Dear Friends:

Below you will find the remarks of Dr. Ron Anderson of Parkland Hospital, who testified before a health care panel at the Capitol on April 11th, with respect to federal budget cuts. I would be very interested in your comments.

Keep the Faith,

Senator Eliot Shapleigh

REMARKS OF RON J. ANDERSON, M.D.
President & Chief Executive Officer
Parkland Health & Hospital System
Invited by Representative Eddie Bernice Johnson
Health Care Panel
A Joint Democratic Forum on the Impact of the Federal Budget on Families
April 11, 2005

Congresswoman Johnson, thank you for the opportunity to testify today. My message is simple – enough is enough. The cuts in the Medicaid system that are contained in the House version of the Fiscal Year 2006 Budget resolution are Draconian and will have an extremely harmful and long-lasting impact on Parkland Health & Hospital System.

To add insult to injury, they come after the 1997 Balanced Budget Act which cost Parkland $80 million and cuts in the state Medicaid and CHIP system in 2003 which cost Parkland an additional $47 million. As a result of those cuts, my system embarked on a cost-cutting plan that eliminated $225 million from our budget over three years. This not only included the elimination of several hundred jobs, but also the reduction in vital services that our vulnerable patients depend on.

The facts are simple. Parkland is the safety-net institution that was established to care for Dallas County residents. As a tax-supported institution, we often treat the sickest and the poorest of our county. However, we are at capacity. The inn is full, and as a result surgeries are being delayed, sometimes for months. Wait times to see physicians or have prescriptions filled are exorbitant. For example, if you need to have a hernia repaired, you will wait, on average, 3 months. Of course, if it becomes an emergent situation, you will be treated immediately. However, as a practicing physician, I can assure that treatment while a problem is still routine is always preferred. The patient has a much quicker recovery and the cost for treating the patient is significantly lower.

In 2001, Parkland treated 58.2 percent of the adult self-pay inpatient discharges in Dallas County. By comparison, in 2003, we only treated 45.4 percent of a larger population of uninsured. In 2001, we did approximately $350 million in uncompensated care. In 2003, this number had risen to $425 million. While the numbers of absolute patients increased and the cost associated with caring for those patients continued to rise, the volume of uninsured in the community increased so greatly that the non-profit hospital sector was significantly impacted. Clearly, this trend cannot be sustained. When safety-net hospitals such as Parkland suffer, all hospitals suffer. This is a community problem. Indeed, a national problem.

The Senate wisely chose to adopt an amendment that eliminated the cuts in the Medicaid system. However, the House version included over $20 billion in cuts. That is $20 billion that will be shifted to local taxpayers to absorb. The entire issue of taxpayer equity is one that must be addressed. We cannot continue to shift federal responsibilities to states that are having budget burdens as well and then on to the local governments and the private sector.

I implore you to stop cutting this safety net program. It does what it is supposed to do. It is a mythology that is out of control since it is growing at half the rate of the private sector on a per patient basis. As a counter-cyclical support system Medicaid enrollment is working as it was designed to do. Reform the Medicaid system with thoughtful and meaningful changes. Reforming based solely on budget restraints is unconscionable. You must also tie this issue to the growing number of uninsured and commit to stopping that terrible trend. Otherwise, the safety net will crater under the weight.