Texas' health-care system bleeds county coffers and sends some to early graves

Texas Observer featured article 9/4/09
Sick + Tired
How Texas' health-care system bleeds county coffers and sends some to early graves.

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On a Wednesday morning in mid-August, Walkes hunches over his desk in the downtown Beaumont clinic. He has a few minutes before changing into a tie and pinstriped suit to attend yet another meeting about how to contain the county’s spiraling health care costs. He spends a lot of time in a suit and tie these days. After the meeting, he’ll don the white coat again and head to Port Arthur. He’ll spend much of his afternoon working the phones, struggling to find physicians and hospitals willing to treat the serious illnesses that await him there.

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“I know of more than a half-dozen people who have died in the past two years because they had cancer or another serious illness and I couldn’t find anyone to treat them,” he says. “I have a diagnosis, but no one will treat them.”

He doesn’t like to talk about the patients who’ve died. “Please don’t make me go there,” he says, massaging his forehead and looking pained as the memories come back anyway. One in particular.

In October 2007, a 27-year-old man showed up at the Port Arthur clinic. The young man—because of federal health privacy laws, we’ll call him Sam—had been urinating blood. Sam was diagnosed with a kidney tumor at the local Christus St. Mary’s Hospital ER. Normally, Sam’s kidney would have been removed, and he likely would have survived. Because he didn’t have health insurance, Christus St. Mary’s referred him to UTMB. From there, his case became a classic illustration of how uninsured patients with serious and costly illnesses are bounced from ER to ER—triaged, as required by federal law, then sent on their way with life-threatening conditions.