The Perry Diet
Pork Picks for Perry
The budget crisis facing Texas is as close to a worst-case scenario as can be. At press time, the state’s politicians were still apportioning blame, but the time of reckoning–when they will be called on to do something–is drawing nigh. Gov. Perry has already shirked his responsibility by presenting an intact budget with nothing but zeros, apparently all programs are equal to him.
Since Perry doesn’t have the political courage or wherewithal to do his job, we’ve decided to show how easy it is to get the ball rolling by pointing out just a few boondoggles that should go the way of the blade. As far as we can tell, every program mentioned is still in Perry’s budget. Our list is just a beginning and comes courtesy of Eva deLuna Castro at the Center for Public Policy Priorities, who identified $139 million in fat with little effort–more than the state spends, of its own money, on child care. She cautions each item has a fierce constituency and eliminating all the fat available still won’t fix a budget deficit projected to be $10 billion or more. It’s also worth mentioning that this is not a new idea. The Texas Monthly’s own Paul Burka suggested a billion dollars in cuts in 1985 during the last fiscal crisis. Many of the turkeys he identified back then are still gobbling strong today.
Budget cutters could start with the state university system. There they will find an array of research programs that benefit private industry–a crass form of corporate welfare untenable when the choice is between that and health care for people. Take, for example, the Texas Food and Fibers Commission at Texas A&M, created to “increase the marketability, durability, and uses of cottonseed and cotton fiber and to set up cotton research facilities in Texas.” Can the state possibly survive without the commission’s wool and mohair laboratory or its dry-cleaning facility? Yes! The state would save more than $3 million for the biennium. Other likely candidates might include the Center for Applied Poultry Studies at Stephen F. Austin State University, the University of Houston’s Commercial Development of Space program, the Texas A&M Cyclotron Institute, UT Arlington’s Automation and Robotics Institute, and UT Dallas’ Nanotechnology program. That’s almost $7 million.
Dating from the time when Texas was dominated by rural politicians, the Department of Agriculture has been a good place for legislators to hide goodies for their districts. Is there any evidence that the $5.7 million we spend on cloud seeding does any good? How about the $17 million giveaway to “generate market opportunities for Ag products?” Looking toward the heavens, even the comptroller has suggested grounding the 36 state-owned airplanes that make up the Aircraft Pooling Board–savings: $1.426 million. Finally a personal favorite of ours that shows zero evidence of producing results: Abstinence Education funding ($3.2 million).
Shielding Dirty Docs
HB 2824 came to the House floor midway through the 1999 legislative session with little fanfare. The measure, a seemingly placid piece of bureaucratic housekeeping authored by former Rep. Patricia Gray (D-Galveston), tweaked minor sections of Texas Department of Health regulatory code. No one much noticed the floor amendment Gray tacked on, a rider straight from a Texas Hospital Association lobbyist’s briefcase. It closed all public access to malpractice complaints filed against hospitals, doctors, and mental health facilities. The amendment also shuttered access to records from health department investigations, essentially barring any patient from knowing a bad doc’s history. Complaints against doctors, and records from state investigations are not only not public, they’re also “not subject to disclosure, discovery, subpoena, or other means of legal compulsion for their release.” Gray later used the innocence by incompetence defense, claiming she had no idea what the measure would do. (Far be it for her to scrutinize an amendment from one of her biggest campaign contributors.)The truth about the bill surfaced a year later when hospitals began refusing patient requests to see medical complaints. The attorney general’s office determined that those records were now exempt from the Texas Open Records Act. Appalled, Gray tried to set things right in the 2001 session. She filed HB 2407, which would have reopened all medical complaint records. It died in Senate committee. Undeterred, she pegged a second mea culpa to SB 279, which passed both chambers. Gov. Perry vetoed the measure, claiming, paradoxically, that it would increase frivolous medical malpractice lawsuits. (Wouldn’t information that warns patients of which doctors to avoid decrease medical malpractice lawsuits?)
