One Small Step for the Big Uninsured Problem for Small Businesses and taxpayers in Dallas Texas

Dallas, Texas has one of the highest rates of uninsured in the United States.  And the rate is highest among small businesses.  This post is not to comment on the reasons for this, which have been well-documented: affordability, the availability of an excellent public hospital for indigent care, a higher than average rate of non-citizen residents, etc.

Rather, this post is going to comment on one possible step that could be part of the solution.  The problem is so big that employers,  business leaders and politicians can't get their arms around it, and debate the many complex issues, so the problem worsens.  Perhaps implementing many little steps would better than waiting for one grand "solution" from Austin or Washington DC that could well make things worse.

Here's an example of a little step that helps.  All Dallas county taxpayers recently received a discount drug card in the mail along with their property tax statement.  The card is also distributed to residents at other locations around Dallas.  The discount drug card allows the holder to purchase prescriptions at a discount at over 40,000 pharmacies nationwide. 

The discount Rx card is not insurance, and it does not really cost the city anything to purchase and distribute to citizens.  If someone has insurance, the card won't save them any money.  But if the individual does not have insurance, the discount card will make medicines more affordable.  The card holder will therefore be more likely to buy and take the medicine and perhaps avoid a trip to the county hospital's emergency room.

This seems like a great program that is relatively easy to implement and that saves the city and its residents (and taxpayers) money.

Perhaps a similar aproach to health care would yield similar results.  Any business not offering health insurance to its employees in Dallas could be required to offer a very low cost discount card that would lower the cost of seeing a doctor or hospital.  The same card could be offered to individuals as well.  Those who do not possess the card would pay a higher rate.

Yes, there will be cheats, just as there are now, who will milk the public health care system without paying anything for it.  But if our  public hospital focused on its original mission of offering indigent care and another affordable option was available, there will be fewer cheaters overusing Parkland.

Parkland is an excellent teaching hospital, and a tremendous community resource that unfortunately is overused and out of capacity. In fact, a Dallas Morning News article quoted officials as indicating that replacement of the aging facility could cost taxpayers $1.2 billion.  My bet is it will cost much more by the time it is eventually built.

How does Dallas County save money with such a scheme?  One way would be to lessen the burden on Parkland, the county hospital that provides indigent care for Dallas County residents. 

Ove time, defining who is indigent and who is a resident of Dallas County has become more lenient.  Many Dallas small businesses that would be willing to pay something for their employees' health benefits have been unable to do so because they have not been able to meet the 75% employee participation required by insurance companies in order to qualify for a group health insurance plan.  Especially among businesses with low skill minimum wage  labor, getting employees to pay any portion of the cost of health insurance is difficult when these employees know they can get the health care they care for free at Parkland.

Perhaps a  mandatory discount healthcare program of some type would cause those businesses and individuals who can afford to pay something for their healthcare from using Parkland, and get this great public institution back in the business of offering health care solely  for the indigent, and not to those who choose not to buy insurance.  It might even help keep Parkland around awhile longer and delay spending $1.2 billion of taxpayer dollars.

Again, this is not a "solution," but perhaps one of many steps that can make health care more affordable to taxpayers and employers in Dallas, Texas.

For more information about affordable group health insurance and employee benefits in North Texas communities such as Dallas, Fort Worth, Plano, McKinney, and Arlington, subscribe to the newsletter at www. or contact Mike Chapman, (888) 398-6246 for a no-obligation consultation.