Friday, January 09, 2009

Failing Texas communities

I've always felt that making a profit on health care services, especially for the poor and most vulnerable, just didn't pass the ethical "sniff test." I know I'm likely in the minority on this one, or maybe not.

Tell me how you feel about it.

Several years ago, I got into a conversation with a very bright young business man. Somehow the subject of universal health care came up.

I'll never forget his words, "Some people actually believe that health care is a basic human right. Can you believe that? That everyone is entitled to health care?"

I also remember that our talk came to fairly speedy end after I voiced my opinion about the matter.

What do you think?

Along these lines, hats off to The Dallas Morning News for its four-week series, "State of Neglect." You can get to the ongoing report here. The timing is perfect just as the Texas Legislature prepares to open its 2009 session.

So far the report reveals how the State of Texas has aggressively "outsourced" health benefits coverage for the poor, the disabled and the elderly to the private, for-profit insurance industry--in this case, Evercare of Texas, a division of UnitedHealth Group. To say that the company has under performed would be a great understatement. If you live in Texas, you'll want to read the report.

The result of this outsourcing has been neglected patient care, an incredible lack of responsiveness, inferior services for those who need them most and amazing profit for corporations and lobbyists who work on their behalf.

Here's how the Dallas Morning News sums things up:

"This month the Texas Legislature will open its 81st session with a $10 billion budget surplus. Many leaders have called this the happy result of a state government that keeps taxes low and regulation light, and that makes Texas, for the vast majority of its residents, a great place to live.

"Unless you are hospitalized. Or buy insurance. Or breathe the air. Or engage in any other daily activity that requires state oversight. . . .

"Texas is near the bottom among the 50 states in per-capita spending on health and human services, but it is a leader in outsourcing these functions to private contractors."

Frankly, the entire situation in Texas in the health and human services sector is an on-going disaster. Reform is needed, comprehensive, radical reform.

It is time we all called for better outcomes for everyone.


Anonymous said...

I understand the temptation to call things like food and health care a "basic human right." No one wants to see another person hungry or sick. But I have doubts about whether you can call these things "rights." I think we have a right to be free from interference by others in critical areas like religion and speech and to be free from crime. Historically, such "basic human rights" have always involved freedom from a negative.

But I am not sure you can say someone has a "right" to a particular kind of benefit, even food and health care. The moment my neighbor has a "right" to these things, he has a "right" to demand them of me, which is to say he has a "right" to require me to spend my time, energy and effort to provide them to him. This is the opposite of having a "right" to be free from interference. It is the "right" to demand something of someone else. That is a very different animal.

Personally, I do not think such things are "rights." We may decide our society is better off having universal health care, but I think it's mistaken to call it a "right." If we decide to provide it, I think benefit or privilege are better words.

Chris said...

If one has a "right" to health care, they cannot have good health without a home, so do they have a "right" to a home? They cannot have good health without food, so should they have a right to free food? They cannot get a good professional job without higher education. Do they have a right to free college? Where does it stop? If you take the money away from producers in the way of higher taxes, where is the incentive to produce? Why waste your time working, going to school,delaying gratification, all you have to do is get your free apartment, free food, free health care and raise your babies. I understand Shelby County Tenn. has learned this lesson well--3 out of 5 babies are born to unwed mothers.

belinda said...

I wonder how some of these folks will feel when it happens to them or someone they love . . .

Anonymous said...


I don't know if health care is a "basic human right", but I'm pretty sure it is a basic human requirement for me to help provide for my neighbors. Was care for the Jew robbed on the road a "basic human right"? Maybe not. But thank God it was a basic human requirement, in the mind of the Samaritan, to help him.

We should be a lot less worried about what others have a right to and more concerned what I have a calling to.

Kent Hill

Larry James said...

Kent, so good to hear from you! Your comment is exactly on target. Love you and how all is well with you and your family.

Chris, you don't really know poor folks. Your statements always assume the worst and reflect the fact that none of your friends are poor or have experienced generational poverty. BTW--read the DMN report that I reference. The subjects of this report are people just like you and me who are being failed and failed miserably by the unjust policies of current state government in Texas.

Chris said...

Larry, you do have some valid points, however, I want to correct one mistake. I grew up poor, my family did not have health insurance. We lived in an isolated part of one of the poorest states in the country, without indoor plumbing or running water. I was "on my own" at age 18, without job skills or opportunity for college. My younger brother was mostly the same way with a little improvement in economic status.

I graduated from an elite university in New York City. My bro has a Ph.D and speaks all over the U.S. and foreign countries on nuclear subjects. My sister didn't do so badly herself.

My point is, do not say that I don't know anything about poverty. The difference is that we didn't go about whining and wanting the government to take care of us. We didn't get involved in the legal system and didn't start a family before we were married.

By the way, Obama knows nothing about economics and I hope everyone is ready for the coming disaster. I will remind you in a couple of years.

Larry James said...

