Even with a pandemic in the background, the Texas Medical Association House of Delegates managed to take important action on several other hot-button public health issues, including sobriety requirements for medical treatment, immigration, race, and climate change.
Delegates readily passed a pair of vaccine policies without any debate.
For one, they called on TMA to advocate for the removal through legislation of nonmedical exemptions from vaccinations approved and recommended by the Advisory Committee on Immunization Practices.
Under a separate policy adopted at the meeting, TMA will continue working to modify the state’s emergency vaccination plan to better meet Texas’s population needs, and to improve and simplify future vaccine rollouts to combat vaccine hesitancy.
Delegates also took a host of actions aimed at eliminating barriers to care, particularly for certain patient populations.
After some discussion, voting physicians decided to oppose Texas Medicaid’s 90-day sobriety requirement for hepatitis C patients to receive treatment, and support efforts to remove the sobriety requirement as a barrier to hepatitis C treatment.
Richard McCallum, MD, an El Paso gastroenterologist, proposed amending the resolution to replace the sobriety requirement with an alcohol treatment program the patient could undertake concurrently with hepatitis C treatment.
“There is a danger that while curing hepatitis C, liver damage will be ongoing from the use of alcohol,” he said. “This defeats the purpose of the treating the hep C virus, which is to prevent cirrhosis and possible liver cancer.”
Several physicians and medical students successfully opposed the amendment, however, with delegates ultimately voting it down.
Whitney Stuard, an alternate delegate and medical student at UT Southwestern Medical School, said that health care agencies like the Centers for Medicare & Medicaid Services and the Veterans Administration “agree that this is an unnecessary requirement. … Not only are sobriety requirements unethical, these requirements are not cost-effective.”
Delegates also called on TMA to:
- “Advocate for policies that protect the rights of immigrants when seeking medical care” and oppose policies that deter health care “such as the collection of patient immigration status information.”
- Recognize that race is an “incorrect metric” to use in estimating patients’ kidney function.
- Encourage postpartum depression screenings as routine protocol for perinatal and postnatal women in health care settings.
- Support lowering the legal age at which a minor can access contraceptives without a guardian or parental consent to at least age 17, and continue supporting initiatives, programs, and funding that eliminate barriers to adolescents accessing reproductive health care.
A more lengthy house floor debate coming out of the Reference Committee on Science and Public Health focused on a measure aimed at recognizing the effect of climate change on public health. After discussing whether to include language specifically addressing human impact, delegates ultimately decided the resolution could accomplish its goal without it.
They adopted policy that TMA “concur with the scientific consensus that Earth is undergoing adverse global climate change and acknowledge that climate change will increasingly affect public health, with disproportionate impacts on vulnerable populations such as children, the elderly, and people of low socioeconomic status.”