Officials at the University of Texas were in a celebratory mood last week with the final opening days of the Dell Medical School, and rightfully so.
It’s been a long road for UT — 135 years, to be exact.
The struggle to bring a medical school to Austin makes the implications of this week’s opening crystal clear for this community: A single policy decision can change the course of history.
In 1881, the Texas Legislature via a voter referendum decided to build an academic institution in the state’s capital and a medical school in Galveston. That choice had the unforeseen effect of helping stabilize the Galveston economy once its position as a commercial center was wiped out by the hurricane of 1900. Investors fled and port commerce moved to Houston, but the medical school remained.
In Austin, that same decision left the capital city without the health and economic benefits that accrue to a city conducting medical research and training its own doctors. In 2016, Central Texans still travel to Galveston for state-of-the-art treatments that cannot be obtained anywhere else in the state.
With the first 50 students finishing their first week on the Forty Acres at Dell Medical School, it remains to be seen whether the political decisions that reversed that 135 years of history will pay off for the state of Texas and the residents of Travis County who voted to help foot the bill for the medical school’s creation.
Austin’s aspirations for a comprehensive medical school have been in the works for decades. However, political will and economic realities never seemed to align — political interest would always wane when the economy would inevitably sputter.
But in the late 2000s, Sen. Kirk Watson began pushing, first for more medical residencies and then later a full-throttle partnership between the university, Seton Healthcare Family and Central Health. In 2011, Watson laid out a complex but workable plan that would replace the aging city-owned hospital with one more suitable for full-scale medical education, modernize the existing clinic system and ensure the university of a continual flow of money to support the care of Travis County residents and develop the program.
At the time he said: “We’ve got to resist the temptation to keep waiting, watching and wishing. We’ve got to throw out the past and reject the old excuses. We must not tell ourselves that somehow, sometime, some better deal will come along. It won’t. This is the moment. This is our chance.”
Rather than pursue full funding from the Legislature, Watson helped rally the call for a Travis County ballot initiative. If voters approved a tax increase, he argued, the region would add another economic driver and benefit from the research and clinical studies that stemmed from the work of the school’s students and faculty.
So, in fall 2012, Travis County voters did their part, approving the measure, which added 5 cents to every property owner’s tax rate. And so, now begins the wait to see if that calculated risk will pay off.
The stakes are high. UT officials say the new medical school will develop a brand-new health care system to replace the current model that includes high costs, unpredictable outcomes and vast racial and economic disparities. On the surface, the face of this inaugural class is promising. According to Dell Medical School officials, 22 percent of the class identifies as an underrepresented minority (African-American, Hispanic or Native American), beating the national average of 13 percent. At the same time, the average MCAT score was in the 88th percentile; nationally the average is 83 percent, according to the American Medical Association.
That Dell Medical School has come this far is in no small part due to community goodwill — goodwill toward the university, goodwill toward former Austin mayor and now senator Watson, goodwill toward the idea of a better medical future for rich and poor alike. Watson is absolutely correct that if this community had waited on the Legislature to fully fund the medical school, chances are high that Austin would still be waiting rather than welcoming its first class of future doctors.
But the gamble has come with critics as the city has continued to struggle with affordability and other governmental entities vie for property tax revenue to fund their own projects. Every group, whether it is Austin public schools, Austin Community College, Travis County or the city of Austin, has its own needs and a diminishing public appetite to pay for them with property taxes.
Talking about the need of investment is easier than waiting for it to pay off. It will be four years before this class will graduate and start its residential training, which hopefully will lead to medical practices in Austin or in underserved Texas communities. It takes years, sometimes decades, to measure outcomes and develop a track record for success that builds a reputation like that at UT Medical Branch.
UTMB started with 23 students. Today it has more than 3,700. Austin had to start somewhere. We agree with Travis County Judge Sarah Eckhardt, who said, “We’re going to have to be really vigilant and honest about this partnership to assure the economic benefit works hand in glove with the improvement of health outcomes all the way down the economic ladder.”
The 5 cents voters approved in 2012 is now actually 4.6 cents, according to Central Health officials. Last year, that amount raised $61.8 million, $35 million of which goes directly to the medical school. The rest is being used to leverage federal grants for health care programs in the county, according to Ted Burton, spokesman for Central Health.
It’s important for all the partners — UT, Central Health and Seton — to keep the community up to date on their progress, while Travis County residents wait for our investment to start paying off. It’s the only way to ensure there will continue to be goodwill for other important investments in the future.