No Insurance, No Service at UTMB Galveston

For nearly a century, the University of Texas Medical Branch at Galveston was proof that the Texas health care system had a heart. UTMB, a state-subsidized nonprofit teaching hospital, treated uninsured, chronically ill Texans who had nowhere else to go.

Those halcyon days are over. In 2011, UTMB denied 91 percent of uninsured Texans seeking medical care, according to a new report from a nonprofit coalition advocating for Galveston County’s uninsured residents. That’s a sharp increase; in 2005, UTMB turned away just 35 percent of uninsured people seeking care.

Dr. Merle Lenihan, a coordinator with the Galveston County Free Care Monitoring Project, which co-authored the study, says UTMB acts these days more like a corporate for-profit hospital, except that “for-profit hospitals pay taxes.”

UTMB is not a corporate, for-profit hospital. It’s a tax-exempt public hospital that received $204.2 million in taxpayer funds and $8.4 million from the state indigent care fund last year. Yet UTMB spent just 3.3 percent of its revenue in 2010 on charity care, according to the new report co-authored by Dr. Lenihan’s group and Gulf Coast Interfaith, a nonprofit affiliation of faith-based and community organizations. Other public hospitals in Texas on average spent about 14 percent of revenues on charity care, while for-profits spend about 2 percent annually.

UTMB has treated fewer and fewer of Galveston’s uninsured residents since Hurricane Ike ravaged the town in 2008. Now, many ER patients are shunted to Mainland Medical Center in Texas City, a 30-minute drive from the island.

Part of the problem is a stalemate between Galveston’s county commissioners and UTMB officials over the county’s indigent health program. Neither can agree on a contract to cover the uninsured. In 2009, commissioners imposed a tax that locals refer to as the “UTMB tax” to pay for uninsured patients. The tax raised $11 million; $8 million has yet to be spent.

A spokesman for UTMB told a Houston Chronicle reporter that Galveston County officials had asked UTMB to turn Galveston residents away. The county’s health district spokesman said they’d done no such thing.

Meanwhile, uninsured patients are desperate to find any hospital that will take them, says Dr. Lenihan. “It’s a very haphazard system that’s in place,” she said. “The result is a lot of unnecessary suffering.”