As the gun-control debate includes calls for expanded services, critics complain Texas hasn’t accounted for its growing population.
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Bringing into focus a clear and distinct view of the rest of this decade in Texas health care. Offering a sharp perception of what lies ahead and what we must change to keep us all healthy.
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New Texas Health and Human Services Executive Commissioner Kyle Janek, MD, has concerns about Medicaid - about having enough physicians to care for patients, about how to improve the health insurer, and other thoughts he shares with Texas Medicine... 
Texas Medical Association's comment,
January 2, 12:00 PM
Check out the video! www.texmed.org/JanekInterview
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-- "A new coalition began sounding a contrarian note about Medicaid at the Texas Capitol on Tuesday. My Medicaid Matters said that Medicaid, the government's main health program for the poor and enfeebled, is 'indispensable.' "
Interesting note: Even though doctors are howling about being paid lower, Medicaid fees for seeing certain enfeebled Texans, hospitals are seething over cuts and Mom and Pop pharmacists are screaming about now having to work under managed-care companies' subcontractors, Texas Medicaid chief Billy Millwee said he and social services czar Tom Suehs would act swiftly if they really thought the reductions had turned Medicaid into a promise, not a reality -- that is, that recipients can't get in to see providers.
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The last month or so, the Presidential campaign has often felt like a war over Medicare. Republicans have claimed that the Democrats have robbed the trust fund to pay for a...
For decades, physicians have given away their services for free to patients who could not afford to pay. However, today’s health care market makes this very difficult. Medicare and Medicaid, which now cover 35 percent of health care in America,often pay physicians less than it costs them to provide their services. Commercial insurance companies’ payment rates, computed largely as a percentage of Medicare, have followed the government-run programs into the basement. The nation’s 50 million uninsured, including 6.2 million Texans, can rarely pay the costs of their health care. The squeeze leaves many physicians struggling to keep their practices open, let alone provide charity care. State and federal leaders must realize that cutting physicians’ payments is not an effective tool for controlling health care costs, and often exacerbates the cost of care. They also must realize that without physicians, no health care delivery system can be effective. Delete the scoop?
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HUGE access problem coming if state doesn't reverse the cut in funding for dual eligibles (covered by both Medicaid and Medicare) real soon. Delete the scoop?
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Invest in mental health and substance abuse community treatment
Mental illness and substance abuse hurt the Texas economy through lost earning potential, treatment of coexisting conditions, disability payments, homelessness, and incarceration.
Mental illness is a leading cause of disability in the United States. About 13 million adults have a debilitating mental illness each year, and almost half of all adults will be affected by mental illness in their lifetime. Five percent of adults have a serious mental illness.About one in five children are affected by a mental health disorder with severe impairment in their lifetime.
More than 8 percent of Texas adults report current depression, and 5.2 percent report serious psychological distress.37 In 2011, almost 30 percent of Texas high school students reported they felt sad or hopeless almost every day for at least two weeks. Suicide is a leading cause of death among Texans under 35 years.
More than 66,000 Texans were cared for in state-funded substance abuse treatment programs in 2010. Substance use is common in Texas students (grades 7-12), with 62 percent reporting they had used alcohol and 17.2 reporting inhalant abuse. Despite significant legislation to curtail drinking and driving, almost 40 percent of Texas driving fatalities are still associated with alcohol use.
In 2009, 23 percent of the adult offenders in Texas state prisons, on parole, or on probation were current or former clients of the Texas public mental health system.43 A Texan with a serious mental illness is eight times more likely to be in a jail than in a hospital or treatment program, at a cost of $50,000 a year. A person in jail without a mental illness costs the state about $22,000 annually.
Mental illness is also strongly associated with high-risk behaviors such as alcohol, tobacco, and illicit drug use, and results in conditions such as obesity. U.S. mental health costs were estimated to be $57.5 billion in 2006 including the cost of mental health care and the indirect costs of disability caused by mental illness. One recent study estimates that Texas state dollars spent on mental health exceed $13 billion each year.
Mental health treatment costs in the United States totaled almost $9 billion in children in 2006; Medicaid covered more than one-third of these costs.47
Proper care for persons with mental illnesses saves costs associated with the cycle of incarceration, homelessness, and so forth. Assessing the return on investment connected with mental health and substance abuse care is complex because there are many different diagnoses, and the disability caused by each and the treatment plans vary greatly. In 2003, depression cost U.S. employers $44 billion in lost productivity alone. One employee assistance program in California showed a return on investment of $5.17 to $6.47 for every dollar spent on employee assistance for a mental health problem.
While Texas has recently made significant investments in community mental health services, we still rank 50th in state public mental health funding per capita.