July 03--This story was first posted at 7:21 p.m. Sunday, July 1, 2012. It was updated July 2.

Improving access to health care for thousands of uninsured Rio Grande Valley residents will require expanding public and private insurance coverage or developing a low-cost treatment option such as a university-based public hospital.

Almost half of Hidalgo County residents lack health insurance, prohibiting the timely access to care that detects illnesses early to reduce treatment costs and save lives. While President Barack Obama's healthcare overhaul would extend coverage for many South Texans through Medicaid, the joint federal and state healthcare program for the poor, it remains unclear whether Texas will choose to expand its program or leave federal dollars on the table.

But the Valley's healthcare system is also challenged by its lack of a publicly funded safety net hospital, pushing sick, uninsured patients into the emergency rooms of the private hospitals. Hidalgo County health director Eddie Olivarez said the Valley's fast-growing young population will intensify the future need for a public hospital, an option in each of the state's metropolitan areas.

"The benefit would be from the cost issue where we could have a partnership from the university and medical school that could provide services to the indigent or the people who are uninsured," Olivarez said following a policy discussion last week sponsored by the Texas Comprehensive Cancer Control Program. "A university-based hospital would be something of great benefit to South Texas."

Community stakeholders met last week to discuss the Valley's cancer dilemma: With so many uninsured in South Texas, what's the best way to provide care before the disease becomes life-threatening? There are more local treatment options than ever thanks to the Valley's burgeoning healthcare system -- reducing the need for anyone to travel north for care -- but financial barriers remain in place for most residents, creating a concern as the prevalence of cancer here increases.

From 2004 to 2008, according to the Texas Cancer Registry, the total number of cases diagnosed in the Valley increased by 18 percent, three times higher than the state as a whole. The Valley's cancer-related deaths increased by 4.2 percent over the four-year period, compared with a 5.2 percent jump for the state.

Cancer dilemmas are common in the Valley, where uninsured patients may be diagnosed at community clinics but have nowhere to turn for chemotherapy or other advanced care, said Grace Lawson, the executive director of El Milagro Clinic, a McAllen-based healthcare center that provides primary care services for the uninsured. Most commonly, patients choose to travel to public hospital systems at points north if they can qualify for services there.

"There are very few places to send a patient in a nonprofit setting in the Valley," said Lawson, whose clinic received a grant last year to provide free cervical and breast cancer screenings for low-income patients. "Our patient navigator has to figure out where we're going to send the patient if she doesn't have the money for a biopsy or chemotherapy."

Ann Cass, a healthcare advocate for a network of nonprofits that works with low-income Valley residents, said the solution to those barriers requires providing more people access to insurance or alternative treatment options.

A Medicaid expansion set to begin in 2014 under Obama's healthcare law will provide coverage to 2 million people across the state. While the expansion's cost will be covered by the federal government for the first three years, the Texas Health and Human Services Commission estimated the expansion will cost the state about $27 billion over a decade.

A public hospital could also prove costly. Although its financing would be covered Valleywide and offset by a university-affiliated medical school, the development of a public hospital system would need voter approval for a taxing base.

But Cass said Valley residents are already paying a cost indirectly.

"Right now, people don't have choices," she said. "They wait until they are very ill and then (go) to the emergency room, where by law they have to be seen. In the end, we all pay for it."

The Associated Press contributed to this report.

___

(c)2012 The Monitor (McAllen, Texas)

Visit The Monitor (McAllen, Texas) at www.themonitor.com

Distributed by MCT Information Services