Healthcare: broken promises, broken state, broken healthcare system


Tribfest 2014 UT Tx vs healthcare panel


Michael Burgess 
Garnet Coleman  Sarah Davis  Kyle Janek  Charles Schwertner  Charles Ornstein (mod.) 

(Update: This panel was packed and during the open questions section, the audience was extremely energized over the issues, going from laud applause to outright boos to panelists who were opposed to the Affordable Care Act. One audience member added that he was surprised that even the state of Oklahoma was ahead of Texas in finding a way to fund Medicare to meet the needs of its citizens.)

Some people just don’t deserve healthcare, according to an increasing number of GOP politicians. Everyone agrees that the U.S. needs healthcare reform but opinions vary wildly about how that should be done. Using tax dollars to fund a government healthcare system for all citizens, as has been done by many countries, is not a reform that Republicans oppose. Meanwhile, no GOP healthcare options have been put forth as alternatives to universal healthcare. It’s easier to criticize an initiative than to work in a bipartisan manner to solve the healthcare crisis that is hobbling the American economy.

To be eligible for healthcare subsidies and assistance in Texas, you have to earn less than $200 a month. But some GOP are concerned that a person who qualifes for healthcare support might somehow, during the time they are insured, might earn more than $200 a month and therefore no longer qualify for assistance.

The only way to qualify for assistance for yourself or your family is to be without any source of (legal) income, whether you need food or healthcare for your children. While you are apply for food assistance or healthcare, do a drug test for good measure. If someone has a drug problem, the last thing we want to do is to provide them with any kind of help.

Regulations were passed to forbid government workers from providing information and instruction to the disadvantaged on how to sign up for healthcare. The reasoning was to avoid non-experts from providing inaccurate or misleading information to clients. Better that they provide no information at all.

Garnet Coleman: “We all understand that people need healthcare. Texas constituents want us to provide this service for them….and with cancer …we have made a commitment to cancer [treatment] but not to those who need the cancer treatment!”

Opponents claim that Medicare expansion is not an option, that we can’t add “able-bodied” people into a system that is already providing healthcare to a current set of Medicare recipients. What does “able-bodied” mean in this context? Able to go out and pay for their own healthcare? Or able to go “get a job” in an economic environment where most people can no longer obtain a full-time job that offers the benefit of healthcare?

Kyle Janek, Commissioner of Texas Health and Human Services, suggested that people don’t need “a healthcare card.”  If they get sick they can just visit certain clinics that will provide health services to those without insurance. It’s understood that most uninsured delay seeking care until they are in crisis. Then, they go to a hospital emergency room. They are billed for services, but hospitals receive a federal kick back for services rendered as “charity” — if there was a universal healthcare system, there would be no bill to the patient and the hospital would be paid by the healthcare plan.

Coleman: “There is a difference between showing up at a clinic for care, and having an insurance card in your pocket and being able to have a primary care physician…. it’s called certainty.”

Janek talked about a “safety net” that is currently dispelling the old myth that the only place you can go for help without a card is the hospital, as there are clinics that “stay open late” to provide healthcare to the uninsured. He admits that there is a “terrible” nursing shortage in Texas. (Update: After the Covid pandemic, there is a terrible nursing shortage everywhere!)

The children’s healthcare act is scheduled to be sunsetted as the affordable care act was supposed to take over for this type of care. It’s not yet in place to provide that coverage.

Again, like every other failing system, right-wing anti-government spokespersons decry how Medicare is overburdened and underfunded – but it’s the standard and well-understood operating procedure for Republicans to starve a program of needed funds for decades and make a campaign to shut down a “failing” system when appropriate funding would keep the system running effectively. This has been demonstrated with the cynical starving of funding for the mental health facilities in Texas, such as the state hospitals, followed by presentations to the Lege to close them and replace them with private, for-profit systems. One of the notable results: surging homelessness and homeless camps throughout the cities.

Panelists suggested that the Affordable Healthcare Act was extraordinarily “disruptive” to the system. Unlike the typical “pro-change” tech conference culture, there is a lack of understanding about the positive potential for disruptive change. – Disruptive change is what is needed to correct a shockingly broken and corrupt system.

So, it costs tax dollars to provide better healthcare to those least able to pay for it? And could this increase the costs of healthcare insurance? Hold the “surprise and dismay” about having to pay higher premiums. The very folks who can afford to pay more are the ones complaining the loudest. If healthy people pay into a “healthcare for all” system, the insurance will be there for them when they need it. Anyone who works for a state agency that keeps and invests a percentage of their salary as part of a pension fund understands that some employees will not stay in the system long enough to retire with a pension. Everyone working full time at a living wage is paying into the Social Security pension fund, too. Not everyone will live long enough to retire and draw social security benefits. But the value of these benefits are understood and workers are required to pay into retirement systems. In contrast, almost everyone would benefit from having healthcare insurance and it would benefit everyone to pay into a healthcare system.

Those with significant health issues refer to people who are currently healthy the temporarily able. Ilness and disease do not prey upon immoral or lazy people. Even the hardest working person can fall ill, perhaps be faced with the loss of their job. Since most Americans’ healthcare is tied to their employment, a catastrophic illness can cause the loss of their home, create overwhelming debt, and place crippling burdens on themselves and their families.

Cynical or myopic obstruction of “Obamacare” is delaying the only workable solution available for affordable healthcare. Some blame the “budget deficit”, saying that if we appropriately fund the system, we are borrowing from our future. But proponents like Garnet Coleman say that more people are invested in shouting inflammatory rhetoric than working towards a realistic and ethical solution.