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Capitol Comment
by Senator Kay Bailey Hutchison
Texas Health Care: Bigger Picture, Better Access
February 22, 2008
The American health care system provides the best quality health care in the world to a majority of our citizens; however, there is a growing disparity in access to health care because of soaring medical costs and rising insurance premiums. This is particularly true in Texas.
Skyrocketing insurance premiums are increasingly becoming an obstacle to quality medical care. Between 2000 and 2006, the median rise in income of 10.8 percent fell far behind the reported 79.7 percent increase in family health care premiums for Texas subscribers to employer-based insurance. The acceleration in insurance premiums occurred while plans offered more limited coverage of services, meaning Texans are paying more for less.
Compounded with the problem of rising premiums is the fact that fewer employers are offering medical coverage. Texas now ranks 48th in the nation, with only 52 percent of Texans receiving the option of health insurance through work. Nearly half of our state’s citizens must purchase their own insurance, which they have to buy individually in the private market without the tax benefits available to employers, who usually subsidize the premiums. More and more Texans are simply choosing to be uninsured because the cost to purchase private insurance is too high.
In 2007, the U.S. Census Bureau reported that Texas has the highest percentage of uninsured residents in the nation, with one in four adults having no medical coverage. Many families must prioritize spending, and unfortunately, health insurance frequently falls behind necessities such as rent, food, and basic utilities. The large number of uninsured in Texas has resulted in cost shifting by insurance providers. Costs associated with the rising number of uninsured in the state and related unreimbursed health care are passed down to Texas families, resulting in higher annual premiums of approximately $1,551.
We can and must do better than this.
First, we must make it affordable for the nearly one-half of Texans who aren’t covered through their employers to purchase their own health insurance. Individuals who do not receive insurance through their employer should be treated equal to those who do. Tax benefits should be available to those who purchase health insurance from the private market just as tax benefits are given to employers.
Providing tax benefits for individuals to buy their own health insurance will increase the supply in the private market. This shift to a buyer’s market will create an environment in which insurance providers must compete for beneficiaries. In order to maximize the rewards of a more competitive market, tax benefits must be combined with increased access to information about health insurance plans and provider outcomes. Once these changes are implemented, patients purchasing health insurance from the private market will have broader options, improved bargaining power, and choices based on value.
Finally, it does little good to equip Texans with quality medical insurance if there are barriers to medical providers, such as doctor shortages in rural areas. We have made significant progress in bringing physicians to the state since enacting medical liability reform. When Texans voted to place reasonable limits on noneconomic awards in medical liability lawsuits in 2003, physicians’ malpractice premiums dipped to some of the lowest in the nation and Texas became a much friendlier place for doctors to practice. We must build on this progress and continue to recruit medical providers to rural communities that are medically underserved.
A one-size-fits-all approach to health care reform that puts the government at the center of every health care decision will not work. With better ideas for access, we can improve the quality of health care, lower premium costs, begin to reduce the number of uninsured, and empower individuals to take ownership over their health.
Kay Bailey Hutchison is the senior U.S. Senator from Texas.
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