By Merrie Spaeth, KERA 90.1 commentator
Dallas, TX – Parkland is treating thousands of patients from North Texas but funded by Dallas taxpayers. This is not fair to Dallas but so far, no one is running for election in Denton or Collin County on a slogan of "We have to pay our share of indigent healthcare costs."
This is one of those policy issues where everyone agrees, and the solution is obvious to everyone but where any politician who tried to be a leader would get bounced out of office. Sort of like what's going on in Austin with school finance.
Here's a funding strategy; that's the easy part. A political strategy and a sales strategy.
The funding strategy is apparent. We're moving toward a regional transportation authority and solution. Same deal in healthcare. Separate, negotiated funding mechanism, probably a percentage transaction fee or membership fee. Do not let the "T" word come out of your mouth.
Now the political strategy. This will take guts. I can only explain it by analogy. When I went to work for Judge Webster at the FBI in 1980, they had lost over 700 jobs in the fingerprint identification department. Turnaround time to identify fingerprints had gone from three days in 1970 to 33 days in 1980, largely because municipalities and states kept adding requirements for fingerprint checks for various jobs. We used what's called the "Washington Monument" strategy. That is, no one wanted to appropriate the repairs for the Washington Monument, until the Park Department closed it to the public. They withstood the howls from the public and Congress, and they used the attention focused on them to make their case. If you haven't noticed, the scaffolding has just come down and the monument's repairs are now complete.
We used the Washington Monument strategy. We shut down the fingerprint I.D. service. We told all the local agencies sending in requests for fingerprint checks that the FBI was overwhelmed by the increase in requests accompanied by the decrease in funding and that we were out of the fingerprint business. Judge Webster had a stomach of steel, and we got our people and our funds to begin the computerization project, which is also now complete. 95 million fingerprint records converted from paper to computer. I know the legal situations are different, but the prospect of a shuttered Parkland should sober the elected officials from all counties.
The final piece: the sales piece. Americans are compassionate but want to see that recipients of taxpayer services are doing their part. This has to be a two-way contract. Those who come to regional healthcare facilities have to have a long-term commitment to wellness - inoculating their children, and developing healthy eating and exercise habits. Lord knows, there's no mystery in how to be healthier, if not perfectly healthy. The evidence is crystal clear. Even small steps - walking each day, incorporating some fruits into a diet, no smoking - make significant improvements in health.
And like any contract, individuals would read it, and talk about it, and sign it. Again, there's a great deal of evidence which shows that when people formally agree to something, many, if not most of them, will live up to it or try to.
My bet is that politicians will be less timid supporting the funding mechanism when they can point to actions recipients agree to.
To save Parkland, we need to regionalize it. We need to dramatize the situation - as opposed to analyze it - and we need to make taxpayers feel that they're not just funding yet another welfare program.
Merrie Spaeth is a communications consultant in Dallas. If you have opinions or rebuttals about this commentary, call (214) 740-9338 or email us.