Dr. Mudit Gilotra, center, assistant medical director of Healthcare for the Homeless - Houston, talks with Robert Tobar about his shoulder pain in January.
Dr. Mudit Gilotra, right, assistant medical director of Healthcare for the Homeless - Houston, talks with Larry Taylor Jr., about his health after he approached the medical outreach team in the drive through of a bank in January.
A family medical examination room. People who are getting sick because they live in unhealthy homes and cannot access routine health care don’t show up for work.
A patient receives a free dental screening during UTHealth Houston's annual community health fair in the Eastex/Jensen neighborhood of Houston in 2023.
Taxpayers have the right, a duty even, to demand that government officials spend the money they take from us wisely. Yet, when it comes to health care, we overlook one of the world’s most inefficient and wasteful systems.
The United States spends twice as much per person on health care as other wealthy nations, yet far less prosperous countries have far healthier populations. Much of the problem is our privatized, for-profit system that rewards health care professionals for overtreating illnesses and injuries rather than preventing them.
The Episcopal Health Foundation, Methodist Healthcare Ministries of South Texas and St. David’s Foundation have a new report on how Texas’ inefficient system costs the economy $7 billion annually in avoidable costs. Worsening climate change will only exacerbate the financial impact, according to a separate report from the Center for Houston’s Future.
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Every child knows an apple a day will keep the doctor away, yet the state’s politicians and health professionals still don’t invest enough in preventing disease in low-income people. The result is $2.7 billion in excess medical spending for hospital care, doctor services and prescription drugs, the EHF study found.
People who are getting sick because they live in unhealthy homes and cannot access routine health care don’t show up for work. That takes another $5 billion out of the economy due to lost productivity.
Other states minimize this economic impact by making health insurance available to low-income families. However, the Texas Legislature failed to expand Medicaid, the coverage plan for people in need, to include working people whose employers don’t provide insurance. Gov. Greg Abbott and Lt. Gov. Dan Patrick have pledged to stop any effort to care for these low-income families with taxpayer money.
So, instead, we pay 12 times more to hospitals to care for these people in the emergency room rather than a primary care clinic after their health has severely deteriorated. The math doesn’t make any sense, and the cruelty takes the cake.
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“How much money you make or where you live shouldn’t determine your health or economic future, but these numbers show that’s the current reality in Texas,” Dr. Ann Barnes, the CEO of EHF, said in a statement. “The bottom line — if everyone in Texas had the same opportunities for good health as the healthiest among us, our economy could potentially save billions of dollars in unnecessary costs and lost work productivity.”
But wait, it gets worse!
The Center for Houston’s Future issued a report Wednesday examining the snowball effect of health care and climate change. Experts examined the expected impact of climate change, particularly extreme heat, wildfires, floods and hurricanes and how they will affect heatstroke, respiratory illnesses and vector-borne diseases.
Again, it is no surprise that low-income people and their families face the highest risks and the worst consequences. They tend to work physically-taxing jobs outdoors and live in sub-standard housing.
The risk of heat stroke is rising not only because of hotter temperatures but also because the Legislature took away the ability of local governments to mandate water breaks. The study found that low-income households are more likely to live in urban heat islands and typically experience temperatures 17 degrees higher in Houston, even at night, making them more susceptible to heat injuries.
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Mosquito-borne illness is also worsening across Texas as temperatures rise. Malaria once affected the entire state, and yellow fever ravaged coastal areas in past centuries. Our region is not immune to tropical diseases such as Zika, dengue, typhus, Chagas and hookworm as temperatures rise.
The health care system, by the way, is responsible for 8.5% of national greenhouse gas emissions.
“We found that some health care leaders and professionals are actively tackling current and prospective challenges posed by climate change. However, others, for assorted reasons, have yet to dedicate significant resources or engage in public discourse on this issue,” the study authors concluded. “This mirrors a broader trend across many industries, where valuable work often occurs in silos.”
The report recommends greater collaboration in developing strategies, protocols and innovations to prevent injuries and illnesses aggravated by climate change. Additional training is needed in medical schools, hospitals and health departments.
Health care professionals must also prepare for worsening natural disasters in emergency departments and emergency management offices.
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We can do so much better, and other governments can supply practical roadmaps for preventing more illness while treating more people for less money. The first step, though, is to demand politicians put economic efficiency above misguided ideology and spend our money wisely.
Award-winning opinion writer Chris Tomlinson writes commentary about money, politics and life in Texas. Sign up for his “Tomlinson’s Take” newsletter at houstonhchronicle.com/tomlinsonnewsletter or expressnews.com/tomlinsonnewsletter.
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