While liability reforms have been good for the health of Texans, many laws favored by Governor Perry have damaged health.  As a physician on the Committee on Public Health of Bexar County Medical Society, I have been trying for many years to help not only my patients, but also Texans in general.  San Antonio, my home for the last 30 years, is reported to have a population mix very similar to that of the future US.  So it makes sense to look at the health policy of Rick Perry as governor to see what effects he might have as President.

Governor Perry was instrumental in passing liability reform and increasing the number of physicians in Texas.  More doctors increased access to medical care for those who have the means to pay for care.  But for the 26% of Texans who are uninsured (highest in the nation), Gov. Perry has shown no interest in helping.  Perry has repeatedly acted to keep poor children off of Medicaid or CHIP and views spending state funds in this manner as wasteful, even with federal matching funds paying most of the cost.  With Texas having the highest rate of unemployment since 1987 and the highest percentage of minimum wage jobs in the nation, such an approach seems very short sighted.

In the last legislative session, Gov. Perry was very clear all programs were subject to cuts and no new revenues would be added even though the Republican Chair of Senate Finance reported recent tax revisions had created a permanent revenue shortfall that would not end with the recession.  A group of disabled citizens in wheelchairs were arrested outside Perry’s office while chanting they would rather go to jail than die in a nursing home.  They knew bold action was necessary to escape Medicaid cuts under Perry.

Recently the Texas Public Utility Commission voted to decrease the assistance of poor elderly and disabled citizens with their utility bills.  This funding is provided through a state tax on every utility bill and the cut comes at a time of life-threatening heat and drought.  It is notable that the Perry-appointed commission chose to keep the unspent tax in state coffers rather than refunding it to taxpayers.

One law proposed by conservative members of his own party and passed by the Republican dominated legislature would have made it illegal to text while driving in Texas.  Gov. Perry vetoed the bill because it was “a government effort to micromanage the behavior of adults.”  The governor failed to draw a distinction between this effort to decrease dangerous behavior known to kill innocent people and DWI laws enacted for the same reason.

When Gov. Perry ordered the vaccination of all Texas 12-year-old girls against a venereal disease there was a huge public uproar and the legislature voted overwhelmingly to overturn his executive order.  Some might say inoculation of all children against HPV is desirable, but to make this decision without long public discussions is in my opinion irresponsible.  Some have said Perry’s order to give the new vaccine was influenced by the promise of campaign contributions from the manufacturer.  Others say his huge ego allowed him to “know” what is best for other people’s children.

It is especially confusing why Rick Perry acted so boldly in a sex-related issue when he has long limited sex education in public schools.  Laws restricting information about birth control in Texas schools contribute to San Antonio having the highest rate of repeat teen pregnancy in the nation.  Perry has taken large amounts of funding away from Planned Parenthood, an organization that provides most of the birth control to low-income individuals.  Whether or not you think the poor deserve free birth control, it is very poor use of public funds to limit access to pregnancy prevention while spending much larger amounts to pay for Medicaid births.

Numerous studies have shown that better education greatly enhances health by helping each individual work with their doctor and improve their own health.   According to Ed Whitacre, a prominent Republican and former CEO of General Motors, Texas public schools were already 44^th in terms of lowest funding per student before Gov. Perry cut another $4 billion.  It is especially puzzling why Perry left over $6 billion in the state’s rainy day fund while forcing education layoffs and cutting programs to help the poor stay in school.  Many Republican business leaders worry about long term effects on the workforce as large numbers continue to drop out of high school.

Perry ignored attempts by health experts to increase workplace safety and did not support a ban on indoor smoking in public places.  But he did support a law to reduce taxes on chewing tobacco.  Comments from a Republican legislator included “we have just created an incentive for people to use cancer-causing products” and “when we have the fiscal problems that we have, it’s wrong to be cutting taxes on products like chewing tobacco.”  Whether Perry is in favor of more tobacco use or is just not opposed to doing what it takes to get more tobacco campaign contributions is not clear.

While he did improve liability laws and bring more doctors into the state, Gov. Perry caused many Texans to be less healthy.  Perry prevents the addition of low-income families to Medicaid and CHIP resulting in 26% of Texans being uninsured (highest in the nation).  He vetoed texting while driving laws and ordered all Texas school children be vaccinated against a venereal disease.  He makes birth control less available while the repeat teen pregnancy rate in San Antonio is highest in the nation and has impaired the ability of Texans to participate in their own medical care.  It is for cutting taxes on chewing tobacco while at the same time claiming to not have enough money to avoid huge cuts to Texas public education that I believe Rick Perry has fairly earned the overall evaluation of his medical legacy as “not worth a spit.”

Robert Luedecke is an anesthesiologist and member of the Bexar County Medical Society Committee on Public Health.

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