Wednesday, August 1, 2012

Texas Needs Realistic Solutions

Today Texas state senators met to discuss the potential impact of the health reform in Texas. Austin orthopedic surgeon C. Bruce Malone, MD, immediate past president of the Texas Medical Association took the witness stand.

Dr. Malone told members of the Senate committees on Health and Human Services and State Affairs that physician practices are struggling to surmount the growing regulatory burdens of the new federal law. Physicians have had to invest in expensive health information technology, upgrade coding and billing systems, implement e-prescribing programs, and endure the frozen fee schedule and continuous pay uncertainty from Medicare. The financial stress is hurting small practices in rural Texas, midsize practices in the suburbs, and large practices in every urban center.

Dr. Malone went on to explain how government regulatory burdens, red tape, payment hassles, and low pay have been eroding the physician foundation of Medicaid and Medicare for more than a decade.

TMA’s new 2012 physician survey shows the fallout. More and more physicians are forced to reduce the number of patients they see who depend on government health care.

The number of Texas physicians available to treat new Medicaid patients has plummeted from 42 percent in 2010 to 31 percent — an all-time low. “I’m not surprised by these numbers. It makes no sense to create health insurance programs that no doctor can afford to accept,” Dr. Malone said.

As one of the 31 percent of Texas doctors who take new Medicaid patients, Dr. Malone said, “I do that because I believe it is my moral and ethical duty to take call in hospital emergency departments (EDs). I need a Medicaid and Medicare number so I can work in the ED.

“When the Health and Human Services Commission (HHSC) says ‘there are plenty of physicians available to take Medicaid patients,’ what it really means is that the commission has a long list of physicians with a ‘Medicaid number.’ It doesn’t mean these physicians are available to care for patients or that they are taking new Medicaid patients.”

According a preliminary TMA survey of Texas physicians, a majority of physicians agree that Texas Medicaid is broken. And, almost all of them believe we need to devise a system of providing care to low-income Texans with realistic payment rates and less stifling bureaucracy.

“What’s lost in the health care debate is the simple fact that patients need a doctor when they get sick. And, physicians want to take care of our patients,” said Dr. Malone. “If Texas wants to create a new system to serve the more than 6 million citizens who have no health insurance, we need realistic solutions that are going to require sacrifice and work from all segments of our society, not just the doctors and hospitals.”


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