Better access to mental health care in schools, significantly reducing maternal deaths, stopping scope-of-practice creep, and ensuring funding for cancer research, medical schools, and Hurricane Harvey relief.
Those are among the issues two key physician-lawmakers will focus on when the 86th Texas Legislature kicks off Jan. 8 in Austin.
Speaking at the Texas Medical Association’s Advocacy Retreat on Saturday, state Reps. John Zerwas, MD (R-Richmond), and Tom Oliverson, MD (R-Cypress), both anesthesiologists, said many of the issues that medicine has long fought for will be up for debate again, despite changes in the makeup of the House, including a new speaker.
“A change in leadership means what’s old is new again, and I expect a lot of the issues that you thought were dealt with before will rear their ugly heads again,” Representative Oliverson told about 300 physicians, residents, students, and TMA Alliance members during the Advocacy Retreat’s concluding event.
Both lawmakers called on Texas physicians to advocate on behalf of medicine, including reaching out to lawmakers, participating in events like First Tuesdays at the Capitol, and even running for office.
“Being a doctor, I think inherently makes you a good legislator because number one, you’re a good listener … and you’re a good problem-solver,” Representative Oliverson said. “I wish there were more physicians in the legislature because we are naturally gifted at problem solving, we are naturally gifted to be good legislators because it’s how we were trained to think.”
Representative Zerwas said it’s up to doctors to speak out for medicine.
“Because health care is a lot of what we deal with and a lot of what is framed in the legislature, it is subject to political manipulation … without there being any second thought about what might be the consequence to patient care,” he said. “That’s why I emphasize to you, that, yes it’s incredibly important that you learn your discipline, you learn your science, you learn your clinical skills, and you hone those throughout your entire career. But if you put this to the side, there will be others who will choose to be involved in this.”
School Safety Through Better Mental Health Services
Representative Oliverson, who last session sat on the House Administration, Insurance, and Public Health committees, said school safety, particularly increasing access to mental health services, will be one of his top priorities for 2019.
“There are practitioners who are already in the public schools — in terms of your social workers and counselors — who have a role to play in the team-based approach to mental health. We just don’t fund public schools to a level to where they can actually afford to provide those services,” Representative Oliverson said. “We’re going to be looking at how to expand mental health services to kids who are in crisis or maybe just exhibiting some signs of being withdrawn, maybe at risk.”
Representative Zerwas said he will work to ensure funding for school safety, particularly access to mental health care.
“We in Austin don’t need to dictate how that school safety is done — you got boards that are elected locally. … But we do need be prepared to have funding available for the various things that people think are important,” he said. “The thing I hear the most on the issue of school safety is counseling. These things are all ultimately a mental health issue.”
Representative Oliverson said he has spent part of this year studying maternal deaths, and he was concerned at how many are caused by cardiovascular problems like primary pulmonary hypertension and preeclampsia. A lack of access to health care, particularly among African-American women, is a major factor in those fatal pre-existing conditions, he said.
“That was a wakeup call to me as a physician and committee member, and I hope … we get a better sense of why it is that cardiovascular disease is such a cause for maternal mortality,” Representative Oliverson said. “I think we’ll … try to figure out what can we do to better reach the African-American community.”
He also said he will be focused on reducing surprise billing — including ensuring physicians get paid fairly — and the ever-increasing price of pharmaceuticals and the burden pharmacy benefit managers (PBMs) place on prescriptions.
“We know pharmaceuticals are the fastest-growing segment of health care costs,” he said. “There is a strong effort nationally … to try to get a light shined on where these prices are coming from, and how they come up with them.”
As chair of the House Appropriations Committee last session, Representative Zerwas was solely focused on writing the state’s two-year budget. He said he hopes to hold that role again this session, when a robust economy is expected to give lawmakers more money to work with for the 2020-2021 budget.
“We’re going to have revenue to do things we couldn’t do last time, and that’s exciting,” Representative Zerwas said.
Representative Zerwas said he’s filed a bill to extend the Cancer Prevention and Research Institute of Texas (CPRIT) for another six years, which would allow the legislature to execute bonds to foster cancer research. He said he will also push for the University of Houston’s planned medical school, and he will try to set aside money for Hurricane Harvey recovery.