When Conservatism Stinks

I hate labels. But I know we can’t escape using them. I’m conservative for the most part, but then I’m not a Republican (although I’ve always voted so while pinching my nose) and certainly don’t buy in to the Tea Party mindset of “just say no often and loud and ignore reality.” And add Patriot to the description so the positions can look iron-clad and justified. Fact is, I don’t like any extremes.

But I am a human. And a Citizen. And neighbor. And a Religious Person.

I support a few charities like Hope Women’s Center in McKinney. But I don’t go to their dinners any more – the banquets where some of Collin County’s finest conservatives stand up and plea for help for a good cause in the region. There are many good causes. And there are several agencies that help. I heard the number of charities in McKinney alone reaches way past several dozen, way more than I would have guessed. And of course, Collin County churches are always there to help. Help to feed and clothe and counsel.

But not to treat for health needs, especially critical health issues.

If Collin County leaders were as caring as they sound when asking for money and help at banquets, we would have our own hospital for indigent care. Oh, calm down. I can hear the Political Conservatives shouting and levitating off their cushy seats at the horrible thought of imposing on a taxpayer to help someone less fortunate.

The cry is first and foremost how poor people are that way because they are lazy. And some are, I’m sure. But what about those who are genuinely in need? And just exactly who makes that call? Would County Judge Self and Commissioner Chris Hill volunteer to stand at the door of Parkland Hospital when a Collin County indigent is rushed in by ambulance or simply taken there by choice so they could hold up their thumbs up/thumbs down sign? Easy enough to sit at the Dais while the real boots on the ground look a person of need in the eyes.

I was the first County Budget Officer in Texas when hired by Dallas County in 1977 after enabling legislation was passed to allow the Commissioners’ Court to prepare a budget instead of the County Auditor appointed by District Judges. The Commissioners’ Court did not prepare the budget for Parkland Hospital, but they had to approve it. Therefore, I had my first introduction into the issues surrounding a public hospital in the late 1970s. There were many.

Of course, one of them had to do with the high costs of a hospital. Extremely high costs. And then the linkage to the cost-drivers, number of people served. And the inability to pay. Whoa! And then the lopsided issue of people being served who came from outside of Dallas County! Although entrants were screened for the ability to pay, and even more pressure was put on Parkland to tighten the standards, it was an imperfect system. And I’m sure it is still so. But it was not an open-door policy by any means.

The ability (and yes, even the willingness) to pay issue has not gone away forty years later. It has only grown in size. So, I have a question to ask of every Collin County citizen/taxpayer. If the situation was reversed with Collin County treating Dallas County’s indigent people, what would you do? And if another county’s response was “tough luck, sucker, the problem is there because you Collin County weaklings just don’t know how to say NO, how to slam the door in the face of the needy,” what would be your reaction?”

For the last 11 years, I have lived in Collin County. For almost six decades before that, I lived in Dallas County with a few years in Denton County. My view is the same: Take care of your own; pay your fair share; do the right thing! DO THE RIGHT THING!!!

But that’s not the response from the Ultra-Conservative, Tea-Party driven Collin County leadership manifested in two men and their backers. And that’s wrong on so many levels that I want to puke.

I was set to blog about the topic this morning after a news story came out a few days ago. Then this columnist below penned his views that included my thoughts and even some of the exact phrases I was going to use. I will take advantage of his writings to complete my comments on this topic.

Meanwhile, I look forward to the day when the Conservative Extremists of Collin County find a balance and do what is right.

Oh, did I just hear you say, “move if you don’t like it.” No way. I’m here for the duration, dude. You move. Actually, just drop your intoxicating mantra, do a group hug, step up to the plate and be responsible citizens. You are the weaklings whose days are numbered. One can be conservative and still say Yes to a need.


How dare Dallas County’s neighbors bite the hands that treat them at Parkland

Dallas Morning News
Written by
James Ragland, Columnist

It’s bad enough that Dallas County’s public hospital has become a lifeboat for so many uninsured people across North Texas.

