in Houston, Texas
Law changing payment rules on heart disease tests adds to Texas health insurance mandates
Thursday, Nov 17, 2011, 03:23PM CST
By Mark Lisheron
human heart

The American people do not realize how lucky they are to have Texas Gov. Rick Perry to blame for everything.

No, Perry didn’t write “Itsy Bitsy Teenie Weenie Yellow Polka Dot Bikini.” That was Lee Pockriss, who died on Monday. But darned near everything else.

Take this Texas-sized health insurance mandate of Perry’s NPR just discovered. Well, they didn’t actually discover it, The Center For Public Integrity did. And it really isn’t Perry’s, but that’s what makes the story so interesting, at least in an election year.

NPR offers a shortened version of a scrupulously reported story by the investigative non-profit website. The thrust of the story is critical of an ardent small-government champion-in-charge while Texas has become one of the most burdensome states in the country for health care mandates.

Nestled in all the Blame Perry tissue paper is a finely wrought gift of explanatory journalism revealing how government grinds on while the press and the public barely notice.

You have to go back to the 2009 session of the Legislature. State Rep. Rene Oliveira, a Brownsville Democrat, reintroduced a bill he had filed in 2007 calling for insurance companies to pay for CT scans and ultrasound tests to help detect heart disease.

Oliveira had such a scan in 2006 that led to double bypass surgery. He said the scan saved his life. The Legislature passed Oliveira’s bill.

If his colleagues were impressed by Oliveira’s story the public wasn’t aware of it, at least not until after Perry signed the bill. Texas Watchdog did a search of Nexis, a paid service that archives stories from all of the major newspapers in Texas, under the key words “Rene Oliveira” and “heart.” The first mention of the bill is six weeks after the end of the session.

In an editorial on July 16 the Houston Chronicle called Oliveira’s a great story and a lousy law. Ten days later, the Fort Worth Star-Telegram reported the Legislature was calling for payments of up to $200 each for a test with no scientific support.

The U.S. Preventive Services Task Force, according to the Star-Telegram story, the “gold standard in unbiased health care recommendations,” opposed the regular screening. The American Heart Association declined to support Oliveira's bill.

The bill did, however, have the support of and contained language provided by the Society for Heart Attack Prevention and Education. This lobbying group of cardiologists, funded by the Association for Eradication of Heart Attack in Houston, had financial ties to medical device and pharmaceutical companies that would profit from the increase in scans.

What’s more, with increased screening and its use of radiation comes the increased risk of cancer, the Star-Telegram said.

The story concluded, “The new Texas law is a classic case of marketing and advocacy preceding science. Ideally, medicine should be based on evidence, not belief.”

This sound but brief thrashing convinced no one during the 2011 regular and special sessions of the Legislature to repeal the law.

The Center For Public Integrity recounts all of this in much greater detail and adds to it estimates by Amit Khera, a doctor and professor at Texas’ Southwestern Medical Center, that the bill exposes insurance companies to expenses of up to $120 million for the questionable scans.

And to think, were it not for his decision to run for president, the public might never have known Rick Perry was responsible for all of it.
Contact Mark Lisheron at 512-299-2318 or or on Twitter at @marktxwatchdog.

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Photo 'Human heart, bisected,' by flickr user Carolina Biological Supply Company, used via a Creative Commons license.
Thursday, 11/17/2011 - 03:49PM

It reminds me of the NYTimes magazine article from a couple of years ago when a study compared the medical charge discrepancy between the Mayo Clinic and South Texas. In TX, medical care is following the business model instead of a healthcare model.

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