There was standing room only Thursday, Aug. 17, at the Health Science Center for the Fourth Annual Frank Bryant Jr. M.D., Memorial Lecture in Medical Ethics. Every seat of lecture hall 3.102 was taken by community leaders, medical practitioners, and Health Science Center students, faculty and staff. More people filled the overflow room. All came to hear Kenneth I. Shine, M.D., executive vice chancellor of The University of Texas System, talk about “next steps” following the Code Red Report that was published last March.
Dr. Shine was followed by four equally compelling speakers from the local community.
The event, supported by the Center for Medical Humanities and Ethics, and Fulbright and Jawaroski, L.L.P., commemorated the life of the beloved San Antonio East Side physician Frank Bryant, M.D., whose loss was noted by the San Antonio City Council when he died in 1999.
Dr. Shine chaired a 19-person commission of community and medical leaders from across the state, which spent 18 months studying the issue of the uninsured and underinsured in Texas. The Code Red Report is a result of the study.
The report was devastating in its observations and focused in its recommendation. Texas has the highest proportion of uninsured people in the nation with one in four Texans without health insurance in 2004. The average cost of health insurance for a family of four living at or below the federal poverty level ($20,000 per year) is $9,100 – almost half their income.
The situation will only worsen, Dr. Shine cautioned, unless bold steps are taken. He noted that Texas has not taken full advantage of federal matching funds and offered 10 practical recommendations to improve the situation, including a 3 percent “quality assurance fee” on hospitals and free-standing surgery centers to obtain a federal match to enhance the efficiency of health care to the uninsured. He noted that 35 other states assess such fees.
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| Dianna Burns, M.D., president of the Bexar County Medical Society, was an honored guest who provided responses to Dr. Shine’s presentation. | |
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Failing improvement in the current level of access to health care, the health of Texans, which is already relatively poor on average, will worsen. Dr. Shine concluded that poor health affects education and work, puts a severe strain on hospitals and emergency rooms, and will ultimately impact the state’s long-term economic viability.
Dianna Burns, M.D., president of the Bexar County Medical Society; John Hornbeak, CEO of Methodist Healthcare Systems; George Hernández Jr., president and CEO of the University Health System; and Kevin Moriarty of Methodist Healthcare Ministries, responded emotionally and positively to Dr. Shine’s remarks.
"It was my honor to serve on this task force and contribute in the development of this important report," Hernández said. "Code Red clearly makes the case for indigent health care to be more equitably supported on a regional, if not statewide, basis, and for the state to strengthen - rather than weaken - Texas' Medicaid program. For each dollar the state budgets for Medicaid, $1.50 in federal matching funds come back to Texas. A weak Medicaid program leaves critically needed money on the table in Washington, placing a greater burden on local tax payers."
“Certainly we are all committed to continuing to address these issues,” said Health Science Center Professor Emeritus Leonard Lawrence, M.D. “That the Health Science Center and the Center for Medical Humanities and Ethics has again facilitated placing a vital issue on the ‘front burner’ speaks clearly to your continuing commitment to equity and to quality.”
