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UTMB — A Critically
Important
Institution |
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The University of Texas Medical Branch is at a crossroads after years of cutting costs and services. It faces a fight for proper funding in the Legislature, and it is seeking a new president at the same time it seeks to sort out its priorities for the future. These critical choices will affect health care for all in Galveston County, especially the poor. In a two-part column, Dr. Bernard Milstein writes on access to health care in Galveston. The University of Texas Medical Branch is important to Galveston, both as an economic engine and as virtually the sole provider of its health care. As it is so critically significant to our community, it is inevitable that the community is concerned when it perceives that there are problems at the institution. And it is readily apparent that there are problems at the institution. From the perspective of health-care professionals, both those outside the institution and the many dedicated nurses and physicians on its staff, it appears UTMB has lost its focus, its raison d’ętre. |
Known
throughout the state
as the hospital of
last resort for
patients with and
without health-care
insurance, the
relatively recent
decision to turn
away indigent
patients has created
confusion among
patients, employees
and physicians
alike. This confusion has led to an understandable reduction in the number of patients, patient referrals and income, creating a critical problem. UTMB has a long and rich history as the oldest medical school west of the Mississippi. UTMB was first a hospital, then it was a medical school and then a research center. But, always, the lifeblood of the institution, and its strength, was the care it extended to the citizens of Texas who recognized it as a haven for health care. Recently, there has been a change in direction because of a reduction in funding for indigent patients. Instead of welcoming all patients with open arms, UTMB has begun to selectively turn some of them away. They are telling physicians around the state not to send patients unless the patients have insurance. And physicians around the state are simply not referring patients. They are confused. UTMB is a public institution. Its budget is funded and underwritten by the citizens of the state of Texas. Part of the funding comes from the University of Texas System and some of it from the Texas Legislature. Other sources of funding come in the form of donations from foundations and some from patient services. Additionally, UTMB pays no taxes and operates with the legal protection of a state institution. |
The
underlying reason
for all of this
public support had
been that UTMB
provided indigent
health care. And
yet, today UTMB is
turning away
individuals with no
other source for
their medical care.
In the case of
Galvestonians, many
of these patients
have no means to
leave the island to
obtain health care. It is therefore entirely appropriate for elected officials, state Rep. Craig Eiland and state Sen. Kyle Janek, to question how this state institution is operating. These men were elected to disburse taxes and fund state institutions. Oversight is critical to this process, particularly when such a drastic change in the direction of an institution occurs as is unfolding at UTMB. The question is whether patients are being turned away because the state is not providing enough funds or whether those funds are not being applied properly. UTMB obviously needs state support to continue to provide indigent care, but it also needs to get back to the basics of providing that care. It needs to be proud of, and comfortable with, being the health-care option of last resort for the citizens of Texas. If it is not, it could find that someone else has taken over that position. Pt 2: Suggestions for a solution Dr. Bernard Milstein is an ophthalmologist in private practice in addition to being a member of the Galveston County United Board of Health.
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