This session two-term Rep. Trey Martinez Fischer (D-San Antonio) has filed HB 419, which proposes again to make medical complaints and health department investigative records public documents. “It’s a no-brainer for us that Department of Health records should be open to the public,” said a Martinez Fischer aide. As Lisa McGiffert of Consumers Union points out, the law also eliminates any accountability for state regulators, since no one knows what complaints come to the agency.
But bills that progressives consider no-brainers are moribund in the Lege these days, especially those that would undo handouts to the hospital and insurance lobbies and provide potential malpractice evidence to attorneys. Earlier this month, the governor declared rising medical malpractice lawsuits an “emergency” issue for this session. Republicans are hellbent to save Texas from a supposed epidemic of frivolous lawsuits even as some data show malpractice suits on the decline. What’s missing is any attempt to stop incompetent doctors.
Killer Budget Cuts
Federal disease specialists have spurred a debate that could have far reaching consequences for Texas. More people must be treated to stop the spread of Hepatitis C, specialists say, including prison inmates. New non-binding guidelines released by the Centers for Disease Control and the National Institutes of Health present Texas legislators with a life or death decision: do they fund increases in prison healthcare to combat the virus or risk the further spread of Hepatitis C and let inmates die? The infection–if untreated–results first in cirrhosis, then liver failure and death. It’s easily transmitted, especially within incarcerated populations. Officials estimate that some 40,000 Texas inmates, a third of the state’s prison population, live with Hep C. Unsanitary tonsorial practices–not disinfecting razors or scissors after cutting hair–cause infection as do the traditional prison pastimes of tattooing and needle sharing.
Annual treatment costs vary, from $12,000 a year for milder cases, to double that amount for tests, procedures and drugs to treat stronger variants of the virus. Currently only a fraction of inmates receive treatment. To implement broader coverage, Texas will have to find more dollars to expand prison healthcare, at a time when legislators–already hostile to convicted criminals–are bent on slashing the budget.
Reflecting the tenor of the times, the Austin-based Young Conservatives of Texas is working to pass legislation that would prevent eligible inmates from receiving organ transplants before free-world recipients. Hepatitis C is the leading cause of liver transplants. By seeking to deny inmates organ transplants, the YCT has targeted the population most likely to need a replacement liver. The ACLU of Texas argues that because such legislation may result in death, it could be considered cruel and unusual punishment and thus unconstitutional.
Correctional health care administrators say publicly they want to combat the disease. The University of Texas Medical Branch handles 80 percent of the state’s prison health care needs. UTMB officials have alerted the governor’s office of the need for more funds. In response, two weeks ago Perry sent corrections committee policy advisor Katherine Arnold to a national conference in San Antonio on hepatitis care in prisons. The conference brought together corrections officials, medical experts, inmate advocates, and drug company reps to talk about the new national guidelines. But, according to participants, corrections officials, rather than confronting the problem, focused on how providing only minimal care (read less money) might help avoid costly lawsuits. According to one advocate for inmates at the conference, budget-cutting corrections officials are eager to find ways to sidestep the recommendations. Even though the Hep C epidemic in Texas prisons will fuel infections on the outside, in these penurious times, there’s little hope for funds to halt the disease’s spread on the inside. Reductions in in-mate healthcare began even before the recent request by the governor that agencies cut their budgets. In December, UTMB stopped routine vaccinations of inmates to prevent Hepatitis B, another deadly disease, for lack of funds.
Who’s In Charge?
House Civil Practices Chair Rep. Joe Nixon (R-Houston) knows who is rewriting the rules that govern your right to a day in court. Opening a panel discussion at a Texas Public Policy Foundation gathering, Nixon asked tort-reform lobbyist Dick Trabulsi: “Dick, would you kind of tell us what the omnibus bill looks like at this point?” Trabulsi explained to the chairman the contents of the most important bill his committee will take up this session. Nixon closed the panel with a question that even stunned the three tort reform lobbyists who shared the stage with him. “Are we ready to do away with joint and several liability all together?” Joint and several liability is a long-established legal practice that allows injured plaintiffs to sue and collect from more than one party responsible for an injury or loss.