In an interview with the Texas Tribune, Lt. Gov. David Dewhurst talks about the state budget, Medicaid reimbursement rates, and other topics. An excerpt:
In 2003, when I came in as lieutenant governor, I saw that Medicaid was costing the state of Texas almost 25 percent of the budget and that health care costs for the vast majority of Texans were increasing each year. Then, in June 2004, at a Harris County Medical Association dinner, a group that probably represents 25 percent of our doctors in the state, I heard them echo my concern of ever-increasing health care costs. In 2006, I worked with my staff during the interim to come up with the best thinking on how we could improve health care for state employees and teachers, as well as the 8 percent to 11 percent of the population on Medicaid at that time. Our intent was to come up with savings through greater efficiency, by working with our hospitals and our doctors to create some monies which we could use to cover the uninsured, and lower the cost to our hospitals for indigent care. Our legislation, which had a number of incentives to try and propose healthier lifestyles, passed in 2007. Shortly after that, I became convinced that health care, because of its overwhelming importance to every individual, had to be improved, lest we face a national crisis.
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We spend more per capita on health care than any other country in the world — and 2.5 times more than the average. We spend something like 170 percent more per capita for health care in America than the country that spends the second most. Yet our outcomes are not significantly better. We’re doing it all wrong. We’re the only country I know of out of the 31 developed countries in the world that pays doctors and hospitals principally for how many procedures they do to you. The other developed countries pay for good medical outcomes. How much more valuable is it to keep someone well by paying doctors more to sit and talk to you to convince you to change your behavior? This is potentially one of the most important things I’ve ever done — to try to push us in Texas to try and reward our good doctors and hospitals with free market incentives that focus on outcomes.
