“Texas’ Other Death Penalty“

A few weeks ago, I did an article about mainstream medicine advocating for health insurance for everyone, and I mentioned that the New England Journal of Medicine (NEJM), one of the premiere US medical journals, did an editorial strongly advocating for health care for all.

While the NEJM stopped short of completely endorsing the Affordable Care Act (Obamacare), they were forceful in arguing for some form of total health care insurance. The NEJM is run by the Massachusetts Medical Society and the authors drew upon their experience with Massachusetts’ health care program.

Additionally, the American Medical Association (AMA), through its publication, Journal of the American Medical Association (JAMA), is not only supporting health insurance for all, it has started offering support services for doctors and patients in regards to this issue.  It has produced handouts for patients explaining the ACA, offers help to patients and doctors to access government information on affordable health care, and offers a patient advocacy site in which questions on the ACA (among other things) can be addressed.

Also, some medical professional societies are doing similar things with respect to accessing affordable health insurance.

Free health and dental clinic by Remote Area Medical during the week of August 19, 2009, Los Angeles, California. (spirit of america / Shutterstock.com)

Free health and dental clinic by Remote Area Medical during the week of August 19, 2009, Los Angeles, California. (spirit of america / Shutterstock.com)

Subsequently, I wrote a later story discussing another article from the NEJM, Dead Man Walking. It talked about problems with uninsured patients not getting desperately needed health care for serious medical conditions. And how, in some instances, they, and their physicians, were unable to do anything to access such care. The end result was, indeed, a dead man walking. And he didn’t walk for long before dying.

Today there is another example of why the alleged “safety net” that the poor, uninsured and underinsured are supposed to be able to make use of, has not only failed (and has been failing for years), but is now shrinking – virtually vanishing.

This article is written by an MD/PhD student in Texas, Rachel Pearson, and published in the Texas Observer. The title is “Texas’ Other Death Penalty.” It’s a simple, clearly written, and horrific description of the safety net failures, specifically in the Galveston, Texas area.

Texas is just one of the states that has refused to open up to Obamacare, and has refused federal funds to expand Medicaid. Local and state Republican officials are insisting that uninsured Texans (possibly 25% of the population) prefer to try to get into vanishing, overcrowded free clinics. Or they go to local emergency rooms, and later face staggering bills.

Or they do without care altogether.

The author of the article cites statistics that upwards of 9,000 Texans will die EACH YEAR as a result of the fantasy safety net that only conservatives seem to be able to see, but of course don’t have to actually access themselves. If they DID need to use it, there would be screams of outrage from the right wing.

Part of the reason is that local hospitals, in this case the University of Texas Medical Branch (UTMB), which used to provide free or low cost care to those who were desperate, is shutting off these services. UTMB used to be a state-supported “charity hospital.” But that has changed. And it’s not just that hospital, but others in the area, as well. Many hospitals, that used to offer some amount of free or lower cost care to the uninsured or underinsured, are providnig that service less and less. They’re feeling the economic squeeze and are cutting back as much as they can.

This isn’t just a recent development. In 2005, UTMB was providing charity care to the working poor, Medicaid, uninsured and underinsured. But only 77% of them qualified at that time for UTMB’s charity services. Already over 20% were being turned away. Shockingly, In 2011, UTMB WAS ONLY ACCEPTING NINE (9) PERCENT of patients sent to them for charity care. And there is no other hospital that is picking up those 91% that are turned away.

If UTMB shuts them out, where do they go? To places like St. Vincent’s, an overcrowded, undersupplied volunteer-staffed, marginal clinic that can only provide the MOST BASIC of care. And the availability of “band-aid” clinics, like St. Vincent’s, is so limited that some people have to take the day off from work and drive two hours each way, just to get there. Then they wait for hours to be seen in order to get a prescription for a necessary medication. Then they MIGHT be able to afford that prescription if it’s on a $4 prescription list somewhere. If not, tough luck. In essence, we’re permitting a large segment of our population to experience third-world medical treatment.

