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Government & Law

TMA Pushing for Affordable Access to Healthcare for All Texans, ‘Lifting Everybody’

TMA Legislative Council Chair Dr. John Carlo on how the pandemic has exposed inequities and “standing together."

When the Texas Legislature reconvenes in 2023, healthcare advocates will be pushing to improve affordable healthcare for high need communities–but the work has already begun.

After a decade of experience helping lead Dallas through public health issues and pandemic responses including HIV, AIDS, and Ebola, Prism Health North Texas CEO Dr. John Carlo is serving as a chair of the Texas Medical Association’s Council on Legislation, where he hopes his advocacy can make a difference for those most in need. “If we can do the best for those that have really the most challenging situations, we’re lifting everybody overall together.”

The council represents TMA’s 50,000 physician members in its work with legislators, the governor’s office, and task forces, tackling tough questions from vaccination mandates to quarantine recommendations developed from evidence and science-based information.

The Council on Legislation helps communicate digestible information on issues that are important to TMA physicians and the public to inform decisions. Helping break down vast amounts of information, “anything from best practices to sharing information, to promulgating educating services,” into an easily readable format to try and answer tough questions, Carlo says.

Although the Legislative Council is not set to reconvene until 2023, there are special sessions likely to happen for redistricting and regarding the expenditure of the COVID funds and federal funds. The council will prepare by developing policies, creating guideposts, and researching to be prepared for the hectic legislative session.

Carlo says the main priority will be access to affordable healthcare. “We’ve got to come to the same page about what we can do differently in Texas to enable more affordable access to healthcare. And I think everybody wants that,” he says. Healthcare is “not just about a public health issue, but is actually now an economic issue that will affect the overall economic health of the state.”

Dr. Carlo’s passion and drive for involvement in TMA is finding out how to develop affordable access to healthcare for all Texans, particularly in disenfranchised and lower socioeconomic status communities. “That’s really the missed opportunity,” he says. “If we can address this in a meaningful way, it’s really prevention at its best, and we can lower overall healthcare costs for everybody. We can make the communities healthier, we can really enable everything from the economy to neighborhoods, it will be in a better place.

When asked his opinion on the lasting impacts COVID-19 will have on our community, Carlo pointed out the continued growth of telehealth, the loss of diagnosis dynamics, and community health inequities.

On telehealth and its impact on diagnosis dynamics:

“I do think that the telehealth effort is here to stay and I think it’s got benefits for many different situations in our healthcare. I think we’ll come out of this, unfortunately, with some degree of relying more on these laboratory tests, rather than what are our tried and true methods of diagnosis in terms of any medical condition going forward That would be something we’ll have to think about some more going forward.”

On how COVID-19 exposed inequities:

“It’s very, very obvious with what we’ve seen in terms of mortality and case rates, and kind of just the, you know, just the disproportional amounts that are affecting communities of color in Texas. And understanding that this is also based on socioeconomics and just sort of the lack of health care access in general. Hopefully, this further shines light on the need to really ensure greater access to basic health care for everybody as a mechanism of community resiliency, and understanding. That’s what makes us stronger and more prepared for the next one, more than anything else.”

Specific to Public Health Legislation, Dr. Carlo recognizes that the COVID-19 pandemic has illuminated the need for advocacy towards public health infrastructure funding, the importance of unity, and understanding on effective community mobilization.​”The overall positive attribute, taking this into a legislative context, is that there certainly is an awareness on everybody’s minds about how significant the consequences of the coronavirus pandemic is.”

On Public Health Infrastructure Funding:

“​​We’ve got to realize that these infectious disease threats are coming faster and faster. And we’ve got to have health departments that have capable staff, strong information technology systems, and dedicated support to be able to respond to these emerging infectious disease threats. Overall, there has been some support for public health, particularly around funding and infrastructure. But there’s also been some concerning pieces around minimizing the ability for health authorities to make decisions and things like that.”

On unity:

The pandemic has framed public health as a civil liberties issue but has shown the importance of “standing together to address public health issues because when we don’t, we’re not effective. I do think that crises bring us together. I would like to recognize the celebration of our health care workers by the community. A thanks to these health care workers that we’ve been with our unsung heroes. We certainly have seen a lot of division and, unfortunately, a lot of politics in the process. I’m just hopeful that we least get to a place that recognizes the importance of working together and looking at it from a public health standpoint, as a way to sort of gauge how we address these things going forward.”

On community mobilization:

“We’ve really got to understand how we can effectively mobilize communities quickly in response [to public health issues] because the time is of the essence early on, and that’s what we really need. But we recognize that those types of orders and initiatives must be done effectively, but also not infringe upon necessarily individual rights and those sorts of things.”

Dr. Carlo summarizes TMA’s Legislative Council’s successes in the past year as acting on the exposed healthcare inequities and developing resilient Texas communities having “increased affordable access to health care for those particularly for those working families that don’t currently have health insurance. That would be my measurement of extreme success.”

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