side, as this report suggests, we haven’t gotten our members to embrace these types of programs, so the question is: Are there incentives or disincentives that could be used?” Certainly, patients, employers, and policymakers can employ a number of preventive care interventions that not only are relatively inexpensive to imple- ment, but also “are probably the best ways for us to avoid preventable illness- es,” said TMA Board of Trustee member Lewis E. Foxhall, MD. Dr. Foxhall, a Houston family physi- cian and vice president of health policy at The University of Texas M.D. Ander- son Cancer Center, says chronic diseases such as heart disease, cancer, and dia- betes remain some of the largest cost- drivers in the health care system. Tobacco prevention programs, cancer


screenings, child and adult immuniza- tions, and physical activity programs are just a few of the more cost- and medi- cally effective interventions available, Dr. Foxhall says. Such efforts could save as many as 2 million lives and $4 billion annually, according to national figures from the U.S. Department of Health and Human Services.


“State health is a team sport, and


there is a growing awareness of the op- portunities we are missing to help peo- ple stay healthy,” Dr. Foxhall said.


TMA protests proposed Medicaid midwife payments


Citing patient safety concerns, Texas physicians in August decried a Texas Health and Human Services Commis- sion (HHSC) proposed rule change that would allow the Medicaid program to re- imburse licensed midwives for services they provide in freestanding birthing centers beginning Jan. 1, 2013. The new provision would not only set a lower standard of care for pregnant women covered by Medicaid, but would also jeopardize the health of those pa-


November 2012 TEXAS MEDICINE 29


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