Free health and dental clinic by Remote Area Medical during the week of August 19, 2009, Los Angeles, California. (spirit of america / Shutterstock.com)

Free health and dental clinic by Remote Area Medical during the week of August 19, 2009, Los Angeles, California. (spirit of america / Shutterstock.com)

Here’s a bit from the story:

“There’s a popular myth that the uninsured—in Texas, that’s 25 percent of us—can always get medical care through emergency rooms. Ted Cruz has argued that it is “much cheaper to provide emergency care than it is to expand Medicaid,” and Rick Perry has claimed that Texans prefer the ER system. The myth is based on a 1986 federal law called the Emergency Medical Treatment and Labor Act (EMTALA), which states that hospitals with emergency rooms have to accept and stabilize patients who are in labor or who have an acute medical condition that threatens life or limb. That word “stabilize” is key: Hospital ERs don’t have to treat you. They just have to patch you up to the point where you’re not actively dying. Also, hospitals charge for ER care, and usually send patients to collections when they cannot pay.”

Beyond the terrible statistics are the human realities: People who need care, who try to access it to get help. Only to get either turned away, charged beyond their ability to pay, or, perhaps, being able to get care that was much less than they needed. The toll on the patients, the staff of St. Vincent’s, and even the hospitals that can no longer afford to treat these struggling citizens, is frightening. Rachel describes how some of her patients at St. Vincent’s have fared when they needed more care than St. Vincent’s could offer. It can almost be summed up like this:

She was told by one of the surgeons who taught her: “A physician never takes away hope.”

In my second year of medical school, I took a small-group course with a famously terrifying surgeon. He told us his moral motto: “A physician never takes away hope.”

I never figured out how that motto could guide doctors through a system where our patients are dying from treatable diseases. Part of my job, it seems, is precisely that: to sit down with patients and, as gently as possible, take away hope.

This story doesn’t have a happy ending. It’s not uplifting. No one experiences a miraculous cure and walks away smiling. They MIGHT have been able to experience that cure, if they could have accessed appropriate treatment, but that rarely happens.

Very sadly, this is not limited to just this area of Texas. Or the Midwest. It’s happening in many areas of the country. It’s happening right now, as you read this. Someone, uninsured, is sitting in pain, debating whether or not to go to a local ER or urgent care. Someone is hoping that the fever will go down so she won’t have to try to find that $4 needed to get her antibiotic prescription filled.

Please take a look at Rachel Pearson’s article. It’s a quick read that gives a different perspective to this problem. It will take you a few minutes to read through it, then a few more minutes to stop the tears. These things shouldn’t be happening to anyone in our America.

Healthcare interview podcast with Rachel and a journalist familiar with this situation:

St. Vincent’s Clinic

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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78 Responses to ““Texas’ Other Death Penalty“”

  1. karmanot says:

    Same here

  2. Mike_in_the_Tundra says:

    I’m not certain everyone has access to a clinic that is good as that. I’m very fortunate to have such a clinic. They have really stepped up care. The doctors are paid a salary (I assume it’s a good one) instead of paying the doctors for each patient visit. New doctors are constantly being hired to take care of new patients, because the doctors have a limited patient load. Which pretty much means my doctor remembers everything about me (including my sex life).

  3. Mike_in_the_Tundra says:

    There’s a great “Christmas Carol” out there. It stars Patrick Stewart as Scrooge. It’s a really great production.

  4. karmanot says:

    you are the best Mods!

  5. Moderator4 says:

    If they constantly change usernames, email addresses, and IP addresses, they can be difficult if not impossible to ban permanently, karmanot.
    Eventually, most of them get bored and go elsewhere, especially if we figure out that they are the same commenter and simply begin deleting all their comments after they appear.

  6. karmanot says:

    Thanks Mod!

    I think this is the same troll (under a different name) that occasionally attacks here and plays tec games like changing his name and address. He once stole my avatar to post anti gay rants.

  7. karmanot says:

    Thanks P

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  9. Houndentenor says:

    That would depend on which style guide you are using.

  10. Houndentenor says:

    Perry is clueless. Cruz knows exactly what he’s doing and saying.

  11. Houndentenor says:

    I just hope there’s still something left of our country’s economy when that happens.

