In the past few days, we have seen the terrible side of health care in the state of Texas. The tragedy of Thomas Eric Duncan, the Ebola victim who received perfunctory and inadequate attention when he first went to Texas Health Presbyterian Hospital Dallas, is only the tragedy of poor Texans writ large.
The tragedy started when the Texas governor and legislators, like those in several other ultra-conservative states, were proud to reject "Obamacare." The state did not do anything to help citizens enroll in the program. The efforts of the federal government to fill the gap were conscientiously not advertised or supported by the state -- although some information did leak out. The signup center in central Austin, near my home, had very long waiting lines, which definitely lengthened as the deadline approached.
In the quest to defeat "Obamacare," the Texas governor, Rick Perry, did not accept any federal funds to subsidize coverage of the very poorest citizens of our state. This means that the pool of the uninsured poor has not substantially diminished, and remains a major financial drain in hospital emergency rooms. Hospitals have continued to treat the uninsured as they did before -- minimal care, with the objective of moving the patient out of the hospital as soon as possible. It's routine. They have to maintain the bottom line. Many hospitals in Texas are struggling to keep their doors open. Federal funding would help them, but of course the leaders of our state have rejected this.
When Thomas Eric Duncan showed up at Texas Health Presbyterian Hospital Dallas, the fact that he was uninsured trumped the fact that he had travelled from a place where Ebola was a known danger. The fact that he was uninsured trumped the fact that he was showing the symptoms of Ebola. The fact that he was uninsured probably trumped all the other information in his medical file.
Probably, to the person who made the decision not to admit Thomas Eric Duncan to the hospital on his first visit, the insurance status of the patient was the only thing that mattered. Probably that person never even considered that Thomas Eric Duncan's treatment (or non-treatment) by the hospital on that occasion might become a national embarrassment.
Now everyone knows the name of Texas Health Presbyterian Hospital Dallas. Now everyone is asking why that decision was made. But at the time it was just business as usual, the same decision that is made every day if you show up at a Texas hospital without insurance.
Because, hey, this is Texas.