Dear Friend of the UT System,
As the Texas Legislature’s 80th session approaches, I’d like to take this opportunity to highlight a few issues that are important to The University of Texas System and in particular its six health institutions. Each campus is confronting critical issues over the next biennium.
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Dr. Shine leads a discussion at the UT System Board of Regents' special called meeting and health institution retreat in December. |
Despite the lack of growth in the National Institutes of Health budget, the UT health campuses achieved a 9.9 percent increase in total research funding from 2005 to 2006, for a combined total of $1.2 billion. Our campuses continue to produce over 70 percent of the health professionals for Texas and to win highly competitive national awards and recognitions. The newly established UT System Academy of Health Science Education inducted its first 24 members, who were recognized by their peers across the System for their excellence as innovators in education. Their accomplishments are noteworthy and we are looking forward to greater successes by these distinguished scientists and educators.
Even with this encouraging news, the pressure on our health institutions to provide health care for those without health insurance continues to grow. Using the appropriations act method for reporting, our campuses nearly doubled the total amount of uncompensated care provided from 2000 to 2005, from approximately $765 million to $1.4 billion per year. Over the same period, the overall state support to our campuses for providing care to those without health insurance declined. As a result, two campuses — UT Health Center - Tyler and UT Medical Branch - Galveston — were required to make significant reductions in personnel and programs.
Texas has the highest rate of uninsured residents in the United States, 25.1 percent, compared with a national average of 15 percent. With the help of the Texas Department of Health and Human Services Commission, more funding appears to be on the way to help pay those who care for Medicaid patients. These funds, however, do not make up for losses associated with giving care to those who have no insurance.
"Maintaining Texas' competitive edge in health research and education requires substantial new resources."
And while enrollment at our campuses continues to grow, state support per student has steadily declined. For example, the average amount of state support for a medical student in 2002 was $55,971, compared with the current $52,221 per student, without any adjustment for inflation.
The upcoming session offers several opportunities to address these issues. In view of the growing shortage of physicians and nurses in the state, the UT System supports increasing enrollment at existing medical schools, significant increases in nursing faculty to allow a higher enrollment of qualified candidates for nursing schools, and a significant increase in the number and funding of medical residency positions. Medical residents, who work in hospitals and clinics upon completion of medical school, not only offer a relatively inexpensive way to recruit and retain physicians for the state, but, properly financed, they could significantly increase the amount of care provided to those individuals who have no health insurance. Medical residents could provide this care in hospitals and at community-based clinics. Health care can be cost effective when delivered by a multidisciplinary team, which includes well-trained nurses, nutritionists, physician assistants and other health professionals. For a detailed description of these proposals, see "Code Red: The Critical Condition of Health in Texas," a report to which the University of Texas System health institutions contributed.
As medical school class size and numbers of medical residents increase, the opportunity to recruit a more diverse student population will be greatly facilitated by efforts such as the Joint Admission Medical Program (see JAMP feature).
Maintaining Texas' competitive edge in health research and education requires substantial new resources. The UT System depends on an appropriation to fund the debt service on $846 million of tuition revenue bonds authorized in the recent special session. These funds have been supplemented by the Regents to provide for a $2.56 billion investment in the future of higher education. Over 60 percent of these funds would be spent in health institutions.
Another cost-effective approach to improving health is through programs of prevention, education and community action through public health. The University of Texas School of Public Health at Houston, which provides these services, has regional campuses in Dallas, San Antonio, Brownsville and El Paso, and soon will be in Austin. A modest investment in additional faculty and programs at these campuses has been requested to strengthen public health across the state, particularly programs to reduce childhood obesity; increase childhood and adult immunization rates; and more effectively identify and treat or prevent infectious diseases. Programs in health policy and patient safety and quality improvement at these campuses will have profound impacts across the state.
I look forward to the 80th legislative session with optimism and hope that the trajectory of the UT health institutions will be maintained and accelerated in a positive direction. The effect of leveraging state funds is enormous. For every $1 in general revenue appropriated, the UT health campuses generate almost $6 of additional revenues from grants, philanthropy, patient care and other sources. To that end, the public’s financial support is a great investment in improving the health of Texas.
Best regards,
Dr. Kenneth I. Shine
Executive Vice Chancellor for Health Affairs
The University of Texas System