  12. Houndentenor says:

    But they do because they can pass those costs off to the government. The same government that they bribe to give them tax breaks. Someone else is picking up the tab and in a job market where workers are easily replaceable there’s really no incentive for them to any differently than they do. Of course you might hope that a CEO or two has a conscience but given the sociopathic Ayn Rand inspired philosophies most of them hold, I wouldn’t count on it.

  13. pappyvet says:

    I see. Then this person is a coward without the guts to do anything except hit in the back and run. I would still hope that you could consider my proposal. Thanks Mod3 !

  14. Moderator3 says:

    This commenter just visited many blogs and said things just to be argumentative. It is a type of spamming.

  15. pappyvet says:

    Not that I have any right but I would council against banning this…….person.
    I personally am not afraid of him/her , and the insight given by his/her hate is most useful. Looking the monster in the eye is sometimes the only way to see just how terrible it is.

  16. pappyvet says:

    Well Hell fuzzy karmanot , if I had known you had a blog I would have gleefully tracked over and chastised this idiot !

  17. Hue-Man says:

    Living in a totalitarian Marxist regime where the cost to patients of emergency surgery or a visit to the family doctor is zero, the medical neglect of people who can least afford to be abandoned seems at odds with the righteous “christian values” that are slathered on by the same TeaParty/GOP politicians. Worse, expensive medical procedures are imposed by the state to chase down suspected drug mules, to discourage women’s right to choose, and to inflict hardship on welfare recipients.

    I’ve never heard anyone refer to low-income “parasites” taking advantage of the medical system; if anything, the poor health outcomes of poor people (getting child care, transportation issues, unhealthy diets, etc.) result in more efforts to get the poor to seek health care for their health problems.

    Finally, a personal medical anecdote to counter the claim of interiminable medical wait times: Wednesday noon, I called for the earliest appointment with my family doctor for a routine 6-month visit. Monday 3:45 pm (Thursday and Friday are Thanksgiving-free normal business days). If I had said it was urgent, I probably could have seen another doctor in the clinic within an hour. Alternatively, I could have seen a doctor in their after-hours walk-in clinic M-F 5:00 PM to 7:00 PM. I avoid the ER unless it really is an emergency (broken foot qualified).

  18. Houndentenor says:

    And if people do get care it costs more to treat them. Preventative care would save a lot of money. Plus the people getting the care would be healthier. Everyone would win. But no. Because if you are a right wing nutjob, anything that makes sense is socialism.

  19. Moderator4 says:

    Yes, we know, karmanot. We left his comment up here as an example, but he has been banned from further commenting on ABlog.
    We would suggest that you also ban him from your own blog, if you have not already done so. ;)

  20. karmanot says:

    He’s (?) a major sicko Mod—dropped by my blog to leave some anti gay and anti vet comments.

  21. karmanot says:

    He dropped my blog to leave some hateful anti gay and anti vet garbage, truly a sick and depraved little man.

  22. Monoceros Forth says:

    The thing is…you can apply this logic–and it is sound logic–to many aspects of being “working poor” in America. You would think that corporations would benefit from not openly treating their workers like intolerable burdens but that’s the method.

  23. therling says:

    Not only does lack of health care result in premature deaths, and lives lived in misery, one has to add countless lost hours of worker productivity. Furthermore, people who are busy being sick are less able to care for others such as children or the elderly.

  24. neither would Adam Smith, whom the reactionaries often cite

  25. The_Fixer says:

    Boy, he is a dandy, ain’t he? He lives to throw verbal bombs. Too bad we’re on to him :)

  26. The_Fixer says:

    How noble of you to express that sediment sentiment.

  27. The_Fixer says:

    Yes! Talk about parasites, those are the real parasites. Without the government shoveling money their way, they would fail under the weight of their own incompetence and greed.

  28. Zorba says:

    Yes, exactly. We can’t teach the “masses” critical thinking skills or anything that might cause them to doubt the status quo. Hence the Bush No Child Left Behind Act, the Obama Race to the Top, and now the Common Core standards. All of which depend upon a lot of standardized testing, which only has led, and will continue to lead, to “teaching to the test” and rote learning. Nothing that might cause them to actually think, question, and examine.

