Latest Columns

Setting the record straight on drug discounts

At a time when drugmakers are charging record prices for their products and jacking up prices on cancer drugs and other lifesaving treatments, 340B is one of the only consumer protection laws on the books. That’s why, in Texas, 141 hospitals participate in 340B and their patients benefit every day.

The "other" wall Texas is building — around teen moms

It’s high time we equip adolescent girls — particularly vulnerable and parenting youth — with the right to make decisions over their own bodies, just as they can for their own children. Adolescents can access contraceptive services without parental consent in 32 states, and an additional 14 states grant these rights to parenting teens, but not to all adolescents.

Congress: Continue CHIP and save Texas children

More than 450,000 children in Texas will lose their health care in early 2018 if Congress fails to reauthorize the Children's Health Insurance Program. These are the children whose working parents are making too much money for Medicaid and too little to afford exorbitant private health insurance premiums.

Congress should work together to regain healthcare momentum

The debate in Congress over whether to repeal and replace the Affordable Care Act (ACA) has been put aside, at least for now. It is time for our federal legislators to shift their focus to other pressing health care topics, providing the opportunity for progress and to work together across the aisle.

Religion, Jane Doe, and your boss

Religion, while often a powerful force for good in this world, has also been used as an excuse to suppress those who don’t agree with a particular set of beliefs. Those who stay silent as the government strips away the rights of our neighbors under the guise of religion — no matter if we agree with the ultimate policy or not — are on the wrong side of that history.

Horizontal integration of health care

The more large players that enter and change the health care space, the more they bring about new competition and help reduce inefficiencies. I never thought I would be advocating for a top-down approach to help patients, but here we are.

Losing a patriot, and carrying on

So that’s what we’ll do now. We’ll honor Cathy with action — just the way she’d want us to. We will carry on and continue to fight weak gun laws with all the trademark passion and persistence we’ve exhibited in the past. But right now, let’s stop for a moment — and honor a Texas patriot.

The government v. Jane Doe

These stories illuminate a larger effort by government entities, whether federal or state, to legitimize crisis pregnancy centers, or CPCs — which function primarily to dissuade people from accessing abortion care — and tout them as actual health care providers.

Learning to embrace marijuana as medicine

A crucial component of helping my patients is guiding them toward realistic expectations so that we not only avoid disappointment but also prepare for the best possible outcome. When it comes to the healing potential of cannabis, I have been focused on figuring out what cannabis can do for people suffering from epilepsy rather than what it might be able to do.

Jane Doe vs. Donald Trump: A young woman fights for her rights

Jane Doe is an unaccompanied minor, which means she came to the U.S. before turning 18 and without her parents. She is currently being detained, as is often the case with unaccompanied immigrant youth, in a government-funded shelter she is not permitted to leave. And federal officials, emboldened and empowered by the Trump administration, are doing everything in their power—legal or not—to stop her from getting an abortion.

Life without Planned Parenthood

In several areas — one in five of the counties served by Planned Parenthood — the organization is the only available option for some women, according to the Congressional Budget Office analysis. In these places, moving new health care providers there would cost time and money — but more importantly, it would be detrimental to their health and the health of the community.

We must help Hurricane Harvey’s other victims

The social media frenzy following Hurricane Harvey helped thousands of people reach needed aid. Just as we have helped our neighbors rebuild their homes, we must help rebuild the lives that are too often forgotten in Houston’s sex trafficking industry.

Texas HHSC needs to stay focused on its vision

The vision statement for HHSC reads, “Making a difference in the lives of the people we serve.” As staff and leadership at the agency have been chosen for this time and place, focusing their talents on bringing that vision to life can bring miraculous change to tens of thousands in need.

Let’s talk: Texas’ deaf community wants to dialogue

The deaf community is not just a group of people with a shared trait and similar life experiences. It is a culture in and of itself, one that is too often ignored and widely misunderstood, which is why deaf standups are probably not on your radar — or why you may have ideas about the deaf community that simply aren’t true.

