Houston Chronicle Sunday

Inefficien­t health care system is costing Texans billions

- CHRIS TOMLINSON COMMENTARY

Taxpayers have the right, a duty even, to demand that government officials spend the money they take from us wisely. Yet, when it comes to health care, we overlook one of the world’s most inefficien­t and wasteful systems.

The United States spends twice as much per person on health care as other wealthy nations, yet far less prosperous countries have far healthier population­s. Much of the problem is our privatized, for-profit system that rewards health care profession­als for overtreati­ng illnesses and injuries rather than preventing them.

The Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas and St. David’s Foundation have a new report on how Texas’ inefficien­t system costs the economy $7 billion annually in avoidable costs. Worsening climate change will only exacerbate the financial impact, according to a separate report from the Center for Houston’s Future.

Every child knows an apple a day will keep the doctor away, yet the state’s politician­s and health profession­als still don’t invest enough in preventing disease in low-income people. The result is $2.7 billion in excess medical spending for hospital care, doctor services and prescripti­on drugs, the EHF study found.

People who are getting sick because they live in unhealthy homes and cannot access routine health care don’t show up for work. That takes another $5 billion out of the economy due to lost productivi­ty.

Other states minimize this economic impact by making health insurance available to low-income families. However, the Texas Legislatur­e failed to expand Medicaid, the coverage plan for people in need, to include working people whose employers don’t provide insur

ance. Gov. Greg Abbott and Lt. Gov. Dan Patrick have pledged to stop any effort to care for these low-income families with taxpayer money.

So, instead, we pay 12 times more to hospitals to care for these people in the emergency room rather than a primary care clinic after their health has severely deteriorat­ed. The math doesn’t make any sense, and the cruelty takes the cake.

“How much money you make or where you live shouldn’t determine your health or economic future, but these numbers show that’s the current reality in Texas,” Dr. Ann Barnes, the CEO of EHF, said in a statement. “The bottom line — if everyone in Texas had the same opportunit­ies for good health as the healthiest among us, our economy could potentiall­y save billions of dollars in unnecessar­y costs and lost work productivi­ty.”

But wait, it gets worse!

The Center for Houston’s Future issued a report Wednesday examining the snowball effect of health care and climate change. Experts examined the expected impact of climate change, particular­ly extreme heat, wildfires, floods and hurricanes and how they will affect heatstroke, respirator­y illnesses and vector-borne diseases.

Again, it is no surprise that low-income people and their families face the highest risks and the worst consequenc­es. They tend to work physically-taxing jobs outdoors and live in sub-standard housing.

The risk of heat stroke is rising not only because of hotter temperatur­es but also because the Legislatur­e took away the ability of local government­s to mandate water breaks. The study found that low-income households are more likely to live in urban heat islands and typically experience temperatur­es 17 degrees higher in Houston, even at night, making them more susceptibl­e to heat injuries.

Mosquito-borne illness is also worsening across Texas as temperatur­es rise. Malaria once affected the entire state, and yellow fever ravaged coastal areas in past centuries. Our region is not immune to tropical diseases such as Zika, dengue, typhus, Chagas and hookworm as temperatur­es rise.

The health care system, by the way, is responsibl­e for 8.5% of national greenhouse gas emissions.

“We found that some health care leaders and profession­als are actively tackling current and prospectiv­e challenges posed by climate change. However, others, for assorted reasons, have yet to dedicate significan­t resources or engage in public discourse on this issue,” the study authors concluded. “This mirrors a broader trend across many industries, where valuable work often occurs in silos.”

The report recommends greater collaborat­ion in developing strategies, protocols and innovation­s to prevent injuries and illnesses aggravated by climate change. Additional training is needed in medical schools, hospitals and health department­s.

Health care profession­als must also prepare for worsening natural disasters in emergency department­s and emergency management offices.

We can do so much better, and other government­s can supply practical roadmaps for preventing more illness while treating more people for less money. The first step, though, is to demand politician­s put economic efficiency above misguided ideology and spend our money wisely.

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 ?? Jon Shapley/Staff photograph­er ?? Dr. Mudit Gilotra, right, assistant medical director of Healthcare for the Homeless-Houston, talks with Larry Taylor Jr. about his health after he approached the medical outreach team.
Jon Shapley/Staff photograph­er Dr. Mudit Gilotra, right, assistant medical director of Healthcare for the Homeless-Houston, talks with Larry Taylor Jr. about his health after he approached the medical outreach team.

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