The very essence of the definition of the word challenge can currently be observed manifesting itself within the U.S. health care system.  The Chinese have a saying, “May you live in interesting times,” and the degree of interesting for those of us in health care administration is multiplying exponentially as we see more and more uninsured citizens and illegal aliens bombarding our already over taxed network of public hospitals and care centers.

In a recent article in USA Today, the degree of overcrowding in the Texas system was spotlighted, and, even though it is only about 8% worse there than it is on average in the rest of the country, that percentage represents a very challenging number of people without options..  Nearly one in three people are now uninsured in Houston.   The article by Richard Wolf, went on to quote other challenges created by the laws of Texas, i.e., no subsidized health insurance program for childless adults, the highest percentage of uninsured children in the country and a surging population are all mentioned. The result is a crushing push on the State’s emergency rooms.  Nearly twice the increase in visits is occurring in Texas than is being experienced by the rest of the United States.

Even when a State does cover children, if it ranks near the bottom in Medicaid reimbursement, like Pennsylvania does, it’s not much help.  When your hospital provides compete coverage for less than half or sometimes a third of the hospital’s costs of treatment,  those losses can’t be reversed by adding more volume.

So, as the challenge continues, we in health care administration are busy re-arranging the deck chairs while our federal officials continue to mark time and avoid creation of a definitive health policy for our nation, the third rail of politics.  Finally, the uninsured wait hour after hour, day after day  and sometimes months to be seen and treated.

These people are our people, and they need to be treated as human beings, not as cost centers.  As we continue to squander one third of our medical budget on the last thirty days of life, as we pamper our elderly and deprive our youth, as we cheat our future, the system begins to look more and more like that in Texas  . . . where one leader interviewed for the article described their decision not to participate in the Federal CHIPS program for children’s health coverage as prudent.  Let’s look up the definition for prudent because the real definition might be challenged.