Texas voters can protect reproductive health care

To be a woman in Texas is to have your autonomy, your health and your well-being constantly under attack by the so-called leaders entrusted with serving you. Extreme politicians love to proclaim a concern for women when they are promoting more bills to restrict access to abortion, while bypassing opportunities to truly serve their best interests.

Meeting halfway: Abstinence, plus marital education

Many conservatives are against comprehensive sex education, noting the skyrocketing rates of teen pregnancies in the early 60’s and believing that teaching contraceptive use gives teens mixed messages. Liberals, on the other hand, urge that education is the key to reducing teen pregnancy and disease. Surely there is ground where both sides can meet for respectful dialog.

Texas lawmakers did a good job protecting kids

It was no small task: the Texas child welfare system is incredibly complex, meshing public and private resources into a safety net that events of the past few years have shown to be riddled with dangerous holes. The 85th Texas Legislature leveraged a key resource in closing these gaps by further investing in children’s advocacy centers.

Why bathroom bills emerge

I've listened with particular interest to media reports regarding the “bathroom bill.” I must admit that, even as a social and political conservative, I think the specific bill may be ineffective. However, the issue of transgenderism, and even homosexuality, and bathrooms is much more complex than I typically hear reported by any media outlet.

SNAP is a food program — not a jobs program

SNAP was designed as an income support, not a jobs program. That’s reasonable when one considers that most SNAP participants are children, seniors or people with disabilities; and that the majority of SNAP recipients who can work already do — just not at jobs that let them escape poverty.

Patch the state budget for fragile kids

Unfortunately it takes a controversy like restoring cuts to the state’s acute therapy program to bring to light the negative effects of rapid growth in government healthcare programs and our failure to reform them. These factors are hurting Texas’ ability to care for the most vulnerable in our state.

Trump transgender tweet ignores medical findings

If gender dysphoria, however, generates other medical problems like depression, then these should be insured in the same way that the sex-related problems of cisgender people are treated. In other words, medical care should be dispensed to transgender people in the same way that it is dispensed to non-transgender people.

The lies behind Texas anti-abortion laws and “bathroom bills”

The truth is simple: Politicians trying to restrict LGBT rights and abortion access tell lies to push their agenda. Then they turn those lies into laws that actively hurt our communities. That’s exactly what Texas lawmakers are trying to do in this special session, where they plan to pursue both a “bathroom bill” and more measures restricting abortion access.

Unintended pregnancies in Texas are not at crisis level

Texas has seen some important abortion policy changes in recent years. The Texas Legislature voted to remove Planned Parenthood from the state family planning program in 2011. Additionally, after new abortion clinic regulations were signed into law in 2013, a significant number of abortion facilities in Texas closed.

Texans deserve better than the Better Care Reconciliation Act

The revised BCRA is basically the same harmful bill with financial incentives for states like Alaska. Simply capping the amount the Feds pay into Medicaid doesn’t solve the problem — it just dumps costs on the states and on county taxpayers. And the amendment proposed by Sen. Ted Cruz of Texas is an awkward mixture of proposals that either can’t work or don’t help.

Texans deserve better than Obamacare

Health care is a deeply personal issue, and the passion reflected by that is evident on all sides of the debate. But one thing is clear: doing nothing to stop Obamacare from continuing to hurt millions of families in Texas and around the country is simply not an option.

Healthcare continues to be small business priority

In yearly surveys, members of the National Federation of Independent Business say their number one priority is healthcare, but the Affordable Care Act, better known as Obamacare, has made things more difficult for them. Its onerous taxes and mandates have increased costs and reduced choices.

Federal healthcare legislation needs more work — from both parties

Over the last several months, our national health system leaders have talked with members of Congress and their staffs to communicate these three principles and to encourage them to craft legislation that achieves them. Unfortunately, the discussion draft of the Better Care Reconciliation Act of 2017 (BCRA) released by Senate leaders last week falls short.

