Thread by @c0nc0rdance

Texas has 254 counties.
185 of them have no psychiatrist (unserved pop 3M)
158 have no general surgeon (1.9M)
147 have no OB/GYN (1.8M)
80 have <5 physicians
35 have 0 physicians

Texas ranks 41st in physicians/100,000 residents,
#1 in % uninsured residents.

Part of the problem is the nature of the state: 85% of the state's residents live in the sprawling metroplexes, the 15% live across the vast spaces of rural farming communities too small to support specialists.

Emergencies mean long drives when seconds count.

The other obvious issue is that Texas doesn't provide state run insurance programs for those living at or near the poverty line.

As this 2016 map shows, the impact is that poor Texans, many of them in rural areas, are largely uninsured.

There's also a regional and racial component to Texas residents lack of medical care. Border states have uninsured rates as high as 39%.

What do you think happens when an uninsured resident goes into renal failure? They have no ability to pay, but can't ethically be refused.

All of this is a prelude:
When COVID came to Texas, it started in our high traffic, medically rich metroplexes. Now it's starting in the border counties in earnest.

These counties lack insurance, infrastructure, and they serve communities that are hundreds of miles away.

The infrastucture in Texas is a creaky windmill missing a few support beams & a strong wind is coming.

The death toll in El Paso & Brownsville & Eagle Pass are going to be predictably terrifying in the months ahead. I can see it coming, but there's nothing I can do about it.

Expect a lot more of this to come.
texastribune.org/2020/11/15/cor…