State needs big thinkers like our local hospital


Leaving Medicaid dollars on the table hurts indigent, taxpayers and hospitals


We were proud to have Hill Country Memorial CEO Jayne Pope write on this page last week and explain the challenges of providing rural healthcare and what HCM is doing to look ahead. The healthcare industry is changing rapidly and our forward-looking facility has to anticipate curve balls that come at it from state and federal governments.
One big issue that was not mentioned, because it is a state issue, was that an expansion of the Medicaid program in Texas would help every hospital in the state. Texas is one of fewer than 20 states that still refuses to expand Medicaid because it is inexplicably tied to the Affordable Care Act and a lot of our lawmakers hate anything tied to the previous president.
Yet, we stand by while more rural hospitals close or file for bankruptcy. Even in this relatively wealthy rural community, our hospital has its own struggles.
With this state’s large indigent population — yes, Gillespie County has poor residents — the only healthcare choice for many who can’t afford insurance is the emergency room, where patients know they cannot be turned down, or a few charity care options. ERs are the most expensive form of care and it focuses on treatment only after patients become sick instead of looking ahead to preventive methods afforded by insurance.
While our hospital addresses whatever inefficiencies it can, we can’t cut our way to better healthcare. HCM is a Baldridge Award-winning institution, but it can’t treat poor decisions by lawmakers. Our hospital and our state deserve better. 
Local hospital officials may not “go there” and discuss the issue publicly, given anti-spending sentiment. But we beat our heads against the wall as local taxpayers pick up the tab for ER care or our hospital is forced to write off more of its services.
That’s not a smart use of resources. It’s time for Texas lawmakers to begin looking forward, as do the leaders at our sterling local hospital. Many officials in larger counties are starting to call for Texas to look at reimbursement in a smarter way, the Houston Chronicle stated earlier this year.
It says a lot about our society that we refuse to discuss solutions for indigent care and try to repeal what safeguards do exist. Many families live one medical emergency away from bankruptcy. Yet, the entire issue is like a Harry Potter villain in “he who shall not be named” because lawmakers are so steadfastly against helping, whether it is for healthcare or education. (Yet, we always seem to find money for the boogeymen at our border, though immigration is at its lowest levels in decades.)
Solutions to our healthcare crises are multi-faceted but they all start with discussion. Texas leaders should do like our local hospital leaders and focus on what’s best for Texans and our rural hospitals. – K.E.C.