We don’t need our richer neighbors up north in Collin County mocking or maligning us for doing the right thing — especially when we’re required to do so by law.

We need them to chip in.

Here’s the long and short of it: Without Parkland Memorial Hospital’s excellent trauma and emergency-room care, we’d have a bunch of people — especially those without insurance — suffering longer or dying sooner.

That’s not a polite thing to say, but it’s true.

Thanks to the Emergency Medical Treatment and Labor Act — a 31-year-old unfunded mandate from Uncle Sam — Parkland can’t turn away anyone coming through its emergency department even if they’re without insurance or the means to pay.

With 600,000 uninsured people in Dallas County alone, you can see how big of a potential burden that is on our hospital and our taxpayers.

But guess what? It doesn’t stop there.

We’re picking up the tab for out-of-county patients, too, as my colleague Naomi Martin recently reported.

Uninsured and indigent patients from across North Texas are benefiting from Parkland’s mandated largess — to the tune of $27.4 million last year alone.

This has been going on for decades.

And you know which out-of-county patients benefit the most from Parkland’s expert care and generosity? That would be Collin, the seventh most populous county in the state and one of the wealthiest based on per capita income.

Still, patients streaming in from Collin County last year cost the hospital $6 million. If you’re hoping we’ll get any of that money back, don’t hold your breath.

That’s a huge and bitter pill for Dallas County taxpayers to swallow. The one-sided deal strongly suggests that Collin and other counties aren’t able — or willing — to take care of their own.

Except — hold on — that is not the way Collin County Judge Keith Self spins it. Instead, he blames Parkland’s “liberal policies” for catching nearly 6,000 Collin County residents in its health care safety net last year.

“These are not indigent citizens,” Self said. “These are people who don’t pay their bill, they’re uninsured.”

In other words, the judge is saying his county is home to a bunch of deadbeats. Perhaps Dallas should figure out a way to slip that into its corporate recruiting brochures.

Anyway, in a tone reminiscent of the partisan bickering coming out of Austin and Washington — and we see where that’s gotten us — Self shamelessly throws salt on the wound by blaming Parkland’s CEO, Dr. Fred Cerise, for the hospital’s dilemma.

“If he’s got very liberal policies — I’m not going to comment on Parkland hospital policies that give more generous health care,” he said.

This is what happens when you’re a blue county in a red state: No do-good deed goes unpunished.

Parkland Hospital slashes 300 jobs amid budget cuts

What the Republican judge fails to acknowledge, however, is that this is far more complicated an issue than Parkland being too generous with taxpayers’ hard-earned money.

About half of Collin County’s 110,921 uninsured residents are eligible for indigent care. And it’s true, as Self mentions, that Collin isn’t the stingiest of counties in Texas when it comes to taking care of the indigent.

But the county simply doesn’t have a big enough safety net. And its health providers still can turn away people who don’t qualify for the network of services it offers.

That’s why so many out-of-county patients end up in emergency rooms — mostly Parkland, which happens to boast some of the best trauma care in the nation.

To be fair, not everyone in Collin County shares the judge’s harsh, if not downright ungrateful, judgment.

Some, like Rick Crocker, head of a homeless shelter in McKinney, understands the critical role that Parkland plays in saving lives. And he agrees that that Parkland “can’t bear the entire burden of this” alone.

It’s a “shared responsibility,” he said.

It sure is. And what we need is a regional partnership coupled with a cost-sharing strategy that takes into account the special role that Parkland plays in North Texas.

More pointedly, we need our suburban neighbors to step up to the plate. And, for once, they need to leave partisan politics out of the mix.

Last I checked, Parkland’s ER doctors don’t ask any of its patients whether they’re “liberal” or “conservative” before treating them.

They simply want to know where it hurts.

For Dallas County taxpayers, we know the answer: That would be the pocketbook, followed closely by the condescending rebukes from suburban politicians who should know better.

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