A mother writes: Dear Speaker Straus

I haven’t really spent much time tracking legislation before; I guess I’ve never really had to. But I started paying attention to what y’all were doing down in Austin the year that I finally accepted that my child was transgender. And what I found, Speaker Straus, is that there was an awful lot happening under that pink dome that could quite possibly kill him.

The questions we aren't prepared for are the ones that matter most for kids

We know kids ask questions. Sometimes as adults we feel inadequate to answer those questions or uncomfortable to explore them. So we shut the questions down. We tell kids their questions are inappropriate, rude or shouldn’t be asked. The questions never go away — they just go unasked. Children with unanswered questions eventually become adults with the wrong answers.

The deadly consequences of Texas’ HB 3859

As a gay child in the foster care system, I spent my childhood in facilities like that. My Child Protective Services caseworker told me at one point that I could either “keep being gay or straighten up” if I wanted to be placed with a foster family.

The ACA provides economic freedom: An open letter to Sens. John Cornyn and Ted Cruz

When the Affordable Care Act passed, I felt enormous relief. My experience with the ACA hasn’t been perfect: I’ve had to change plans twice and the costs have risen each year. However, even though my income has been too high to receive tax credits towards premiums, the ACA has felt life-changing in that it has given me true economic freedom. I can pursue my best career path while still being assured of coverage for any health issue that may arise.

Don't increase the hassle factor of Medicaid medicines

Physicians and patients need a transparent process for determining which drugs are covered by the state’s Medicaid Vendor Drug program and ultimately, who is making the decision as to what is best for the patient. The health care community treating patients and the patients affected should be able to provide feedback on why certain medications should be accessible.

A bill to aid deaf children needs to be “heard” in the Legislature

As we reach the end of a legislative session surrounded by hundreds of bills that died on the vine, there is one that stands out as worthwhile and urgent: Senate Bill 354, the Language Equality and Acquisition for Deaf Kids bill (known as “LEAD-K”). This bill would ensure that deaf children arrive at kindergarten with language milestones commensurate to their hearing peers.

With step therapy, patients don’t get the best treatment

The decision for what medication to use and when to use it is based on the patient’s medical condition, his or her history and myriad other factors that are based on a deep knowledge of the drugs, condition and patient preferences and goals. Only the physician and the patient know what choice will be best for that patient. Not the insurance company.

You’re too young to be a grandma

Parents are uniquely positioned to help kids understand the choices they make during their formative years and the consequences they carry. Specifically, you have the opportunity to help your teenaged kids avoid becoming pregnant (or getting someone pregnant).

Let us help kids in foster care

Only one of every four foster care providers in Texas is a faith-based organization. Providing conscience protection for families will enable pastors to encourage loving families to be part of a caring network for these children and to stop worrying that potential lawsuits will take limited resources away from the people we should be helping.

Better temporary care for foster children in Texas

Keeping children in their existing communities will bolster security and reduce the stress of being taken from their home. By becoming temporary caregivers, community members could test the waters before becoming foster parents and simultaneously expand the pool that Child Protective Services can use for placements.

Nurses are not physicians

Advanced practice registered nurses (APRNs) perform a vital, important function in our health care delivery system. However, they are not physicians, any more than I am a nurse. Texas is correct to keep its team-based care approach. It ensures patients receive care from each member of the patient care team, based on his or her knowledge, training and expertise.

Finally, a health care model that drives down costs. Don’t break it.

Everyone knows the costs of the American health care system are epically high. But health centers keep costs down, saving the system $24 billion per year by keeping people out of costly emergency rooms for things like an earache or cold. But a rash of policy decisions coming out of Washington this year won't retain or improve health centers' delivery model. 

A proven way for Texas lawmakers to improve primary health care access

Despite growing evidence and a body of research showing favorable patient outcomes and excellent quality of care in states where advanced practice registered nurses have full practice authority, Texas still prevents them from doing what they can do and what patients desperately need. As a result, Texans who could be treated by an APRN have no care at all.

