TMA Letter to Budget Conferees

May 12, 2011

Dear Budget Conferees:  

On behalf of the Texas Medical Association, which represents more than 45,000 physicians and medical students, I am writing regarding your efforts to craft the state’s budget for the 2012-13 biennium.  

We very much appreciate the difficult decisions the House and Senate have had to make over the past several months in an attempt to craft a budget that balances Texas’ limited revenue against the needs of a growing population. As the budget process comes to a close, of paramount concern to our members is that Texas enact a humane budget that recognizes that deep cuts in the state’s health care safety net and public and mental health systems ultimately will only cost Texas taxpayers more and harm physicians’ ability to care for the least among us.    

In your deliberations on Article II and Article III, we ask that the following recommendations be among the foremost priorities:  

• Preserve access to community-based mental care, crisis mental health services, and state and community mental health hospitals by fully funding the Department of State Health Services’ funding requests for these services. Without timely access to care in the community or appropriate inpatient settings, the state’s already strained hospital emergency departments and jails will pick up the slack, but at a much higher price.
• Maintain a stable base of physicians participating in Medicaid and the Children’s Health Insurance Program (CHIP) by rejecting any physician payment reductions further than those already achieved during this biennium. Without timely and meaningful access to physician services, more Medicaid and CHIP patients will be forced to rely on emergency departments for care that could have been provided more cost-effectively in a physician office.
• Decrease Texas’ chronic disease burden — and associated costs — by investing resources to reduce high obesity and smoking rates. Smoking-related illnesses and obesity are leading factors in Texas’ rising Medicaid and state employee health care costs. Tobacco use is the leading cause of preventable death in Texas and costs the state $20 billion annually in direct and indirect costs. Among adults, Texas is ranked the 14th fattest state in the country. Forty percent of Texas children are overweight or obese. Obesity is responsible for 27 percent of the growth in health care spending. Treating obese patients costs 37 percent more than treating normal-weight patients.
• Promote healthier mothers and babies by ensuring adequate funding for non-abortion-related family planning services. Nearly 2 million low-income women are in need of birth control, but family planning programs reach fewer than 20 percent of the eligible population. Access to birth control helps women better plan and space their pregnancies, which contributes to a lower incidence of premature births and thus lower Medicaid costs.
• Expand Texas’ physician workforce to ensure current and future Texans are able to obtain high-quality medical care when they need it. Specifically, we ask that you:  
• Restore funding for the children’s Medicaid and physician loan repayment programs,
• Restore funding for the Texas Statewide Preceptorship Program,
• Restore funding for the family medicine and primary care residency programs, and
• Restore funding for graduate medical education programs.

In the days ahead, we know you will face immense pressure to further reduce spending. However, for Texas to remain a prosperous and desirable place to live and work, it is essential that Texas invest in its greatest asset — the health and well-being of its people. We ask that you take steps to enact the best possible budget for our patients and your constituents.  

Thank you for your consideration.

Sincerely,

Susan Rudd Bailey, MD
President
Texas Medical Association