Legislative Affairs - January 2010
Tex Med. 2010;106(1):49-53.
By Ken Ortolon
Fort Worth orthopedic surgeon Joe Todd, MD, says that physicians seem to have a natural aversion to politics.
"I think there's an attitude that politics is dirty, and doctors don't want to be involved in it," said Dr. Todd, who chairs the Candidate Evaluation Committee of the Texas Medical Association Political Action Committee (TEXPAC). "Physicians would rather be left alone and not make the practice of medicine political," he said.
But TEXPAC leaders say staying out of politics truly is not an option for physicians because of how the political and legislative processes impact medicine.
"Politics governs almost everything we do as physicians," said Corpus Christi ophthalmologist Jerry Hunsaker, MD, TEXPAC membership chair. "If you're not working to make the system work for you, it's going to run you."
TEXPAC leaders are pushing to boost membership levels by two-thirds in the 2010 membership year ahead of what they see as a crucial election this November, which will set the tenor and tone for the Texas Legislature for the rest of the decade. All statewide elected officials, including the governor, will be on the ballot this year. Also up for reelection are half of the Texas Senate, all of the Texas House of Representatives, the entire Texas congressional delegation, and several seats on state appellate courts. U.S. Sen. Kay Bailey Hutchison's seat also could be up for grabs if she resigns to focus her full attention on her gubernatorial campaign.
"In 2010 we really have a huge election cycle and a challenge," said Wichita Falls pathologist Susan Strate, MD, chair of the TEXPAC Board of Directors. "Obviously, it's more important than ever that we elect the right candidates so that we can increase the success of our lobbying during the next legislative session."
The best way to make sure that medicine's voice is heard in the next session, Dr. Strate says, is to join TEXPAC.
Building on Past Success
Organized in 1962, TEXPAC is one of the oldest and most successful political action committees in Texas. In 2008, some 93 percent of TEXPAC-endorsed candidates were victorious.
With more than 7,300 members, TEXPAC also is the largest bipartisan political action committee in the state and ranks first in size among other state medical associations.
Only about 15 percent of the more than 45,000 TMA members, however, belong to TEXPAC. Dr. Hunsaker says TEXPAC's goal is to increase that to 25 percent in 2010. But he says all TMA members should consider joining TEXPAC.
"Obviously, the more physicians who belong to TEXPAC the more respect we garner from politicians," he said. "If we could get 80 to 90 percent of physicians who are TMA members to join TEXPAC, we could have an even more significant impact on the political process and could ensure the state of health care in Texas is not only what we as physicians would want, but what almost every one of our patients would want."
Membership in TEXPAC is open to all TMA members and Texas Medical Association Alliance members. Alliance members may join individually or in conjunction with their spouse.
Ironically, TMA Alliance members tend to join TEXPAC at a higher rate than physicians, says Dr. Todd. TMA Alliance President D'Anna Wick says that may be a result of how much alliance leaders stress joining TEXPAC every time they attend county medical society alliance meetings.
"All the leadership, every year that I have been involved, have stressed the importance of having our voice heard in Austin as well as in Washington," she said.
There are several levels of TEXPAC membership, but the basic membership for a physician is $125 annually. TMA members also may join the 300 Club for $300 annually, and couples may join the Capitol Club for $1,000 per year.
Alliance members may join for $50, residents and their spouse for $40, and medical students may join for $10. Additional information on membership levels is on the TEXPAC Web site .
Some 70 percent of TEXPAC dues are spent on direct campaign contributions, while another 5 percent goes to in-kind support for candidates. Another 15 percent is spent on candidate and political research; 10 percent goes to membership development.
Cutting the Excuses
While Dr. Todd says physicians traditionally are averse to getting involved in politics, Dr. Hunsaker says one of the reasons he often hears for physicians not joining TEXPAC is that they disagreed with a TEXPAC endorsement in a past election.
"The recurring criticism has been that TEXPAC doesn't listen to 'local docs' in various races," Dr. Hunsaker said. "So we're trying to make sure that we touch base with as many local physicians as possible so they can make their opinions known."