An opportunity to do more for Texans with intellectual disabilities

Some truly outstanding people work in the living centers. They make herculean efforts to improve the quality of life for residents. However, they’re fighting against a rip tide that can drown the most determined caregiver. Direct care is one of the most difficult jobs: turnover is outrageously high, and as a state we provide few incentives to keep doing it—let alone to do it well.

The struggles of negotiating with health insurers in Texas

Insurance carriers driving out high-quality providers with unfair practices does not serve consumers or their communities. It limits access to timely emergency care. Don’t be fooled by the false narrative that freestanding ERs avoid contracting with health plans for financial benefit. Insurance companies should improve their networks and offer fair payment to the freestanding ER industry.

The problem of children having children

Three years ago, I visited a children’s shelter and learned about a 14-year-old mother with two children. The child-mom and her babies were in the Texas foster care system. Legally, Texas was the parent of all three: all three vulnerable children at risk for more abuse, poverty, and a lifetime on welfare.

A better place to build a wall

For President Trump, improving the security of Americans lies in bolstering a defense system that is “stretched far too thin.” This affirms a Republican ethos on safety and security and yet we know, from years of work in economically distressed communities, that these cuts target the very security systems — social, educational, emotional and health — that children rely upon to survive and thrive.

Invest in better food — and build a better economy

A food retail incentive fund would provide financial assistance to businesses looking to expand healthy retail into "food deserts" while also attracting additional private and philanthropic dollars to further bolster development. This novel approach would unleash the power of the free market and create businesses and jobs.

To help address foster care tragedies, better understand and listen to youth

Working collaboratively with youth and valuing their perspectives is a key part of the solution to the state's foster care problem. Young people are telling us something when they run from care, and it is time to start listening. They often know what works best for them and research suggests that allowing youth to participate in decisions about their lives may help them heal.

Answering the call for Texas’ children

The Texas Legislature, on average, has consistently funded only 80 percent of what it costs to provide for children in foster care. On average, community foster care and partner providers who provide specialized services for acutely traumatized children lose money every day they care for a child.

The case for banning powdered alcohol in Texas

It’s such a bad idea that more than 30 states have already banned powdered alcohol completely – even Louisiana! Texas should follow their lead by passing a ban instead of creating regulations that could help establish a market for powdered alcohol in our state.

Texans suffer under continued attacks on women’s health funding

Years of hostile policies have already left tens of thousands of Texas women without access to cancer screenings, birth control, HIV tests and other preventive care. It’s time for politicians to get serious about helping Texans access quality, affordable health care and allow Planned Parenthood health centers to fully participate in Texas’ health safety net.

What insurance companies aren’t telling you about FEC charges

Yes, ER visits are expensive. Consumers are paying to have highly trained staff and millions of dollars’ worth of equipment and pharmaceuticals on hand to save their life. And that is why consumers need to start listening to ER doctors when they say that an injury or illness does not require emergency care.

Saving children from the system meant to protect them

CPS intervention separates over 30,000 children from their parents each year. Seizing children should be the last resort. State custody presents risks to children that dirty homes, disconnected utilities, and differences of opinion on what constitutes good parenting simply do not justify.

Changing the conversation around abortion

As Texas-based abortion funds that work directly with people most impacted by abortion restrictions (the majority of whom are low-income women of color who are already parenting), we know that the fight for reproductive rights and justice is about more than the right to choose an abortion — it's about real access and affordability when that right is already established.

Texas and Medicaid: How big can you dream?

If Texas controlled its own Medicaid program and received a no-strings federal block grant, we could change everything: radical administrative simplification, eligibility standards, verification processes, insurance packages, “work requirements” and reimbursement schedules.

Legislative action for young parents in foster care?

