50 Years of Advocacy
By Ken Ortolon Texas Medicine May 2012

TEXPAC Celebrates Its Golden Anniversary 

Cover Story – May 2012  

When Lewisville obstetrician-gynecologist Michael Burgess, MD, decided to run for the U.S. Congress in 2002, he definitely was a long shot to win that race. There was a crowded field in the Republican primary, and the odds-on favorite was the son of then-House Majority Leader Dick Armey, the man retiring from that seat. 

"Starting out, it looked like his chances of success were not great," said Fort Worth orthopedic surgeon Joe Todd, MD, chair of the Texas Medical Association Political Action Committee (TEXPAC). 

But then TEXPAC stepped in. 

"Physicians and [TMA] Alliance members around the state went to work for him, particularly those in his district," Dr. Todd says. 

TEXPAC held a fundraiser in Austin for Dr. Burgess that spring, which he says allowed him to maintain "a presence" with mail pieces and other advertising the week before the primary election. And local physicians and alliance members got personally involved in the campaign. Denton dermatologist Robert Smith, MD, delivered campaign push cards to medical offices across Denton. 

Dr. Burgess says those efforts "made a tremendous difference" and helped him squeak into a runoff election by a mere 90 votes. He went on to defeat Scott Armey in that runoff and win election to Congress that November. 

"When you really look at it from an analytical perspective, TEXPAC made the difference," now Representative Burgess said. 

Dr. Todd says electing Representative Burgess was a huge milestone for TEXPAC. "It was the first time we had a TMA member physician from Texas elected to Congress," he said. "And it was important to get one of our own up there in Washington, D.C." 

This month, TEXPAC achieves another milestone as it celebrates its 50th anniversary. Founded in 1962 when political action committees were still in their infancy, TEXPAC grew over the intervening decades to become one of the premier political action committees in Texas. 

Despite some bumps along the way, TEXPAC compiled an impressive record of achievement over the past five decades, from unseating numerous incumbents hostile to organized medicine's agenda, to reshaping a trial lawyer-dominated Texas Supreme Court, to electing a number of its own to state House and Senate seats. Those victories played a direct role in some of TMA's biggest wins in the legislative arena, including landmark tort and managed care reforms. 

"TEXPAC has accomplished a great deal," said Wichita Falls pathologist and former TEXPAC Chair Susan Strate, MD. "By working to help elect the right candidates, we've been able to have a significant impact on countless legislative decisions that affect our patients and how we practice medicine."  

 Modest Beginnings 

TEXPAC has achieved many milestones over the years. In 1996, it elected 90 percent of its endorsed candidates. And in 2002, it raised more than $1 million and saw its membership peak with 7,200 members. 

But its origins were much more humble. In 1962, TEXPAC had only a handful of members, most of them concerned about increasing government intrusion into the practice of medicine as Congress debated creating the Medicare program. The American Medical Association had founded its political action committee, AMPAC, just one year before. 

"The political atmosphere nationally was fueled by a small but dedicated cadre of social activists who were then and still are blatantly intent on nationalizing the entirety of health care delivery," the late Milton V. Davis, MD, a former TMA president and early AMPAC board member, said in an interview with Texas Medicine in 2002. 

During its early years, TEXPAC had little money and little influence and struggled to convince physicians they needed to get involved in the political fray. 

"Only a few physicians initially believed either that there was a need or that we could or should actively participate," Dr. Davis said. 

 In 1967, TEXPAC raised only $20,000. But TEXPAC's fortunes soon began to change. Under the leadership of then-director Robert G. Mickey – who later became TMA executive vice president – TEXPAC recruited county medical societies to help promote TEXPAC membership by placing a voluntary TEXPAC dues check-off on their membership application forms. Within a year, 13 of the 20 largest county medical societies had joined. 

By the mid-1970s, annual contributions approached $400,000 and TEXPAC began to flex its muscles. 