TEXPAC recently updated the operating guidelines in its endorsement process to ensure that an endorsement is not made without seeking and gaining input from local physicians in that particular House, Senate, or congressional district.
The updated rules also require candidates for Congress, Senate, and all statewide offices except judicial candidates to get a "super majority" vote of 60 percent of the TEXPAC board before being endorsed. Dr. Strate says that ensures a greater consensus among TEXPAC members in supporting endorsed candidates.
TEXPAC leaders hope these changes will bring back into the fold physicians who may have been unhappy with a past endorsement, but Dr. Hunsaker warns that TEXPAC will never be able to please everyone all the time.
"That would be impossible," he said. "We usually have physicians on both sides of almost every race."
In cases where local physicians disagree on whom to support, TEXPAC can and does assist both sides, Dr. Todd says.
"There are some races where doctors are just simply divided on who the best candidate is. TEXPAC sometimes has to make a decision to back one or the other," he said. "Even when we do that, we continue to assist physicians who support the non-TEXPAC-endorsed candidate in their efforts to promote their candidate, because we see value in that."
TEXPAC officials also are working hard to engage physicians who may have joined out of concern over a particular issue even after there is significant legislative success on their issue. A case in point is tort reform.
TEXPAC enjoyed some of its highest membership levels in the period before the 2003 medical liability reforms were enacted. Many physicians, such as Austin internist Peggy Russell, DO, joined at that time because they saw lawsuit abuse as a threat to the future of medicine.
But once tort reforms were enacted, many of those members dropped out of TEXPAC. Dr. Russell is among those who continue to belong to TEXPAC because she says ongoing political involvement works.
"The interests of medicine are very specific and complicated, and having them well represented in the legislative process is essential to maintaining the profession and the quality of medicine," she said. "And TEXPAC does a good job."
To meet its membership goals for 2010, TEXPAC has initiated several new outreach efforts. First, Dr. Strate and other TEXPAC leaders met with the leadership of the largest county medical societies last summer.
"We sat down with their legislative committees and their leadership to get their recommendations on what we could do to improve TEXPAC and what we could do to recruit members," Dr. Strate said.
TEXPAC also has stepped up personal recruitment efforts. Members of the TEXPAC board, including the eight alliance members who are on the TEXPAC board, make one-on-one contact with physicians and alliance members in their senatorial districts to urge them to join. Plus, Dr. Strate says participants in a recent specialty society retreat in Frisco were urged to each recruit five new members.
TEXPAC also reaches out to specialty societies and county medical societies across the state to raise awareness of the organization among all Texas physicians and their spouses.
And, TEXPAC meets with physicians from large group practices across the state, hoping to enlist their aid in getting their physicians to join TEXPAC.
Finally, joining TEXPAC was made easier. Physicians and alliance members can now join through the newly enhanced TEXPAC Web site . Dr. Hunsaker says joining through the Web site is easy and secure. Plus, members can contribute whatever they want throughout the year or sign up to have their membership renewed automatically each year.
But Dr. Strate says even more physicians and alliance members need to step up to the plate.
"Physicians need to be involved. It is the best investment, dollar for dollar, that they'll ever make for their practice and their future," she said. "Some people understand the lobbying part and the importance of TMA's involvement when the legislature is in session. What people don't understand is that is the end of the ballgame.
"The ballgame really starts back when you elect the legislator into that office. If you don't elect the right candidates in the first place, your lobbying efforts will be much more difficult."
Ken Ortolon can be reached by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by e-mail at Ken Ortolon .
TEXPAC Dues FAQs
Leaders of the Texas Medical Association Political Action Committee (TEXPAC) say physicians need to understand that political involvement during legislative sessions is only part of the battle when it comes to promoting the interests of patients and physicians in the Texas Legislature.
The battle really begins in the election process, and the best way to ensure election of pro-medicine candidate is to join TEXPAC.
