Do Not Underestimate the Stakes

November 2005


Dear Fellow Texans,

Dr. Gunby

In January 2005, the physicians of the Texas Medical Association published the first edition of Healthy Vision 2010 . We put our stethoscopes to the heart of Texas' health care system, reached a diagnosis, and prescribed a rigorous course of treatment.

Our conclusion: This patient is sick, but not dying. Ten months later, the patient is even sicker, but still not terminal. We remain confident that our prescription for accountability, efficiency, and effectiveness will heal the patient. Our treatment will ensure that the Texas health care dollar is actually spent on health care … not elsewhere.

We offer this second edition of Texas Medical Association's Healthy Vision 2010 as the medicine Texas should take to return to physical and fiscal health. We cannot underestimate the stakes. Texans are growing older, fatter, poorer, and less well-educated. Unless we act now, chronic diseases and our unhealthy lifestyles will continue to eat away at our bodies while our desperately underfunded physicians' offices and hospitals crumble at our feet. The number of uninsured will continue to skyrocket, constantly robbing the system of its remaining vitality. The health plans will continue to bleed employers, employees, physicians, and hospitals to boost their profits. Taxpayers will decide they can't afford another dime to care for Texans who are poor or old or have disabilities.

That is not a healthy vision. That is a nightmare.

We can and we must begin the healing today. This will be a long and intensive course of treatment. The prognosis is good, but the patient needs extensive rehabilitation. We must enact changes in our private and government health care programs ... among individual Texans, health plans, employers, doctors, and hospitals ... in Austin and Washington.

The physicians of Texas invite our state's political and economic leaders to join us at the table as we search for the cure. We must be creative, brave, and innovative as we devise ways to make health care and health insurance affordable for Texas families, businesses, and taxpayers. We must encourage Texans to take better care of themselves - and take more responsibility for their health. We must improve patient safety, make life- and dollar-saving health care information technology readily available to physicians and patients, and bring some sense to the extraordinarily expensive and often very painful final days of our lives.

Early in 2006, the Texas Medical Association will convene a Texas health care summit. We'll bring together the thought leaders and the decision makers, all the stakeholders, to search for common ground. Surely, we won't agree on all of the solutions, on all of the treatments we recommend as part of Healthy Vision. But just as surely, we must all agree on the need to dismiss the status quo and move forward. We have no choice but to reject the nightmare scenario and embrace a healthy vision for the future.

We cannot underestimate the stakes. A healthy Texas depends on healthy Texans. A healthy Texas economy depends on a healthy Texas workforce. A healthy Texas tomorrow depends on healthy children today.

Healthy Texans depend on a robust health care system - healthy physician practices and hospitals. Healthy Texans depend on making healthy lifestyle choices and informed health care decisions.

The 41,000 physician and medical student members of the Texas Medical Association are dedicated to improving the health of all Texans. Since 1853, TMA has worked to advance professional standards, enhance the public health, and enable physicians to concentrate on applying the wondrous power of their healing hands.

As physicians, our primary concern is promoting health. We stand for and support:

  • What's good for the health of our patients,
  • What's good for the physical and fiscal health of Texas, and
  • What's good for the health of the health care system.

We encourage you to study this second edition of Texas Medical Association's Healthy Vision 2010. Read the details of our diagnosis and treatment plan. Discuss them with your doctor, your legislator, your friends and colleagues. Demand accountability, efficiency, and effectiveness.

Do not underestimate the stakes. A healthy Texas depends on healthy Texans.


Robert T. Gunby Jr., MD
Texas Medical Association

P.S. I must express my sincere gratitude to the physician leaders and staff of the Texas Medical Association for the hours of research and analysis that went into this document. As physicians, we know the difficulty that often comes with accurately diagnosing disease and devising the appropriate treatment regimen. This "patient" deserves - and has received - our very best work. Thank you very much.

Next: Healthy Vision 2010: The Diagnosis