One of its earliest major victories was persuading Republican George Pierce to take on a trial lawyer incumbent for a House seat in San Antonio in the late 1970s when Texas was still a one-party state and the legislature typically was 90 percent Democrat. TEXPAC endorsed Mr. Pierce in the 1976 election, and local TMA Alliance members -- led by June Bratcher -- organized a grassroots campaign to get physicians and other health care professionals out to vote. 

Mr. Pierce fell short in that election by fewer than 1,000 votes, but two years later he ran again and ousted the incumbent with TEXPAC and local TMA Alliance support. 

Those races sparked an unprecedented level of grassroots political involvement by TMA Alliance members on behalf of TEXPAC that eventually prompted TEXPAC to create the June Bratcher Award, which honors an alliance member each election year for outstanding political involvement. 

In 1991, TEXPAC was instrumental in helping David Sibley, DDS, JD (R-Waco), beat a trial lawyer-backed candidate in a special election for the Texas Senate. Dr. Sibley made it into a runoff and eventually won in a campaign that occurred during Operation Desert Storm in Iraq. 

Playing off Desert Storm, TEXPAC bought five miles of yellow ribbon to boost turnout for Dr. Sibley in the runoff. It worked. TEXPAC helped increase turnout by 300 percent in key precincts, and Dr. Sibley won. 

In 2000, TEXPAC took on another San Antonio incumbent who had been hostile to medicine's agenda when it worked against Republican Rep. Bill Siebert. 

Representative Siebert had a reputation as a stalwart backer of the major health plans during what current TMA lobbyist and then-TEXPAC Director Troy Alexander calls the "low pay, slow pay, no pay era" of managed care. 

"He was an active voice on the House floor on behalf of big insurance against physician interests and had been a real opponent of medicine at a time when medicine was really finding a lot of support on both sides of the aisle," Mr. Alexander said. 

TEXPAC endorsed Representatives Siebert's opponent, Elizabeth Ames Jones, in the Republican primary when virtually no other major political action committee would oppose the incumbent. And San Antonio pathologist and former TMA President William Hinchey, MD, says local physicians and alliance members got involved in a big way. 

"A lot of us had a personal relationship with Siebert's opponent," he said. "That helped get the alliance geared up." 

This was a significant beginning for TEXPAC's engagement in primary contests where differences in candidates can be small. It also highlighted the fact that there now is a strand of candidates who are very hostile to medicine and support the move of big business to relegate physicians to the role of "labor," Mr. Alexander added. "The traditional support medicine has enjoyed in some political circles has eroded. Medicine must support candidates on both sides that understand the importance of the patient-physician relationship." 

TEXPAC scored many other key victories over the years, including helping Republican Kevin Brady (R-The Woodlands) defeat optometrist John McCall for a state House seat in 1990 and helping elect Rep. Susan King (R-Abilene) as the first woman representative from West Texas. TEXPAC was virtually the only political action committee to back her, a TMA Alliance member and wife of Abilene otolaryngologist Austin King, MD.    

Clean Slate for '88  

While these and other successes helped TMA push through significant managed care reforms and the historic tort reform package of 2003, TEXPAC's success in reshaping the Texas Supreme Court clearly stands as its crowning accomplishment. 

In 1977, TMA succeeded in passing a major medical liability reform package that included damage caps, a statute of limitations on lawsuits by minors, and remedies for bad faith causes of action. Over the next decade, however, the trial lawyer-dominated Texas Supreme Court dismantled those reforms. 

Texas began to see spikes in medical liability premiums and an increase in frequency and severity of lawsuits, and by the mid-1980s, the state was in a full-blown medical liability crisis. 

 Longview surgeon John Coppedge, MD, served on his local hospital board in 1987 when its liability carrier refused to write the hospital a policy unless it required all of the physicians on its medical staff to increase their liability coverage, in some cases to levels that were either too expensive for the doctors or not available to them. 

