With Texas making headlines regarding its uninsured rate and rural hospital closings, the Texas Medical Association has a tall task ahead of the 2019 legislative session in Austin. The 2018 election saw Democratic gains across the country, including Texas, but the state still remains in Republican hands. Legislators will have a chance to improve some of the state’s most persistent problems, and the TMA hopes to represent physicians and uphold its mission of improving the health of all Texans.
The TMA is the country’s largest association with 52,000 physician members, and D CEO Healthcare spoke with the organization’s president Dr. Douglas Curran, a family practice physician from Athens, Texas about the organization’s legislative priorities in 2019.
Curran emphasized the TMA’s desire to address the state’s uninsured rate, which sits at 17 percent and leads the nation. He wants to find help for the working poor who can’t afford insurance and often drive up total medical costs because they wait until their problems are more costly before they seek help. In the end everyone else picks up the tab, driving up medical costs for everyone. Curran wants to see Texas take advantage of federal dollars, whether that means expanding medicaid or looking at block grants from the federal government. Texas is one of 14 states that hasn’t expanded medicaid.
He also spoke about Texas’ poor maternal mortality record, which one medical journal called a rate reserved for “war, natural disaster or severe economic upheaval.” Curran mentioned improving conditions in the NICU, prenatal care, and how improving insured rates would impact maternal mortality as well. Again, the solution looks to be greater funding and taking advantage of federal dollars.
Curran also mentioned the need for more transparency in the insurance industry. One problem is surprise medical bills, where a patient thinks they are in network but because it is unclear who will treat them in certain situations, end up with monstrous bills when they are seen by out of netowrk doctors, even in an in-network hospital. Texas passed legislation to help address the problem with the help of local lawmaker Kelly Hancock, but Curran says more can be done. “Surprise bills happen because of narrow networks designed by insurance companies, which make it difficult and challenging to get in network,” he says. “I think it is by design that they make it complicated.”
In regards to the politics of the legislature, Curran is confident that there is momentum for getting access to federal dollars in the Texas Republican houses of government. “There comes a time when it is the right thing to do for people. I am a fiscal conservative myself, but somewhere along the way you have to do the right thing for people,” he says. “If you work hard you should get insurance.”
Curran also mentioned the need to continue funding research and the state laboratory, as well as the desire to raise the legal age for purchasing tobacco to 21. He also pushed back against the anti-vaccination movement, stressing the need to get every child vaccinated and have schools clearly communicate what percentage of their children are vaccinated. He noted that even among Republicans, there is 86 percent support for vaccinations. “There is just a small few that don’t believe in science, and I am not sure you can convince them otherwise,” he says.
He also noted the painful closures of rural hospitals, many due to unfavorable reimbursement rates. For towns like Athens where Curran practices, he says 30-40 percent are the working poor who don’t have insurance, and treating them can be costly for rural hospitals. “It’s really sad what is going on in rural Texas,” he says.
Curran emphasized using common sense to solve and simplify our medical problems. “We need to move forward and keep what we have done that is good and fix what is broken. We need to stop worrying about whether we are Democrat or Republican, conservative or liberal. We need to work together as human beings for the common good.”
Learn more about the legislative priorities of the Texas Medical Association listed here.