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TEXAS NEEDS MORE REALISTIC SOLUTIONS


implement e-prescribing programs, and endure the frozen fee sched- ule and continuous pay uncertain- ty from Medicare. The financial stress is hurting small practices in rural Texas, midsize practices in the suburbs, and large practices in every urban center. Government regulatory bur-


dens, red tape, payment hassles, and low pay have been eroding the physician foundation of Med- icaid and Medicare for more than a decade. TMA’s new 2012 physician sur- vey shows the fallout. More and more physicians are forced to re- duce the number of patients they see who depend on government health care. Texas physicians available to


Austin orthopedic surgeon C. Bruce Malone, MD, imme- diate past president of TMA, testified Aug. 1 at a special joint hearing of the Texas Senate Committee on Health and Human Services and State Affairs Committee. The committees are ex- amining the potential impact of the Patient Protection and Af- fordable Care Act on insurance regulations, Medicaid and the Children’s Health Insurance Program, health care outcomes, health care workforce, overall health of all Texans, and the state budget. Dr. Malone made these remarks:


All of us want to do the right thing for our patients and Texas taxpayers. We all want to find cost-effective ways to ensure people who live in our communities can get the care they need when they need it. As TMA president, I had the opportunity to travel the state and visit with my colleagues from El Paso to Tyler, from Wich- ita Falls to the Valley.


I can tell you firsthand, physicians’ practices are struggling to surmount the growing regulatory burdens of the new fed- eral law. Physicians had to invest in expensive health infor- mation technology, upgrade our coding and billing systems,


18 TEXAS MEDICINE September 2012


treat new Medicaid patients have plummeted from 42 percent in 2010 to 31 percent — an all-time low. I am not surprised by these numbers. It makes no sense to create health insurance programs that no doctor can afford to take. I’m one of the 31 percent of Texas doctors who say they


take new Medicaid patients. I do that because I believe it is my moral and ethical duty to take call in hospital emergency departments. I need a Medicaid and Medicare number so I can work in the ER. When HHSC [Texas Health and Human Services Commis-


sion] says “there are plenty of physicians available to take Medicaid patients,” what they really mean is that they have a long list of physicians with a “Medicaid number.” It doesn’t mean these physicians are available to care of patients or that they are taking new Medicaid patients.


HHSC is running a system based on a false sense of access. A huge majority of Texas physicians agree that Texas Med- icaid is broken.


And, almost all of them believe we need to devise a system


of providing care to low-income Texans with realistic payment rates and less stifling bureaucracy. Look, for instance, at the 20-percent payment cut for the


JIM LINCOLN


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