"That's when I got involved in politics and with TEXPAC," Dr. Coppedge said, adding that trial lawyers controlled the Supreme Court and it was obvious the court needed fair and impartial judges. 

"There's no sense in spending time, energy, and money passing tort reform until you ensure that there will be a Supreme Court that won't strike it down," Dr. Coppedge said. 

Dr. Coppedge became a key part of a TEXPAC-led coalition that backed a bipartisan slate of candidates for the Texas Supreme Court in 1988. The coalition also included the Texas Civil Justice League, the Texas Association of Defense Counsel, and other organizations. 

That campaign spawned the now famous "Clean Slate for '88" slate cards, but accounts of their origin differ among those involved. 

One version of the story holds that during a presentation on the court races by TMA lobbyists at a meeting of the Jefferson County Medical Society in Beaumont, a physician in the back of the room spoke enthusiastically about the slate of court candidates but said he didn't want a bunch of biographical data or State Bar of Texas polls that he could discuss with his patients. 

"Just give me card I can give to my patients," he said. 

By the next day, TEXPAC produced a mock-up of the slate card, listing the five endorsed candidates. TEXPAC later amended the cards to add a sixth endorsed candidate. 

Dr. Coppedge, however, says he and then-TEXPAC Director Alex Short hit on the slate card idea because they felt the group needed a simple way to educate voters to support a slate of candidates that included both Democrats and Republicans. 

Regardless of which story is true, the cards were highly effective. TEXPAC and its coalition partners eventually printed and distributed more than 1 million cards. In the end, five of the six Clean Slate for '88 candidates won their races. 

TEXPAC remained active in court races over the next several elections until the trial lawyer influence on the Supreme Court was limited and voters elected an impartial panel of conservative judges who practice judicial restraint. 

Dr. Todd says he also became involved in TEXPAC about the time of Clean Slate for '88 and believes the victories that year truly laid the groundwork for the passage of Proposition 12 and tort reform legislation in 2003. 

"I think one of the most important things TEXPAC has done through the years is get involved in these judicial races," he said. "By 2003, we had the perfect storm. We had a governor who was a big proponent of tort reform, and we had a legislature that was inclined in that direction. And then we had in place good people in the judicial system to back it up." 

TEXPAC continues to lead the way by evaluating and endorsing candidates in courts of appeals races across the state.   

Real Grassroots  

While TEXPAC has helped elect hundreds of candidates with its endorsements and campaign contributions, past and present leaders and staff say the highly developed level of real grassroots activism on the part of TEXPAC members sets this political action committee apart from the rest. The personal relationships that physicians and their spouses develop with candidates and elected officials are particularly important, they add.   

And since the days of June Bratcher in the 1970s, TMA Alliance members have been critical to those grassroots efforts, so much so that more alliance members from Texas have received the AMA's Belle Chenault Award for political action than from any other state medical society alliance. 

"The main thing TEXPAC has going for it that other big PACs don't have is the grassroots," says incoming TMA Alliance President Linda Swan Adkins. "The trial lawyers have a lot of money, as do a lot of the other PACs, but as far as actually getting out and actually working for a candidate, I think TEXPAC is head and shoulders above everybody else." 

Darren Whitehurst, TMA's vice president for advocacy, says TEXPAC "is not just a campaign donation-writing organization. Every candidate out there has a relationship with a physician – either their own doctor or a physician who has treated a family member or loved one. Somewhere down the line a physician has touched their lives. That's the strength of this organization, and it will be the strength of this organization 50 years from now." 

The efforts of politically educating TMA members and spouses throughout the '80s and '90s began to yield new dividends in 2004. TEXPAC Director David Reynolds says the organization has helped four members of the house of medicine get elected since that time. Those include physicians Mark Shelton, MD (R-Fort Worth), John Zerwas, MD (R-Richmond), Charles Schwertner, MD (R-Georgetown), and Representative King, who all currently serve in the House. In addition, despite supporting "friendly incumbents"' in their initial races, TEXPAC has gone on to back Sen. Bob Deuell, MD (R-Greenville), and former Sen. Kyle Janek, MD, for reelection to the Senate. 

