Q: When is an insurance crisis not a crisis?
A: When the people without insurance are poor working stiffs.
That’s another lesson to be learned from the Farmers dust-up, which primarily concerned 700,000 middle-class homeowners threatened with having to find new residential property insurance. That’s a real problem — but how does it compare to the more than 1 million Texas children who still lack health insurance, not to mention their families? Yet as the Lege considers Medicaid and the Children’s Health Insurance Program, it will almost certainly have but one idea in mind — cutting either or both as much as possible. Since Texas is ranked 45th nationally in spending on public health, it begs the limbo question: “How low can we go?”
Beyond the budget, the first blow struck in the health care wars is Sen. Jane Nelson’s SB 12, likely the first in a series of assaults on citizen access to the courts, all in the name of “tort reform.” It would radically limit punitive damages as well as legal fees in health liability lawsuits, tilting the scales of justice heavily in favor of institutional health care providers.
But the health care fight remains primarily one of budgetary priorities, since it is a state political truism that Texas is a “low tax, low service” state. In fact, the former is only true of state taxes per capita, where we rank 49th of the 50 states. When state and local taxes are combined, we jump 10 places to No. 39. Comparing local taxes alone, we’re a lofty No. 14. And because of that lopsided state/local tax structure, the people with the least to spare are spending the largest percentage of their income in taxes: nearly 18% for the poorest people, and only 5% for the wealthiest.
So we’re still spending the money – just clumsily, ineffectively, and unfairly.
This article appears in December 13 • 2002.