TX health commissioner doesn't believe census on high number of uninsured

The virulent and nasty strain of Republican Reality Derangement Syndrome, most prevalent in Texas, shows no sign of easing. Reality Check on Kyle Janek:

The new executive commissioner of Texas' Health and Human Services Department—the social services behemoth that's currently in the process of building a whole new Texas Women's Health Program (WHP) so it can exclude Planned Parenthood from providing contraceptives and cancer screenings to low-income Texans—has some interesting views on the condition of public health care in his state. And by "interesting," I mean shocking. I mean shockingly ignorant. Astounding, even.

Dr. Kyle Janek is an anesthesiologist by training, but for the last 18 years has served as a Republican in the Texas Legislature and as a lobbyist for various medical organizations. Governor Rick Perry appointed him as executive commissioner of the Texas HHSC on September 1st. You might expect that in 18 years of being plugged into Texas politics and state health policy, he'd have a decent grasp on the issues facing Texans.

You'd be wrong. Because Kyle Janek doesn't believe—despite credible, widely accepted evidence to the contrary—that one of Texas' most pressing health problems, its high number of uninsured adults, is real. He doesn't believe that more than a quarter of Texans are uninsured, as estimated by the U.S. Census Bureau. He told a Texas Tribune reporter in early October that he believed that number to be "inflated," and then reiterated his point in an extended interview with Tribune editor Evan Smith on October 31st. (Through his press representatives, he refused an interview with RH Reality Check.) Here's his most recent take via the Tribune:

"It's not that I don't believe those numbers. I don't believe the reasoning for those numbers."

Janek used to represent me in the Texas Senate, and at that time was widely reputed to be one of the moderates. So something has obviously changed; either the accuracy of the political reporting or Janek's interpretations, uninfluenced by a desire for re-election. I don't really care which it happens to be, for the record.

Janek's problem: he said the Census Bureau only takes a "snapshot" by asking people if they're uninsured, and doesn't ask them if they had insurance in the past or if they think they have a job lined up with insurance in the future. Janek must not be aware that for nearly 25 years, the Census Bureau's "snapshot" has shown practically the same thing: since 1987, Texas repeatedly has one of the highest, or the very highest, number of uninsured adults in the country. That rate has not been below 1987's 23 percent; it peaked at 26.8 percent in 2009 and is currently estimated at 26.2 percent.

That's a remarkably consistent snapshot of something that Janek seems to believe changes for millions of people by the day. Janek says he isn't sure why Texas "is different" when it comes to health care, but he told the Tribune it could be because the weather here is nice.

"Do we have so many people that are temporarily uninsured? Or is it the general climate of better weather and glorious place to live? Folks come here, and that attracts more folks with health care needs or disabilities?" he wondered during the interview. Surely our high uninsured numbers couldn't be due to the fact that Texas jobs generally don't provide health insurance, that Medicaid in the state is limited, that insurance rates are unregulated or that Texas has a large immigrant population, as the Washington Post reported last year. No, it's probably just the purty weather.

This is just embarrassing. For Janek, for Rick Perry (who appointed him), and for all of the rest of us in Texas.

So there's a lot of different ways we could go with this news.

One would be that even when you think Rick Perry has appointed someone of some repute to a statewide  post, it's bound to turn out to be another epic fail. Keep in mind that just in the past few months, the governor appointed Michael Williams to head the Texas Education Commission and his own chief of staff to the state Supreme Court, clearing a path for yet another toady. (There's a reason why a person is willing to take a pay cut from $312,000 a year to $175,000, and it isn't about the money.) And now the health commissioner, just by opening his yap, looks like the worst of this lot.

Another path -- well-worn -- would take us down Lamentation Alley, where we moan again about the curious conservative belief system and how it is destroying everything that used to be great about Texas. I'll pass on another serving of that.

Let's just consider what this entrenched patronage system is providing us, all the way down the line. The advance, to understand the next excerpt -- that you should read in the first link at the top -- is that Janek believes the solution to the problem (that he doesn't think actually exists) is to fund more medical schools in Texas.

Why does Janek think that Texas legislators, county commissioners and other politicos are suddenly ready to funnel millions, probably billions, of dollars into medical schools? 

Perhaps because he's hired a conservative think-tanker to help make that happen. Her name is Mary Katherine Stout, and for $150,000 per year, the former Perry staffer, Wal-Mart defender and far-right Texas Public Policy Foundation economics "expert" will act as a "special advisor," "involved in a number of policy and planning issues," according to HHSC spokesperson Stephanie Goodman. Goodman told RH Reality Check that Stout will be "looking at ways [Texas HHSC] can work with medical schools to support their efforts to make sure Texas has enough health professionals."

In the past, Stout has particularly focused her efforts on criticizing Medicaid and especially CHIP, the popular children's Medicaid program, which she has said is rife with luxury car-driving freeloaders and should be closed to people who are verily rolling in cash and furs, like "those making as much as $40,000 annually for a family of four." Stout's coldness is unusual even for Texas right-wingers, and her cruel preoccupation with making sure as few Texas children as possible receive needed aid borders on the bizarre. To that end, this was her 2007 proposal for fighting "The Left" in the National Review:

Perhaps we should fight their strategy with our own campaign to tell stories of success, of people working hard and making good decisions for their family, of people who made something out of nothing, or who turned something into more. Yes, send me your stories of success, of personal responsibility, and of government’s depredations on a family trying to make ends meet.

These are the words of a "special advisor" on Texas public health care policy, who'll be whispering in the ear of a man who believes the state has "inflated" uninsured numbers because hey, poor people can always go walk in and get some open heart surgery at a public hospital or amorphous medical school of dubious funding origin.

This is one of those times when I wish Texas really was a whole 'nother country, for entirely different reasons than the secession petition-signers.