Dr. Shelton ultimately bested a field of six, including the personal injury trial lawyer who authored Cheaper to Kill Than to Maim. Dr. Zerwas won a runoff after coming in first in a field of seven, and Dr. Schwertner won his primary outright in a crowded field. Local physicians and TEXPAC got on board early for Representative King and helped pull her through a rugged primary and runoff. 

Mr. Reynolds says TEXPAC has elected at least one physician or alliance member to the legislature each cycle since 2006.  

Ms. Adkins says alliance members also were critical in helping Representatives King and Shelton win their House races. 

This year, TEXPAC and the alliance are deeply involved in helping a number of physicians and TMA Alliance members who are running for legislative seats for the first time. 

For example, former TMA Alliance President Keely Hunsaker, DDS, has campaigned this year in Houston for Greg Bonnen, MD (R-Friendswood), who is running for the House District 24 seat in Galveston County; for alliance member Sonal Bhuchar (R-Sugar Land), who is seeking the House District 26 seat; and for Susan Todd (R-Fort Worth). Ms. Todd, wife of the current TEXPAC Chair Dr. Todd, seeks the House seat Dr. Shelton is vacating to run for the Senate against incumbent Democrat Sen. Wendy Davis. 

Mr. Reynolds says electing these and other physician and alliance candidates running this year is vital to communicating medicine's agenda to fellow lawmakers. 

"There are 181 highly talented, incredibly smart lawmakers from all educational and professional backgrounds serving their constituents in the House and the Senate. TMA can lobby and educate those members until we're blue in the face, and we often do, but it's vitally important to have someone serving as a trusted legislative colleague and friend with actual firsthand knowledge of medicine's complex issues that other legislators can rely on for insight to help better understand how a particular policy decision will impact their district and Texas as a whole."   

 Getting Creative   

Grassroots activism is not the only thing that has set TEXPAC apart over the years. The organization also has a knack for displaying its creativity.  

 One such occasion led to the now infamous "duck" mailer that went out to prospective TEXPAC members during the health system reform debate in 1993. The mailer, a membership recruitment and fundraising piece, prominently featured a photo of a duck (well, actually a goose) with the headline "Don't Let Reform Duck Up Health Care."  

Then-TEXPAC Director David Marwitz says then-First Lady Hillary Clinton – who was leading the reform effort – purportedly waved the piece around the White House, shouting, "Look what they're doing to me in Texas." 

That mailer was so popular that 15 other state medical societies mailed it to their membership. 

Also during the HillaryCare debate, TEXPAC printed and distributed more than 1 million "My Doctor, My Choice" bumper stickers opposing the Clinton health system reform plan. 

Another membership piece portrayed trial lawyers as train robbers and urged physicians to join TEXPAC to fight for tort reform. That piece earned TEXPAC threats of a libel lawsuit. 

One of TEXPAC's greatest successes was creating the First Tuesdays at the Capitol program, a partnership between TEXPAC and the TMA Alliance. 

The idea actually originated with Ms. Todd, who was looking for a way to heighten medicine's presence at the Capitol. Instead of the alliance doing a one-day health fair once each session at the Capitol, Ms. Todd and others decided to organize a monthly event to bring physicians, medical students, and alliance members to Austin to lobby their lawmakers. They set the events on the first Tuesday of each month of the session to capture the symbolism of the general Election Day, which is always the first Tuesday after the first Monday in November. 

The program debuted in 2003 with great success. The alliance and TEXPAC have cosponsored it every legislative session since, with thousands of people participating in those years. 

"That was a huge accomplishment for us to pull off," Dr. Hunsaker said. "But then to keep it going has been even a bigger accomplishment. It's a difficult feat to get that many doctors and alliance members down there over and over and over, have it run well, and have everybody feel that they accomplished something." 

