Saturday, November 26, 2022

Health care reform does more harm than good

By pressing ahead with its massive, budget-busting health care reform plan, the federal government is ignoring one of the guiding principles of our health care system: first, do no harm.

For the medical professionals on the front lines of our health care system, these words have profound meaning.  Simply put, if a procedure or treatment will cause more harm than good, that action should not be undertaken.

The federal government’s prescription for our health care system violates that rule.  It creates more problems than it solves – ballooning our deficit, overwhelming our health care system and burdening employers at a time when they are struggling just to survive.  It’s no wonder that a new CBS poll finds that 62 percent of Americans support the effort to block implementation of this fiscally irresponsible plan.

In Texas, I am deeply concerned with the devastating impact the federal reforms will have on our state budget.  The Health and Human Services Commission estimates that it will cost up to $24 billion over a 10-year period.  Considering our projected budget shortfall for the upcoming legislative session will be somewhere between $9 and $16 billion, it is clear that our health and human services budget — which accounts for a third of total spending already — will continue to consume precious resources that would otherwise be available for our schools, our highways and other important services.

We all share the goal of connecting more citizens to health care, but Texans need to understand that an insurance mandate doesn’t truly achieve access.  If there are not enough nurses, physicians, emergency responders and other health care professionals to treat the influx of new patients, access to care will diminish for all of us.  

Already, Texas is facing critical shortages of nurses to treat patients in our hospitals, clinics, nursing homes and home health care settings. About half of our counties are federally designated as having shortages of primary medical care.

Additionally, the system we use to determine whether citizens are eligible for state health and human services is already stretched to the limit.  Texas has been working tirelessly to clear a backlog of applications for food stamps, which have increased substantially in the wake of Gulf Coast hurricane devastation and as a result of the national economic downturn.  Forcing 2 million more Texans onto the Medicaid rolls under this federal plan will require a significant investment in infrastructure, staff and other resources.

As a business person, it offends me that the government would saddle employers with additional costs and penalties in the midst of a tough economy.  Texas has fared better than most states, but every job is precious in our state with a current unemployment rate of 8.2 percent.  Because of the federal bill, more Texans will lose their jobs. 

Instead of mandating more people into an already overburdened system, we should be focusing on the root problems in our health system.  In Texas, we have been working to promote personal responsibility, understanding that healthier lifestyles lead to longer, healthier lives and also reduce costs.   We expanded the availability of insurance pools and are in the process of rolling out a new partnership to assist small businesses with the cost of health insurance for their employees.  Many experts believe that small businesses represent the key to addressing the uninsured, and that makes perfect sense, given that half of all private sector jobs in Texas are at small businesses.

We also have been working to make better use of the tax dollars we spend on Medicaid, the government-sponsored health program for the poor.  Most Texans would be surprised to learn that Medicaid offers a wider array of services than most private health plans and rewards those who deliver a higher number of services rather than those who achieve the best outcomes for their patents.  We laid the groundwork to address those issues last session.

I am concerned that the federal government’s plan will jeopardize our efforts on the state level.  One size does not fit all, especially not in Texas.  We are not Massachusetts.  Our state government spreads more health care dollars across more terrain than any other state.  We have challenges along the border, in our remote rural areas and in our inner cities that are unique to our state.  Our costs will be disproportionately higher.

As Chairman of the Senate Health & Human Services Committee, I am ready to work with my colleagues to better understand this bill and minimize any negative impact it will have in Texas.  Along with the Senate Committee on State Affairs, we will hold a joint hearing next week to identify issues and consider our options in preparation for the next legislative session.

Clearly, deep philosophical differences about the appropriate role of government will remain in the backdrop of our discussion.  These differences are important, but they should not prevent us from having a thoughtful, civil discussion on the best way to move forward.

SENATOR JANE NELSON represents District 12, including portions of Tarrant and Denton Counties.  She is Chairman of the Senate Committee on Health & Human Services.

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