Lloyd Van Winkle, MD
 TAFP President

Reflecting on the surprising news from Austin of the last few days brought to mind a recent trip to a grocery store. While picking up a few things for my wife, I found myself following a mother who had bravely embarked on a shopping expedition with her children in tow. She had with her an infant son and an 8-year-old little boy. The 8-year-old “helped” in the pushing of her grocery cart, while the infant was doing the terrible-two thing in the cart seat. They were moving through the produce section of the store, when, in response to a change of circumstance, the mom issued a call to action that was a familiar refrain in my childhood home.

As they passed a display of oranges carefully stacked into a perfect pyramid by some obsessive compulsive produce manager, the youngest child, while sitting in the seat of the shopping cart, reached over and pulled an orange out from the base of the display. In an instant, the mother’s calm demeanor turned to panic as the mountain of oranges shifted and tilted, then, began to cascade off the side of the counter, one after another. They plopped onto the tile floor and rolled about.

The startled mother, a clear veteran of many such disasters, reacted swiftly and decisively. She knelt at the side of the display quickly using her chin, chest, and out-stretched arms to restrain the eminent collapse of the monument to citrus perfection. Her 8-year-old son stood there without moving frozen in place surveying the scene of delayed but eminent disaster. Motionless, wide-eyed, and mouth agape, he appeared to be trying to look as innocent as possible, while wondering how long his mother could forestall what looked like an inevitable event. Then, this mom spoke with a voice of urgency and desperation that memorable command which echoed back to my childhood. Turning her gaze to the 8-year-old, she barked out these words, “Don’t just stand there. Do something!”

Well, the legislative session is over; we’ve been doing something. This session, literally thousands of bills and amendments were written, proposed, introduced and debated. Days and nights of hearings have passed. Opposing points of views have been considered. Testimony has been given by doctors and concerned citizens before committees of senators and representatives. Conference committees have resolved differences.      

The legislative session is over. The questions about which bills would get out of committee and make it to a vote are answered. Which bills would pass or fail is known. Many Texans from all walks of life have gone the extra mile to make our voices heard in an effort to improve the health and well being of the citizens of this great state. Austin is quieter now. Becoming, once again, the laid-back town it should be. In the halls of the Capitol, what you hear now is talk about redistricting and what will be the outcome on that issue.

The political process has done its job once again and scores of Texans have taken part in that process in many ways. They made thousands of phone calls. They have read their e-mails and feeling moved by an issue, have taken the time to contact their legislator and make their voices heard. While they were possibly only becoming a mark on a tally sheet, they understood that those voices and tally marks add up. Those individual voices when speaking in unison become the music that politicians can mysteriously hear over the deafening din of the legislative machine. Everyone (doctors, nurses, patients) who phoned and made their positions known became a positive part of the legislative process. All of those who heard a call for help and responded with a call of their own deserve thanks. When they were needed, they didn’t just stand there. They did something.

Some watched the process and, instead of a phone call, they responded in writing. The written word is powerful, and while it takes more time than a call, it often makes a significant impact on the legislator that receives it. A written comment from a constituent is hard to beat when trying to get a politician’s attention. Not all of the letters written went to legislators; some went to newspapers as letters to the editor. Whether the letters were written to an audience of one or of thousands, they helped to clarify the debate and shape the outcome of the process. Those who wrote letters deserve a thank you. When they were needed they didn’t just stand there. They did something.

When the bills came up for discussion at committee hearings, some of us came to Austin to testify. We came to explain in person how the issues in question would affect the health of Texans. Innumerable doctors cared enough to leave their practice for one or several days. They paid a price to come. They accepted the loss of revenue and in some cases the expense required to hire coverage so they could give testimony. They did this because they felt their patients, their fellow Texans and the issues in question were worth the sacrifice that going to Austin to testify requires. Those who came to represent us in hearings deserve our thanks. When they were needed, they didn’t just stand there. They did something.

Many came to TAFP committee meetings and contributed to the legislative affairs process within our organization. They generously gave of their time at interim and annual sessions or in conference calls and e-mail discussions. This process is critical to our policy development. They helped promote the cause of quality patient care and generate materials that helped shape the debate in this legislative session. They also deserve our thanks. They didn’t just stand there. They did something.

The TAFP staff worked long days, many nights and weekends to organize the efforts of our doctors. They kept us informed and they clarified the issues at hand as well as identified where our input would be most effective. They also coordinated the academy’s efforts with those of the TMA and other organizations. They followed all the bills, in many cases helped draft them and nurse them and us along as the session progressed. The staff, in general, Tom Banning and Greg Herzog specifically, deserve recognition for a job well done because, clearly, they didn’t just stand there. They did something.

All of these untiring efforts resulted in a great legislative year. The Texas House and Senate, the representatives of all Texans, speaking through their votes passed meaningful and landmark health care bills. The result was one of the most productive and successful legislative sessions that Texas medicine has seen in recent memory. Those legislators who took our calls, read our letters, heard our voices, and then voted, acted in a fair and even-handed-fashion. On some points, compromise was necessary, but most of our positions were well reasoned and reasonable. Because the bills were needed and well prepared, the votes on them were bipartisan and resulted in overwhelming majorities. They were votes for a better system of health care for all Texans. Our legislators deserve our appreciation and they need to be remembered by all of us on Election Day. When the time came to act for Texas, they didn’t just stand there. They did something.

The efforts of all involved resulted in the overwhelming passage of more than a dozen healthcare related bills. Included in the group were the Prompt Pay Bill and the Medicaid Reform Bill. Many Texas physicians worked for passage of these bills and are familiar with them. I, too, had the opportunity to follow these two bills more closely than some others. My familiarity with them included watching the give and take that took place to resolve the House and Senate versions into a final bill. The House and Senate easily passed the finished products. I felt these bills were important to a healthy medical system for Texas.

Unfortunately, when it came time to breathe life into this legislation, all of the efforts to bring a better health care environment to Texas did not become reality. The bills that everyone worked so hard for, were not signed into life, but were instead condemned to die under the force of veto.

The governor’s last-minute veto of these bills was unexpected. Because there had been no expression of concern from the governor during the bill’s development process, when changes could have been made, we were already looking forward to the positive changes these bills would have made. The use of the veto was baffling, crushing the hopes of all those who put so much blood, sweat and tears into preparing them. These were not bills that barely passed or were only supported by one party. These bills were thoughtfully crafted and thoroughly debated. The governor said no to the carefully considered will of the elected officials of this great state. When it was time to do something, the governor just stood there.

I hope when election time rolls around, we reflect on the events of this legislative session. I hope we all will remember, and tell our patients who acted to support the efforts to improve health care in Texas, and remember who did not. Then, don’t just stand there. Do something.