These mothers were struggling parents in the beginning — but their stories also reveal messages of resilient and accomplished parenting. We need to understand more about the struggles and successes of parents who have experienced foster care, to identify these youth and offer them the care they need and deserve.

Doctors dislike surprise medical billing, too

In practice, doctors generally charge higher rates and insurers generally pay lower rates; when they can’t agree, the patient gets a surprise bill. Since we live in a free society, it is reasonable to support both the physician and insurance company positions, but it seems unfair to place the patient financially in the middle of this difference of opinion between businesses.

Will ‘Pro-Life’ Bills Actually Save Lives?

Texans have again sent to the Legislature a pro-life majority, which includes some who merely profess that view for re-election efforts. Regardless, voters across the state expect those campaign promises to be upheld, protecting innocent unborn human life and safeguarding pregnant women.

Texas has a smoking problem

Texas should prohibit all forms of tobacco use on the grounds and campuses of all state agencies, including state institutions of higher education, and we should do everything possible to prevent kids from starting to smoke.

Texas' new frontier for HIV/AIDS

As we commemorate World AIDS Day on Dec. 1, our hope is health care providers, the public and policymakers in Texas realize the virus is still invading neighborhoods at astonishing rates, often so silently that increasing numbers of youth don't realize they are living with HIV.

A better way to fix health care

The Affordable Care Act, a sweeping law full of crushing regulations and burdensome mandates, has accomplished exactly the opposite of what President Obama naively promised while shattering the confidence of millions Americans in the process.

Medicaid expansion? No way!

Overinflated promises being made for expansion of Texas' Medicaid program remind us of two time-proven adages: "If it looks too good to be true, it probably is," and "There ain't no such thing as a free lunch."

What LifeWorks can say about the UT slaying suspect

I have been asked repeatedly over the past few days "what I can say" about LifeWorks' involvement with Meechiael Criner, the suspect in the death of UT-Austin student Haruka Weiser. If he is found guilty of this terrible crime, we will be left to debate whom is to be held responsible for his fate — himself alone, school bullies, foster care, parents? I hold no hope for an easy answer.

Abortion funds and activists are mobilizing for marginalized Texans

As a leader at an abortion fund in Texas, I see firsthand the consequences of restrictive anti-abortion laws — consequences that too often fall on people of color, non-english speakers, undocumented immigrants, LGBTQ people and those who are struggling financially.

Texas doesn't need Planned Parenthood

The recent decision made by officials at the Texas Health and Human Services Commission to terminate Medicaid contracts with Planned Parenthood marks a step toward higher health and safety standards for women and children.

Access delayed is access denied

Texas politicians will go great lengths to make a necessary, legal, and constitutionally protected medical procedure nearly impossible to access in our state, with the greatest harms falling on young people, immigrant women, low-income families and those living in rural areas.

Lamar Smith’s lesson in congressional hypocrisy

U.S. Rep. Lamar Smith’s record reveals a public servant staunchly on the side of protecting Americans’ privacy — unless you’re a victim of asbestos-related disease. In that case, he believes you should be required to make public large chunks of your sensitive personal information on the internet.

Space, the final health care frontier

Some Texans live in places so remote, they might as well be outer space. That's why many of the medical innovations that we’re developing for astronauts have the potential to improve the practice of medicine on Earth.

Why aren't we talking about health care?

It was supposed to be the No. 1 election issue this year, but it quickly faded. With Ebola now dominating headlines, it’s time for a rational debate over what we should’ve been talking about all along: health coverage.

How Texas kicked its big drug problem

A decade after an overmedication crisis in Texas’ foster care system was brought to light, the state has dramatically reduced psychotropic drug use among foster children. And understanding how Texas did it could be key to solving future policy problems.

Strike down Texas' new abortion rules

Politicians painted House Bill 2 as an effort to make abortion safer. The reality Texas women face today has exposed those claims for what they are: deceptive tactics that will ban abortion for most Texans and make women's health care less safe.