TMC PULSE

t m c » p u l s e | n o v e m b e r 2 0 1 6 10 LOIS M . R A MON DET TA , M . D. Professor in the Department of Gynecologic Oncology and Reproductive Medicine at The University of Texas MD Anderson Cancer Center; Chief of the Division of Gynecologic Oncology at Lyndon B. Johnson General Hospital, Harris Health System "I believe in universal health care. I believe that health care is a human right. I don't believe people should have so much trouble getting it. People come to the table with different levels of health literacy and navigation ability. It's a shame that some people have such a hard time getting basic health care. I am still seeing a ridiculous number of cervical cancer patients in the county with advanced disease. It still blows my mind. I call it the 'what the @#$%' cancer because, what happened in our society to end up like this? Did we really fall so far behind in education in elementary school and middle school on how to take care of yourself and forget to men- tion how to take care of your reproduc- tive organs? There are a lot of places to get pap smears in the city, but somehow people don't know that they even need them or don't make time for them. I have a woman, young, in her 30s, with stage four cervical cancer. To see these patients not only have their quality of life destroyed, but their whole life in general destroyed by something that was preventable by I believe in universal health care. I believe that health care is a human right. I don't believe peo- ple should have so much trouble getting it. People come to the table with different levels of health literacy and navigation ability. It's a shame that some people have such a hard time getting basic health care. — LOIS M. RAMONDETTA, M.D. getting a vaccine that's safe and effec- tive, is so frustrating. How is it that we have so many dif- ficulties with educating young people about protecting their reproductive organs and their lives? We have such low vaccination rates and such low pap smear rates and death and quality of life affected for no good reason. I think we could get up to 80 percent vaccination rates for boys and girls. It's not going to be an immediate fix. It's going to take 10, 20 years, but at least then we will have less death and destruction from HPV-related cancers. The two biggest problems in my world are obesity, which is the main cause of endometrial cancer, and HPV, which is the main cause of cervical can- cer. That means we start in elementary school with better foods and education about how to take care of yourself throughout school. That is key. I feel like we have an opportunity to lead the nation in how to solve prob- lems if we could fix one big problem and that is the academic competition between Baylor, MD Anderson, UT and Harris Health. We have this massive population of under-insured patients that are seen in one big Harris Health System, but managed completely by different academic groups." PEGGY SM I T H , PH . D. Director of the Teen Health Clinic and Professor of Obstetrics and Gynecology at Baylor College of Medicine "I really keep my eye on Austin as opposed to the national stage, because those are the laws that impact me and the work that I do. As a state that has no personal income tax, we are very depen- dent on two things: property tax to pay the way for certain issues—including health care and education—and the sales tax that generates the revenue for a lot of the programs in the state. If you look at the state budget, there are two important things to remember: first of all, constitutionally and unlike the federal government, we must balance our budget and that can be very easy or it can be very hard, depending on our cash flow. If you look at our budget as a pie, anywhere from 70-80 percent of our revenues are either constitutionally or federally locked in. So we have very lit- tle wiggle room in terms of health care. This year, our revenues from sales tax are down by about a billion dollars. When you factor that in, because of the balanced budget requirement, all programs are going to be affected. We have to see how that will play out. Texas has opted not to expand Medicaid; that dog will not hunt again in this next election. Maybe the legisla- tors can come up with a way to repack- age that sort of approach in a way that is palatable to a conservative House and Senate. It puts more of a burden on places like Ben Taub and some of the other hospitals and programs that serve individuals who require uncompen- sated care." — Staff Report

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