  29. Thom Allen says:

    “Willfully clueless” is brilliant. Thanks. But you could also add Gohmert and so many others who adopt the same position. Though each may have been blessed with a different measure of stupidity.

  30. Whitewitch says:

    I am not sure we can blame it all on those three things….it is ignorance though and it is true if the Republicans could kill public education they would be happier than pigs in mud.

  31. Whitewitch says:

    Me either Zorba…and sadly – they are so self-righteous about it. Hear someone on the radio last night evoking people NOT to sign up for Obamacare – to be proud and self-sufficient and take care of yourself…as if anyone having a heart attack or dying of cancer could do that?

  32. Whitewitch says:

    Agree – I meant the Evil Rush Limbaugh….who is probably not a rocker either.

  33. karmanot says:

    Datz right! :-)

  34. nicho says:

    A good argument for letting the big banks fail.

  35. nicho says:

    And this is why single payer will be fought tooth and nail by the corporatocracy. There are hundreds and hundreds of corporations — many of which you’ve never heard of and probably never will — that live in the shadows of our healthcare system and make billions of dollars off of it — and have nothing to do with patient care. A lot of people think that it’s them, their doctor, the hospital, and the insurance company. Not even close. People would be shocked at the number of corporations “wetting their beak” in the system. Single payer is going to put a lot of these cash cows out of business.

  36. Dakotahgeo says:

    Believe me, when the ignorant Americans finaaly wake up to the fact that they’ve been taken on a Republican conservative Tea Party hayride, there will be hell to pay! I just hope the retarded right wing doesn’t stand close to any trees or rope when the fit hits the shan!

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  38. pappyvet says:

    LOL ! I just couldn’t resist sharing a joke with you. Always love your posts.
    At my age , being able to split anything including an infinitive is seen as a plus.

  39. beleck3 says:

    the sad truth is the Republican base believes the lies Perry, Cruz and Bush have told over and over. the amount of fear these people have about being poor is what Perry, et al use to scare them. it is most amazing they have that much fear and are hurting themselves when they vote Republican. years of brainwashing against the Left started in the 60’s and is now a fine art of PR. as Margaret Thatcher said, “There is no such thing as Society.” St. Ronnie of Reagan was the American leader who sold America’s Middle Class and their fears to the Rich, and this sorry state of no health care for the poor is a result.

    never, ever vote Republican if you believe in society, common good, schools, roads, clean air, clean water and in general, healthy life.

    years of lies. and the Right will never change their hatred towards the less than.
    we see the results of years of hatred, in the South, especially. People here in Louisiana voted Jindal again, and he has destroyed our public hospitals, like Perry obviously has done in Texas. Keeping the poor oppressed is the easy way to scare the base into obedience. Fear of the other, lest they live in your neighborhood and you see they are just like you.

  40. Monoceros Forth says:

    Heh, thanks. I’m aware that many of these rules aren’t so much laws of grammar as guidelines to style. Grammar is more or less fixed but style is a question of taste. For example there really is no rule about splitting infinitives; it is not ungrammatical to split one but I do think that in most cases it is better and more emphatic style to avoid split infinitives.

  41. Loona_c says:

    Sadly this is true and obscene. I live in Texas. And Perry and Cruz are willfully clueless. To think that “using the ER” is cheaper or more cost efficient is absolutely ridiculous. And to deny expanding fund from the federal govt. for Texas Medicaid recipients is criminal.

  42. Loona_c says:

    I think you are correct. Somewhere along the way the rule changed. In creating mass mail merge letters I used to have to read each letter to correct “Thank you for James’s application” because the merge document formatted “‘s” on ALL documents/names. Lately I don’t have to because “the rule changed.”

  43. pappyvet says:

    That is odd isn’t it

  44. pappyvet says:

    I love good grammer. And I aint got no any problem with anything you say Monoceros ;]

  45. cole3244 says:

    it all stems from bigotry, racism, and hate.

    the more ignorant the more pliable you are, ergo the rights fear of educating the masses.

  46. Monoceros Forth says:

    When you add an apostrophe to a word with an S at the end to signify possession, you don’t add another S.