"Many physicians think their TMA dues pay for everything that needs to be done," said Wichita Falls pathologist Susan Strate, MD, chair of the TEXPAC Board of Directors. "They know it pays for our lobbying activities and think that's really all that needs to get done. And they miss the fact that's really only a part of the process."
Following are answers to some frequently asked questions about how TEXPAC works and how your dues dollars are spent.
Q: What is TEXPAC's membership goal?
A: TEXPAC's goal is to increase membership to 25 percent of TMA physician members. TEXPAC's high-water mark was during the 2002-03 tort reform fight. During the 2002 membership year, TEXPAC raised more than $1 million from 7,278 contributors.
Q: How does TEXPAC currently generate income?
A: TEXPAC receives 65 percent of its dues income in the first four months of the fiscal year mainly through TMA/county medical society membership dues invoices. The remaining 35 percent of its income is generated during the remainder of the year through TEXPAC direct-mail solicitations, peer-to-peer recruitment efforts, and issue-related action alerts.
Q: What is the TEXPAC membership year?
A: Like TMA, TEXPAC collects membership dues from Oct. 1 to the following Sept. 30. Your membership year runs from the time you pay your dues until the following Dec. 31; however, if you pay your TEXPAC dues from October to December, your dues will be good until the next December.
Q: Can TEXPAC/TMA require physician members to join TEXPAC?
A : No. The Federal Election Commission has ruled that all political action committee contributions must be voluntary; hence, all contributions to TEXPAC must be an optional "below the line" transaction.
Q: How does TEXPAC invest members' contributions?
A: The TEXPAC Board of Directors invests member contributions into the campaigns of medicine-friendly candidates for the Texas congressional delegation, Texas Senate, Texas House of Representatives, statewide offices, and appellate judge seats.
Q: What is TEXPAC's winning percentage on the campaign trail?
A : Generally, 95 percent per election.
Q: Does TEXPAC solicit/collect membership dues for the American Medical Association Political Action Committee (AMPAC)?
A: No. AMPAC chose not to work with TEXPAC in any collective fund-raising efforts.
Q: What are the average state medical society annual political action committee membership levels and dues?
A : Those membership levels and dues are:
Q: What is the average physician contribution to TEXPAC?
Q: What are the average annual basic political action committee membership dues for limited license providers?
Q. Why should I join TEXPAC?
A: There are many reasons to choose from, so pick the most compelling one:
- TEXPAC is the unified political voice for all of Texas medicine.
- TEXPAC is a known and trusted entity so all candidates seek to harness our support and resources to help in their election efforts.
- TEXPAC and TMA are relied upon by legislators to help them understand critical issues impacting your ability to deliver the best care to your patients.
- TEXPAC is a perennial winner, regularly tallying an A+ effort in helping to elect medicine-friendly candidates to public office by combining resources, grassroots, and cutting-edge campaign tactical outreach to more than 45,000 TMA members. TEXPAC has been known to turn elections by three points or more in favor of our candidate.
- TEXPAC supports statewide, congressional, Texas Legislature, and various judicial candidates who are knowledgeable of medical issues.
- There is strength in numbers when the entire house of medicine collaborates as a team.
- TEXPAC was integral in helping to elect physician and alliance leaders to Congress, the Texas Senate, and Texas House of Representatives.
- TEXPAC trains and educates physician and alliance members on how to become elected leaders.
- TEXPAC has a thorough vetting process to which all TMA members have access to encourage their colleagues to support their candidate.
- TEXPAC works closely with the TMA Council on Legislation to vet candidates on key issues that will come before them during the legislative session.
- TEXPAC has been the integral component to hold the trial lawyers in check, to hold the insurance cartel accountable, to increase funding and reimbursements in the public payer systems, to maintain patient safety by blunting any unfounded effort to increase the scope of limited-license providers, and to help pass legislation improving the health and safety of children.
- Finally, a wise sage once observed: If you're not at the decision-making table, then you're probably on the menu. Count on TEXPAC being at the table on your behalf.
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