Texas Medicine Letters: May 2012

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Letters – May 2012 

Texas Kids Deserve Better 


As a future pediatrician, I was encouraged by a recent headline in the Feb. 22 online edition of the San Antonio Express-News: "Report: Uninsured Louisiana Children Fall." The story details the 2011 Louisiana Health Insurance Survey, a report that found that the percentage of uninsured children in Louisiana had decreased to only 3.5 percent. This represents a drop from more than 11 percent when the initial survey was conducted in 2003.   

Why all the excitement about children in Louisiana? Over the past two decades, as in Texas, Louisiana has ranked in the bottom five states when it comes to percentage of uninsured children. Texas, however, has the dubious honor of leading the nation in uninsured children since 1998 and residing in the bottom three states since 1990.  The most recent data (2009) show Texas is tied with Nevada for the highest percentage of uninsured children at 17 percent, compared with a national average of 10 percent. This success story for Louisiana's children should be a motivator for child health advocates in Texas, such as those in the Texas Medical Association.  

If we are to succeed in improving access to health care for our youngest Texans, we will need to come together, crossing political and ideological lines. The initial passage and subsequent reauthorization of the Children's Health Insurance Program (CHIP) exemplifies how bipartisanship, compromise, and a dedication to the well-being of children can result in meaningful change. This program for insuring low-income children now covers roughly 7 million children nationwide, including more than 500,000 in our state. 

As Texas Medicine and other publications have documented, our last legislative session was a disaster for Texas children. Instead of working together to enhance the health of our state's children, we fought tirelessly to preserve the inadequate status quo. Thankfully, our neighboring state has set an example – demonstrating how we might work to ensure access to health care for all of our youth. Together we can address this issue and do better for the health and future of Texas children. 

Ryan D. Van Ramshorst, MD, San Antonio  

Texas Medicine Lost a Legend 


If you don't believe that time sneaks up on you like a windshield on a bug, you are truly mistaken because it was about three decades ago when Ralph Chase, MD, pediatrician extraordinaire, and I first met after he had already been in practice for about 30 years.

One afternoon, this short, benevolent Napoleonic-like man appeared in my Eldorado office to extol the use of physician assistants in rural medicine. "If you don't have one, you need one," he said, and thus began a long and fruitful relationship as we worked to integrate physician assistants into rural family practices. An article appeared in Texas Medicine about these needs, and then he went on to bigger and even more productive civic activities as he continued to grow as a grand champion of women and children.

Ralph's big heart just played out in March, but of all the physicians I know, his legacy as a visionary for medicine and for San Angelo is permanently etched in memory. He has been described as the most influential person to ever live in that city. He has accomplished so much that a list of his achievements would occupy about the same space as Gray's Anatomy or Current Therapy 2011.

He started practice just as the great polio epidemic reared its ugly head, and Ralph worked tirelessly in the town that was hardest hit by the disease. His intellectual interests helped initiate the annual Distinguished Lectureship, which has brought some of the worlds' great thinkers and Nobel Prize winners to San Angelo. His work to centralize adequate immunizations and health care social services resulted in a new building dedicated as the Ralph Chase State of Texas Service Center.

But with all the recognitions and acknowledgments, duly earned and well deserved, Ralph remained a lover of people. His infectious greeting, "You are a wonderful person, and I love you," has become so much a mantra that it is referred to as YAAWPAILY in these parts.

"He never quit giving to the community and to the city of San Angelo and to its citizens," and "His efforts on behalf of all children, especially those underprivileged children, have been innovative, untiring, and continual since he began his pediatric career here" are just a couple of oral tributes made about Uncle Ralphie, as he was known to pediatric patients and those thousands who have grown out of the age group. His own statement is the best, I think: "People who say that going into medicine now is the pits, well, it's just not true. If you're going into it to have a condo in Vail and a BMW, it's the pits. But if you want to be a doctor for the patients, it's great."

If there were more compliments to be paid to this great man, it might be that Ralph Chase is the kind of doctor to be when we grow up.

 Jim Bob Brame, MD, Eldorado 

Editor's Note: Dr. Brame was TMA president in 1986-87. 

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