Governors across the country, including Texas' own Rick Perry, are preparing their State of the State speeches. In fact, the recently reelected governor of California and the newly elected governor of New York have already delivered theirs. And each of them took the opportunity to announce that affordable health care will be top priorities for their administration in 2007, including comprehensive children's health care initiatives and efforts to reduce the number of uninsured adults in their states.

What will we hear in Texas about these issues? After all, more of our residents are uninsured than anywhere else in the country and health care costs threaten to overwhelm middle-class families, small business owners, hospitals, physicians -- and our future economic growth.

The need to fix our health care crisis transcends partisan politics. Gov. Spitzer is a liberal Democrat and Gov. Schwarzenegger -- like Gov. Perry -- is a conservative Republican.

Nor is it a matter of geography. California, Texas, and New York rank first, second, and fourth in the number of uninsured working-age adults. They also rank first, second, and fifth in the number of uninsured children. If anything, the problem is more pervasive here because the percentage of Texans without insurance coverage -- 31 percent of working-age adults and 20 percent of children -- places us far ahead of every other state in the nation.

It isn't because health care providers haven't raised the issue, either. In careful reports, a coalition of the state's medical schools, the Texas Medical Association, and others have offered dire predictions if Texas fails to act now to stop the vicious cycle of uninsurance.

But where health professionals may have fallen short is in not partnering with the single most powerful force in Texas politics: the business community. By failing to make the business case for dealing with the uninsured, the issue was AWOL from the 2006 elections and is still a non-issue today, as lawmakers gather for the legislative session and Gov. Perry prepares for his third term.

Gov. Schwarzenegger calls his own state's high number of uninsured residents "a hidden tax on every person in this state" and "a terrible drain on our economy." Gov. Spitzer says that "expanding access to health care will reduce state spending significantly in the long run."

Here's the situation in Texas:

• One in every four Texans -- 5.6 million people -- is uninsured. In Houston, one of every three people has no access to basic health services.
• Taxpayers, Texans with insurance, and employers who offer health benefits pay extra for caring for the uninsured, adding $1,551 to the average Texas family's private health insurance premium.
• Some 79 percent of uninsured Texans either work themselves or live with a family member who does. These employed but uninsured Texans work mainly in small firms, which are the largest generators of new jobs.
• Uninsured patients are more likely to forego or delay treatment for acute illnesses or injuries, or to go without needed treatment for chronic conditions or illnesses. For employers, that means their sick workers will get sicker and be off the job longer.
• Many uninsured patients are forced to get their health care in already overcrowded emergency rooms at three times the cost of a physicians office and often at taxpayer expense.

And here are a few steps for Gov. Perry and our state leaders to consider:

• Expand the "three share" pilot project in Galveston County, where employers, employees, and Children's Health Insurance Program (CHIP) are picking up equal shares of health insurance premiums for workers in small businesses that can't otherwise afford to provide health care benefits.
• Encourage doctor participation in Medicaid by raising reimbursement rates.
• Bring home the dollars we deserve from Washington, D.C., where hundreds of millions in available federal funds are waiting for us if we will simply take advantage of the generous federal matching funds for Medicaid and CHIP by enrolling all eligible Texans in those proven programs.
• Ease the burden on local taxpayers by aggressively pursuing available federal reimbursements for school-based Medicaid services.
• Invest in proven nursing programs at state colleges and universities to address the record nursing shortage.
• Pilot test other innovations that would help uninsured working Texans buy into various state-run insurance programs.

We don't need to copy the California or New York models. This is Texas, after all. We have unique challenges and -- of course -- that huge share of our population without health insurance. What we need is a Texas plan. And we need our state leaders to champion it.

Without a comprehensive initiative to solve the health care crisis, Texas will not be able to sustain a healthy economy or build a future of progress and prosperity. Other states are moving forward with bold initiatives to reduce their uninsured. If Texas wants to remain an attractive place to do business, we should, too.

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