    This is incorrect. The terminal ‘s’ is omitted from the possessive forms of plural words ending in ‘s’. The possessive forms of singular words ending in ‘s’, including proper nouns, are formed in the usual way. Names from classical antiquity ending in ‘s’ are sometimes excepted from the rule.

  47. Jafafa Hots says:

    When you add an apostrophe to a word with an S at the end to signify possession, you don’t add another S.
    Charles Franks writes a memoir? It’s Charles Franks’ memoir.

    For pluralization you would not use an apostrophe, if there were multiple Texases you write Texases.

  48. Monoceros Forth says:

    Hey, I like Rush! (The Canadian rockers, that is.)

  49. Zorba says:

    Whitewitch, I have never, ever understood the voters who continually vote against their own self-interests. {{Sigh}} :-(

  50. pappyvet says:

    Bug spray

  51. karmanot says:

    lessthantolerant is already dead.

  52. docsterx says:

    Thanks. The thing that our “Holger Danske” doesn’t realize is that the real Holger, when needed, rises to protect ALL his citizens, weak and strong. Our Holger just wants to be the champion of the “beleaguered” wealthy, white, elitist few percent.

    BTW, I left a few comments for you on the trans fat thread re: fatty acid analysis for chemistry geeks like us.

    And “lessthantolerant” is indeed a misnomer. It should be “absolutelyintolerant.”

  53. karmanot says:


  54. karmanot says:


  55. karmanot says:

    Viewing your file I see that you are a very nasty troll. I seriously doubt anyone will notice you and if they do will assume you are an internet parasite.

  56. Monoceros Forth says:

    It is striking how the communities and societies that fret the loudest about such “parasitism” are rarely societies that contribute much of anything to human civilization. You look at the reddest states, the ones loudest in their embrace of “conservative principles”, and you find that they’re the most backward, the worst educated, the least developed. Cruel societies are societies from which great men and women flee.

  57. Monoceros Forth says:

    Well done, sir! I thought the name of “Holger Danske” was familiar. Hans Christian Andersen wrote a short story about Holger Danske, did he not, and how his beard grew through the marble table on which he lay? There is some irony in the contrast between Andersen’s gentle humanity and the harsh, bloodthirsty spite evident in “lessthantolerant”‘s remark.

  58. docsterx says:

    Note the surroundings here as David Cameron makes a speech calling for austerity: http://www.businessinsider.com/picture-of-david-cameron-calling-for-austerity-2013-11

  59. docsterx says:

    He probably should have picked a white hood and a burning cross.

  60. docsterx says:

    Don’t let his remarks distract you. The real issue is the lack of needed health care services for all. His comments are designed to enrage us, get us angry with him, what he espouses and divert us from the information Rachel presents about the Galveston area.

    He’s threatened by his powerlessness: his bigoted way of life is going to change, he’ll have fewer compatriots, his children will date brown, yellow, black and same-sex children as they grow up. He is unable to cope. He has only his hate, anger, his gun, his church, his political and his woman. And his woman is getting other ideas about that. And his ability to keep his gun, since he’s obviously mentally unbalanced, may soon end. His church may be getting more liberal (the Phelps and their like will always be marginal.) His political party is disintegrating, both from internal rot and external pressures. I almost feel sorry for him. Almost.

    “Holger Danske” his avatar is a legendary hero who lies sleeping until a great problem with his country will cause him to awaken, regain power and save his country. If he believes he is Holger, he’s also delusional.

  61. SkippyFlipjack says:

    Shouldn’t it be “Texas‘s Other Death Penalty”?

  62. phred says:

    I assume that lessthantolerant is advocating letting *other* people die? I lived with Republican health insurance–hope hope for a quick and painless death–for many years, and it wasn’t pleasant. I had a broken tooth digging into my tongue, I had to taper off the meds I was taking because it was either that or housing, and kept my house at 50F to save money. I applied for dozens, probably hundreds, of jobs for which I was completely qualified, and got almost zero response. I finally found a job, with insurance, and now I’ve probably paid far more in taxes than I ever got in benefits. You know something? I don’t mind paying taxes–taxes pay for civilization. So tell me, lessthantolerant, what happens when you lose your insurance and need a doctor? Are you willing to die?

