House Bill 3781 by Rep. Myra Crownover
House Public Health Committee
April 21, 2015
The Texas Medical Association wishes to express our support for House Bill 3781 by Rep. Myra Crownover to establish the Texas Health Improvement Network (THIN) — a collaborative, multi-entity initiative to address the significant health disparities and challenges in our state.
Our members have made it a priority to advocate for population-based health policies because Texas is continuing to face costly and long-term health concerns such as:
- High rates of obesity among our children and adults, and growing rates of related chronic conditions such as diabetes and hypertension;
- Outbreaks of infectious diseases;
- Later diagnosis of some cancers and higher rates of cancer mortality among African-Americans and other minorities;
- Preventable hospitalizations for pneumonia;
- A growing demand for community mental health services in excess of available resources; and
- Decades of late access to prenatal care and increasing rates of premature births.
Our member physicians care for patients affected by these problems every day. But our members also work to support population-based health because we understand that physicians must be engaged in all aspects of health policy and services. We volunteer in clinics, on state advisory panels, on school boards and health advisory committees, and at school sports activities; and many of us serve as public health authorities and leaders in other community-based activities. Through TMA’s formal councils and committees on these subjects, physicians study these key health concerns and identify evidence-based approaches that most effectively get at the root of these costly health concerns. TMA physicians believe we will not see any abatement in these state health disparities until we can better focus on understanding the many factors contributing to these conditions.
With a rapidly growing population, and a rapidly growing population with preventable health issues, Texas already is using one out of every five general revenue dollars in our state budget for the Medicaid program to care for those who are too young or who are unable to work because of an illness or disability. While we cannot readily address the social and environmental factors (e.g., income, geography, stress, housing, air pollution, and food access) that influence the health of Texans, we can do more to assess how these social, economic, and environmental factors are affecting our communities. We can do this with timely data analytics from the many effective health initiatives underway in our communities, such as the hundreds of 1115 Medicaid waiver projects reaching tens of thousands of Texas residents throughout the state.
We are advocating for dedicated, organized efforts to understand why so many of our residents are sick or at high risk of becoming ill with a preventable disease. TMA recognizes that long-term results can only be achieved with a thoughtful, organized approach that looks at the Texas population level as well as our strengths and resources. THIN represents a commitment from our top higher education experts to do this work. And there is not a more qualified person in the country to lead this effort than David Lakey, MD, associate vice chancellor for population health in The University of Texas (UT) System Office of Health Affairs. Under Dr. Lakey’s leadership, we can be assured that this will not be an educational initiative locked within the confines of our academic institutions, but will include input from the physician community. Physicians are a trusted source of health information, and state efforts must engage us in collaborative efforts to improve population health.
The Texas Medical Association has addressed the Texas Legislature many times about the fragmented and under-resourced public health system in Texas. We will be unable to sustain our vibrant economy and population if so many of our patients not only are getting sick with preventable conditions, but also are getting sick earlier and are sicker for longer periods. These are persons who cannot contribute to Texas as they would like — and our economy needs them.
A planned, measured strategy as is proposed by THIN will enable us to help our patients — our population — to begin to “bend the curve” in the use of our state resources for “sick care.”
We greatly appreciate the thought and initiative shown by Chair Crownover in working with Executive Vice Chancellor Raymond Greenberg, MD, PhD, of the UT System Office of Health Affairs to propose the Texas Health Improvement Network. We pledge our support and look forward to participating in this landmark work in the years to come.
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