Houston Democrats

Crossposted at Texas Kaos .

It is a quiet crisis, because those upon whom it falls the hardest are the most powerless: children, the poor, proud working class families. But the problem of access to public healhcare is growing in Texas and our out of touch Governor simply does not care. When it is a choice between tax cuts and poor children, the tax cuts win every time.

From Port Lavaca Wave, via Ron Haussecker and the USDemocrat-Texas yahoo group:

"As you may recall for fiscal year 2006 DSHS cut the funds at all local health departments by 8.73 percent and now that the Preventive Health Block Grant funds from the federal government are going away. DSHS is proposing these new cuts," Cate said. "Calhoun County Health Department's problem is that DSHS is maintaining its own programs, while all local health departments across the state, which give direct public health care services to the citizens, are cutting personnel. For all of the smaller health departments across the state, this is a survival issue, as losing critical staff has led some health departments to close down as a result of a cascading affect that materializes once a critically low level of staffing is reached. There is not a whole lot that a local public health department with two or three staff can do."

To put this in prespective, recall that Texas ranks at the bottom on provisions for children's health and for public health in general:

[ 1 = best, 50 = worst ]
Public Health 45th
Mental Health 47th
Public Welfare and Medicaid 46th

[ 1 worst, 50 = best ]
Percentage of Population without Health Insurance 1st
Number of Women Receiving Prenatal Care 45
Rate of Disease per 100,000 People 9th
Percentage of Poor Covered by Medicaid 44th

These data are from a source which is now 6 years old. Since we have actually cut spending on key social needs in the last 6 years in order to provide "tax relief", I doubt things have grown better. Indeed , the article I quoted to start my diary offers a reminder that we forswore some federal grant monies because we would not provide our matching share. This amounted to the loss of millions of Federal dollars.

LINK And one result of the GOP-led drive in 2003 to close a $10 billion
revenue shortfall without raising state taxes has been the loss of
health insurance for large numbers of low-income kids, reinforcing
Texas' ranking as a leader in uninsured residents.

Enrollment in the Children's Health Insurance Program (CHIP) has
declined each month since the Legislature toughened eligibility rules
that year, with reductions totaling more than 200,000 children.

Some of the losses have been absorbed by Medicaid, but children's
Medicaid enrollment also has plunged by more than 78,000 since December,
according to the Center for Public Policy Priorities, an advocacy group
for low-income people.

The belt-tightening exercise not only worsened the struggle of working
families unable to afford private health insurance, it added to the
budgetary strains of taxpayer-supported public hospitals, which provide
emergency treatment for indigents who no longer get preventive care.

Children were victims of several factors set in motion by the governor
and the Legislature, including poor worker training and other problems
with the handling of Medicaid and CHIP applications by a new private
contractor. State leaders also ordered higher premiums, required
families to re-enroll for CHIP every six months instead of every year
and denied coverage to families with modest bank accounts.

Two years ago, with the CHIP caseload dropping, Strayhorn called the
latter provision, a so-called assets test, a "mean-spirited" requirement
and asked Perry to have it rescinded.

"We are talking about disqualifying working poor families who have
managed to put aside in their personal savings accounts as little as
$5,000 for their children's education, or for unexpected emergencies or
any of the normal costs of living," she said.

It is not simply justice and compassion, there is also the issue of prudent public policy. "An ounce of prevention is worth a pound of cure", we are told. Think for a second of the social and financial costs of untreated childhood diseases? of the lack of prenatal care? I , of course , have not even mentioned the costs on productivity and competitiveness that the woeful failure of our public health policies impose on Texas (and the US ) everyday.

Beyond all this , we must add the unquanitifible risk that such mean spirited public policy places on all of us. In an age of emerging worldwide disease threats , Bird flu being only the most recent, it is impertive to remember that virsues don't check country club memberships or political affliations. We are all at greater risk because of these idelogues are in love with their little ivory tower schemes. Lori Garret chronicled the real and fearsome possibilities in her books The Coming Plague and Betrayal of Trust: The Collapse of Global Public Health.

Ironically, no CEO worth his salt would run his corporation this way, at least not for long. In Perry and the Texas Republican leadership we have the worse of both worlds. They lack compassion and they lack even basic business smarts.