  63. Whitewitch says:

    The Grinch is also Great!!! 1938 is my favorite with the adaption with Bill Murray my comedy version fav…..

  64. pappyvet says:

    Absolutely !

  65. pappyvet says:

    I also try never to miss A Christmas Carol. My favorite is still the 1938 version with Reginald Owen. As well as The Grinch who stole Christmas with the wonderful Boris Karloff reading. I just wanted to adopt CindyLou Who at once;]

  66. Whitewitch says:

    P.S. A Christmas Carol is my FAV movie. I watch it when ever I can – every version as many times as I can at this time of year….it gives me hope the evil will wake up and change – even if it is only because they fear where they will go when they die, rather than just to be a decent human.

  67. Whitewitch says:

    I think they are like Rush…they feed on the hatred – and feel more powerful when their fellow travelers are pushed under their feet. I am glad the mod left the post…it is good to know your enemy.

  68. pappyvet says:

    LOL! Yes but you had the correct quote. As many times as I have posted about the rightwing culture of hatred , I am still sickened when an alleged human being says such things. When truth and decency are so very obvious , I cannot help but think that people like lessthantolerant are that way not because of truth or courage but because they enjoy hatred. And if that is true , then they are sick both emotionally and mentally.

  69. NMRon says:

    It’s amazing. Texas under Rethuglicans has become the epitome of every third world shit hole on the planet. Worst healthcare in the nation, worst education system in the nation, degrading highway system and getting worse; civil rights? Hahahahahahahaha. There is no metric of quality of life that isn’t the bottom of the barrel. Anyone thinking of relocating there or of relocating their business there is full on stupid.

  70. GarySFBCN says:

    Excellent post with a powerful title.

    It should be easy for someone skilled in ‘messages’ to craft a very short, succinct argument because there’s more than enough damning ‘material’ in that article. And yes, crafting and promoting messages is extremely important in this idiotic ‘news’ environment.

    Unrelated and related, I saw this earlier in the week. While this is the mayor of London saying these despicable things, it is very much the same delusional attitudes, combined with no empathy, that prevail in the US:

    “Boris Johnson has launched a bold bid to claim the mantle of Margaret Thatcher by declaring that inequality is essential to fostering “the spirit of envy” and hailed greed as a “valuable spur to economic activity”. ”


  71. Whitewitch says:

    I had to change my post having seeing you had already gotten made this point.

  72. Whitewitch says:

    Sadly, it seems that many of the poor still vote republican and in essence they are electing to die rather than participate in Socialism – even though Social Security is socialism…and public roads…sadly this is the way of the future. Poor and Wealthy ….no other class.

  73. fletcher says:

    Right! I see his avatar is of a hooded head. Probably doesn’t want us to see his unkempt hair and beard due his being scared off by the beady-eyed evil-looking critter who stares back at him every morning from the bathroom mirror.

  74. pappyvet says:

    Are there no prisons , are there no workcamps ? Thanks Mod3 everyone should from time to time be reminded of what ignorant hatred looks like. Very rightwing , not very American.

  75. Moderator3 says:

    I actually considered deleting this comment, but people need to see how the right wing thinks.

  76. lessthantolerant says:

    Feeding parasites more entitlements only increases the number of parasites. letting them dies from lack of health care at least keeps the numbers from expanding too fast.

  77. pappyvet says:

    A single-payer system finances health care for an entire population by using one public agency to collect all contributions and pay all bills.A single-payer program would replace premiums, co-pays, deductibles and other out-of-pocket we now must “enjoy” with health insurance companies. Comprehensive coverage identified by the single payer care, would be equal for all residents.

    As far as cost is concerned , health spending in the United States currently exceeds $2 trillion. A single-payer system that did nothing more than reduce administrative expenses to the levels of other countries would save roughly $300 billion annually.
    As far as the horror stories told about programs in other countries are concerned , they are for the most part just that , stories. No healthcare system ANYWHERE is without them. But for maximum coverage and quality care , a single payer program has no equal.

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