Chris, okay. On January 20, 2011, let's meet here and compare notes on the "disaster" that has happened. How could it be worse than what he has as he begins? But, I'll show up, if I am still around, and we'll unpack what he has done. BTW--poverty for white folks growing up in the country in post-Drepression America has almost no connection whatsoever to what we see in the inner cities of this nation. Your comparison betrays your lack of understanding.

Anonymous said...


I couldn't agree more. If you feel a calling to help ensure the poor have food and health care, that's great. I hope most Christians do (although I know better).

But Larry's post started off with a discussion about whether health care was a "basic human right." I simply disagree with that terminology. If I have a "right" to something, I can demand it and enforce that right. I don't think food or health care fall into this category. Perhaps a good thing, but not a "right." It's an important distinction and should not be ignored. That's all I was saying.


I can't believe I'm saying this, but I'm not sure you're being fair to Chris. You said, "Chris, you don't really know poor folks." When Chris pointed out she (?) grew up poor, you changed the subject to race. While I agree there are important differences between white, rural poverty and minority, inner-city poverty, they are not wholly unrelated. Chris made the valid point she is not as clueless about poverty as you might think, having experienced it herself, and I think it's a fair point.

Anon. 12:17

Karen Shafer said...

To this point:

'I've always felt that making a profit on health care services, especially for the poor and most vulnerable, just didn't pass the ethical "sniff test." I know I'm likely in the minority on this one, or maybe not.

Tell me how you feel about it.'

I have a close friend who worked for over twenty years at Child Protective Services, first as a caseworker, then as a supervisor. This must be a record, because it is a very tough gig. I heard many times that he was one of the best and effective CPS workers in the city.

He tells me that when the state began outsourcing casework to private, 'for-profit' entities some years ago, the system, challenged as it was, really fell to pieces, and the care and protection of children diminished considerably and disastrously. I'm sorry I can't remember dates, but he presents a convincing picture from the inside of what for-profit protection and care of human beings can look like. There's always the temptation towards quantity rather than quality since the contracting agency gets paid for the 'numbers', and there is often no oversight.

Anonymous said...

Obama has no where to go but UP! and he will

Anonymous said...

For those who don't believe that healthcare or food (or housng, for that matter), are 'rights': to whom would you deny these basic human requirements for life?

The tone of the conversation carries an assumption that the individuals who have these things have earned them without help from society at large.

Did none of you have a free public education? No one took advantage of fair housing laws? No one benefitted from legislation that made it illegal to discriminate because of sex, ethnic origin, religion or sex?

The idea that we should reduce all society to a Darwinian survival of the fittest situation to the extent that even food and shelter depend upon luck, circumstance and the ability to claw your way through to survival makes me so glad that most of you are locked safe from the rest of us behind these cyber walls.

Anonymous said...

Karen Shafer - your comment is just plain nutty. why would you think any company or doctor or hospital would not want to make a profit from their services. we already have nonprofit healthcare - look at Parkland, not only is it non profit but it is funded by us the taxpayer. I have no problem with that, by the way; but i do have an issue with comments like you make that seem to have the "over the top" comments. just plain crazy.

Anonymous said...

Anon 8:53:

Societies can decide that they want to provide certain minimum benefits to their members/citizens. That is not the same as saying those things are "rights." Words matter. As I said, you can demand and enforce a "right." You can request, seek and argue for a benefit. Benefits are rightly the result of a political process. Rights can rightly not be taken away by the political process. Again, words matter. Being careless about them only promotes sloppy thought and sloppier action.

By the way, free public education and anti-discrimination laws are perfect examples of the kinds of benefits which we as a society have decided we want for ourselves.

Anon 12:17

Anonymous said...

Anon 12:17,

I totally forgot about the Civil Benefits Act and the Voting Benefits Act!

Rights don't grow from a political process. Rights are may be recognizes in a political process. But society determines that there are some things which we either grant or deny individuals. The more moral and compassionate a society the greater the recognition that there are somethings that we recognize certain things that none of us should have to do without.

There is very little that a person can do (absent extreme circumstances), that should cause us to say a person doesn't 'deserve' shelter and food. These are things that go to the recognition of a person's dignity.

I believe that we resort to politics as a determiner of these things, when a segment of society seeks to ignore and insolate themselves from the guilt, shame and insensitivity relative to their refusal or failure to recognize the 'rights' of their fellow human beings. Why else would we even suggest that we can debate whether or not certain people deserve food or shelter?

Karen Shafer said...

Anon 9:38 A.M. By the way, why not leave your whole name, as I did, so that I can address you by it? If you're proud of what you say, claim it.

I'm not sure you actually read my comment. I was relaying the reality of services to abused, neglected, and at-risk children as it actually happened once CPS began to outsource its services. This is not my opinion, nor is it an abstract theory. It is the experience of a person who successfully served this population for over twenty years, working against great difficulties.

"Over the top?" I only wish. If you actually knew some of the stories of what these children live through, it might shake up your polemics a little bit. I recommend you go volunteer at Jonathan's Place, the emergency shelter for these kids, then get back to us with your viewpoint.

Jeff said...

I'd love to hear you defend your position from a scriptural basis, preferably quoting JC. Rush Limbaugh and Jesus are spiritual opposites.