Dr. Todd, Ms. Adkins, and others say the large number of physicians and alliance members running for legislative offices this year may be a direct result of the heightened awareness of how politics impacts the practice of medicine fostered by participation in the First Tuesdays program. 

TEXPAC and the alliance teamed up again in 2010 when they created TEXPAC-Alliance Volunteer Days, events that see alliance members spend the day campaigning for TEXPAC-endorsed candidates.   

Looking to the Future  

As TEXPAC moves into its second half-century of political involvement, Drs. Todd and Strate say it is positioned well for continued success in impacting electoral politics on behalf of physicians and patients.  

"We're becoming more and more hands on and more and more a grassroots organization," Dr. Todd said. "Our relationships with legislators have become closer as the years have gone by as we've become more and more involved in their election campaigns." 

Dr. Todd added that 2012 can be a watershed election year for TEXPAC. "The TEXPAC board has proudly endorsed eight physicians and alliance members for election this year, and should we be successful we can basically accomplish in one cycle what's taken us three cycles to accomplish and that is to elect three more TMA family members to serve. Helping to elect physicians and alliance members does not guarantee that TMA will be successful in the legislature, but it does afford us that many more opportunities to educate elected lawmakers." 

Dr. Strate says TEXPAC is focused on maintaining those relations. The TEXPAC board will not endorse a candidate without input from local physicians in a candidate's district. 

"Obviously, that's where the rubber meets the road in politics," she said. "That relationship is key, and TEXPAC is really a mechanism to build those strong relationships between local physicians and an elected official." 

Looking back at the past 50 years, past and present TEXPAC leaders say physicians should be proud of what TEXPAC accomplished for them and their patients. And they urge more physicians and alliance members to get involved. 

"Political action works, but we need the support of all the physicians in the state to be effective," Dr. Todd said. "We have grown and become a very influential PAC through the years, but we're only as successful as our member support allows us to be. So get involved and join TEXPAC." 

 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 email. 

 Gala to Celebrate TEXPAC's 50th  

Help the Texas Medical Association Political Action Committee (TEXPAC) celebrate its golden anniversary at TexMed 2012 in Dallas at 7 pm Thursday, May 17, in Lone Star A of the Sheraton Dallas Hotel. The event includes dinner, drinks, and entertainment by the Capitol Steps, a Washington, D.C., comedy group that satirizes politicians from both sides of the aisle.  

Tickets are $50 each and will be available at TexMed registration. You do not have to be a TEXPAC member to attend. 

Sponsorships for the event also are available at several levels. They range from $100 to $10,000 and offer VIP tickets and preferred seating. For details or to join TEXPAC, contact Tracey Cantu by telephone at (800) 880-1300, ext. 1363, or (512) 370-1363, or by email.

The Texas Medical Association Political Action Committee (TEXPAC) is a bipartisan political action committee of TMA and affiliated with the American Medical Association Political Action Committee (AMPAC) for congressional contribution purposes only. Its goal is to support and elect pro-medicine candidates on both the federal and state level. Voluntary contributions by individuals to TEXPAC should be written on personal checks. Funds attributed to individuals or professional associations (PAs) that would exceed legal contribution limits will be placed in the TEXPAC administrative account to support political education activities. Contributions are not limited to the suggested amounts. TEXPAC will not favor or disadvantage anyone based on the amounts or failure to make contributions. Contributions are subject to the prohibitions and limitations of the Federal Election Campaign Act.  

Contributions or gifts to TEXPAC or any CMS PAC are not deductible as charitable contributions or business expenses for federal income tax purposes. 

Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of the employer of individuals whose contributions exceed $200 in a calendar year. To satisfy this regulation,  include your occupation and employer information in the space provided. Contributions from a practice business account must disclose the name of the practice and the allocation of contributions for each contributing owner. Should you have any questions, call TEXPAC at (512) 370-1361. 

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