Texas Republicans have been complaining loudly since the Supreme Court decided that the Affordable Care Act passed constitutional muster. The law is a huge overreach by the federal government, it's a "stomach-punch" to the economy, Obama is a socialist, etc. etc. There's even quite serious talk about refusing a Medicaid expansion that would cover an additional 1.5 million poor people, thus foregoing billions of dollars in federal assistance.
The expansion would seem a no-brainer, but that's not what this is about. Texas' fight against Obamacare is about freedom: Freedom from federal interference, the freedom of citizens to do as they please, the freedom to make hyperbolic pronouncements about U.S. policy. Most of all, however, this is about the freedom to have a terrible health care system.
But Texas' health care system isn't just terrible. As we learned yesterday from an annual state-by-state assessment of health care services and delivery by the federal Agency For Health Care Research and Quality, it's the most terrible. That's not an easy distinction to claim. As you can see from this list, we just barely edged out such paragons of effectiveness as West Virginia and Arkansas.
The agency compiled the rankings based on state's scores in 12 categories. Overall, Texas got 31.61 out of a possible 100 points. It did fairly well in maternal and child health measures but preventative care? Not so much. Diabetes treatment? Bad and getting worse. Heart disease? Terrible. Home health? Unbelievably terrible.
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The rankings don't delve much into how Texas' health care system got to be so terrible, so feel free to guess. Throngs of people uninsured? A statewide fetish with limited government? Parkland? Whatever the reason, the bottom line remains the same.
Speaking to the Associated Press, Texas Health and Human Services Commission spokeswoman Stephanie Goodman spun the news as best she could. Sure, the score was very bad and underscores the need to improve, but the state is already taking steps in the right direction.
"Late last year Texas received approval for a new effort that will help fund innovative local projects," she told the AP. "Hospitals and other health care providers have come together to form regional partnerships, and they'll soon be sending the state their plans for making better use of Medicaid funds to expand access to preventive services and reduce the need for expensive emergency room care."
So maybe next year we'll have rocketed past West Virginia, then Arkansas the next year. Then again, maybe we should stay at the bottom, just to make a point. You can take your socialized medicine and shove it, Mr. Obama. We'll get by just fine without it. And remember: Don't mess with Texas.