a different story.
It is a sadly different story.
State law puts the burden of public health care on the counties. But in 1983 Collin County sold its public hospital.
Income created from this sale is the sole county health care support for the poor in Collin County. The county is able to make ends meet by defining "poor" so strictly that few qualify. For the purpose of health care, one can only earn $179 per month to be considered poor. For those who are completely destitute, Medicaid and the county fund do help.
Collin County has relatively few real welfare families that can pass the $179 test. Our working poor and our unemployed experience the real health care crisis.
The CHIP program is helping with the health care of the "near poor" by paying for Medicaid for the children of families earning between 100 percent and 200 percent of poverty level. The pending House budget reduces that level to 150 percent. According to the Center for Public Policy Priorities, the House budget bill will result in $17.3 million in lost benefits to Collin County poor.
Last August, I was laid off from my job. For the first time in my life, I found myself in the ranks of the unemployed. As the months went by, I began to worry about health insurance. Thankfully, my wife has a good plan at her company, but I was acutely aware that we were only one layoff or one illness from joining the ranks of the uninsured
I have always believed that our country was rich enough that no person should suffer from lack of good medical care. But for those without insurance, and for the working poor, there is no real safety net other than CHIP and a couple of small charity clinics in Collin County. No county or state prenatal care, no mental health care, no children's health services, no prescription services.
In 2000, there were over 1,000 babies born in Collin County after what the state describes as "no or late prenatal care." Parkland Hospital reports that over 5,000 Collin County residents without insurance sought treatment in its facilities.
What happens when an uninsured resident is in an accident or needs urgent care? Parkland officials tell me that when one of our residents needs emergency care, he gets it. And he gets a bill. Since the great majority of the bills go unpaid, bill collectors dun the patient and credit ratings are ruined. When the patient gets healthy, the credit rating follows like an anchor. In our database-linked world, employers and landlords use an applicant's credit rating to deny employment and housing.
Charities and churches try to help, but the volume of those needing assistance is too large for their resources. Catholic Charities is opening a clinic, and the Plano Interfaith Alliance has worked to find solutions for our working poor. They can't do enough.
Health care is a proper role for government. One of our nation's earliest laws, passed in 1798, established what is now the Public Health Service. Every other industrialized nation in the world has found a way to care for its sick and injured. We need a national solution to help the uninsured, but even more, we need help now for our neighbors here in Collin County.
A possible solution would be to reopen a county public hospital; another would be to expand Parkland Hospital's tax base from Dallas County to a more regional basis. Parkland could then use the revenue to open satellite hospitals and clinics here in our county.
There are other ideas that could work, but a public discussion must begin now. We need to understand the extent of the problem that is all around us. We must engage our county commissioners, our governor and our legislators. For I might be, or you might be, the next person who finds he needs medical care, but doesn't have the insurance to pay for it.
Bill Baumbach is a resident of Wylie and one of six Voices of Collin County columnists. A different Voices columnist will appear every Friday