Texas
Related: About this forumEMTALA and our cruel health care system in Texas
Theres much that is being lost in the hyperventilating over the mistake-riddled roll out of the Patient Protection and Affordable Care Act, or ACA. But the discussion of our health care system comes down to a few simple things. Before this law was passed our health insurance system was a disaster. The ACA was not designed to fix our health insurance system. Its a plan that is palatable enough for the health insurance corporations, and was therefore allowed to pass through our corrupt political system. And yes, Obama and the Democratic Party own it.
To show what a cruel disaster the former system was, and will continue to be in Texas because of the decision not to expand Medicaid please read this article, Texas Other Death Penalty, A Galveston medical student describes life and death in the so-called safety net. The description of how the emergency room law, Emergency Medical Treatment and Labor Act (EMTALA), works is shocking and its despicable that we allow this to continue.
My patient went to the ER, but didnt get treatment. Although he was obviously sick, it wasnt an emergency that threatened life or limb. He came back to St. Vincents, where I went through my routine: conversation, vital signs, physical exam. We laughed a lot, even though we both knew it was a bad situation.
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But UTMB is no longer the state-subsidized charity hospital it used to be. The changes began before Hurricane Ike in 2008. But after the storm, UTMB administrators drastically cut charity care and moved clinics to the mainland, where there are more paying patients. The old motto Here for the Health of Texas was replaced by Working together to work wonders. Among those wonders are a new surgical tower and a plan to capitalize on Galvestons semi-tropical charm by attracting wealthy healthcare tourists from abroad. Medical care for the poor is not, apparently, among the wonders. Whereas UTMB accepted 77 percent of charity referrals in 2005, it was only taking 9 percent in 2011.
UTMB ascribes these changes to financial strain from Hurricane Ike, the countys inability to negotiate a suitable indigent-care contract and loss of state funding. The state blames budget shortfalls. The Affordable Care Act, better known as Obamacare, could have been a huge relief. However, Gov. Rick Perry rejected billions of dollars in federal funding to expand Medicaid, funding that should have brought access to more than a million Texans, including many St. Vincents patients.
More at http://eyeonwilliamson.wordpress.com/ .