Contempo Magazine Blog

By Dr. Tony Magana

Close to 30% of eligible voters in Texas will be Hispanic by the time of the next election. A Republican candidate who can match George Bush’s ability to garner significant Hispanic support in his gubernatorial and Presidential elections could find a winning strategy. But will this be possible for Hutchison or Perry?

The upcoming gubernatorial race in Texas could prove to be a test for how Republican candidates can develop a successful strategy to gain the Hispanic vote. The most successful campaigner in Texas history, Governor Rick Perry is facing a serious challenge from the popular Senator Kay Bailey Hutchison. On the surface this appears to be a race between a socially and fiscally conservative Republican incumbent versus a moderate Republican but in reality is a much more complex situation with numerous possible outcomes.

The southwestern states including Texas have a eclectic mix of voting groups affecting elections including fast growing Hispanic populations, conservative Republicans who were once Democrats, and transplanted northerners which consist of young professionals and retirees. The Democratic party has been making progress in gaining seats in the Texas legislature and also making the races closer in state wide elections. Apart from gerrymandered urban districts in state and local elections, the typical Texas Democrat tends to be a centrist or ‘blue dog” more often than a traditional East coast progressive. But despite their gains, the Texas Democratic party like the Republicans still have problems with minority voters.

There remains considerable controversy about what happened in the 2002 Texas gubernatorial race where a Mexican-American candidate from South Texas, Tony Sanchez, who outspent Perry 2 to 1, did so poorly in the election as did Houston area legislator, Rick Noriega, against incumbent John Cornyn in the 2008 Senate race. Both elections recorded a high percentage of Hispanic voters voting for the Hispanic candidates but this occurred in the setting of an overall very low voter turn out by Hispanic voters. The final election tally showed the Democratic candidates did much worse than pre-election polling had predicted.

The Texas Democratic party remains immersed in a lawsuit over the Presidential primary process. The 2008 primary was a strange concoction were convention attendees and their votes for the candidates were determined by a two separate means. Instead of relying upon just the popular vote, for the first time, caucuses were held in the late evening which also awarded delegates to the convention but on a formula based upon the previous election’s turnout. Many Hispanic supporters of Hillary Clinton maintain that they were never told about these caucuses. Although Clinton won the popular vote in the Texas primary, Obama ultimately got the majority of delegates from Texas because his supporters dominated the late night caucuses. In addition, areas like South Texas which had low voter turnouts in the previous elections were penalized, some say unfairly, while other areas like Houston’s African American districts received extra delegates because the previous election featured an African American, Ron Kirk, in a statewide election.

Albeit, this time it appears there will no major Hispanic or minority candidate from either the Democrats or the Republicans in the upcoming primaries for governor. A few political Texas insiders from the Democratic party say that popular former Dallas mayor and African American, Ron Kirk, was given the position of U.S. Trade Representative, to clear the way for a white Democrat to run for governor and the Senate. Although pundits would argue that Hispanics will overwhelmingly vote in the Democratic primary, if a Republican candidate in this assuredly close race makes an effort to court the Hispanic vote this could have significant consequences not only for the Republican primary but also whether the Republicans can win the general election.

No doubt feeling the pressure from the conservative base, Senator Kay Bailey Hutchison, joined Senator John Cornyn in voting no to the nomination of Judge Sonya Sotomayor to the Supreme Court. Governor Rick Perry has a close relationship with radio commentator, Rush Limbaugh, and even named Limbaugh an “honorary Texan” so most Hispanics will have assumed had Perry had a vote his would have been similar to Hutchison.

Anyway you look at it, for the Republicans in Texas to get any significant Hispanic support they have to understand they first have to dig themselves out of hole. Some analysts have pointed to the fact that Republican Senators from Texas and Arizona who voted against Sotomayor, despite having large Hispanic populations, might have insight into those populations as being more conservative then conventionally supposed. Abortion, gun rights, and pro-faith issues which are potentially strong in the Hispanic community of the Southwest may mitigate the long term effect of the negative Sotomayor vote somewhat goes the unproven theory.

Conversely, reflection on the poor showing of John McCain in the Presidential election of 2008 despite his being a strong advocate of immigration reform by Hispanic voters from the Southwest had little to do with his own personal feelings, in my opinion, but was in fact a protest vote against the Republican party as a whole for tolerating the likes of Duncan Hunter and Tom Tancredo with their shameful anti-Hispanic rhetoric.

For either Hutchison or Perry to capture a significant portion of the Hispanic vote they will have to switch from a passive mode of appeal where Hispanics are assumed to be in the general population of conservatives to an active one that addresses issues relative to the Hispanic community where a conservative answer will have appeal. They will need to find an issue which could mobilize a higher turnout for their own Hispanics supporters and just as important also not risk triggering anti-Republican turnout.

Following the Presidential election, the Pew Hispanic Research Center did a survey of what issues were relative to Hispanics. The major issue was not immigration (only 31 percent reported this) but was first, the economy at 57 percent, followed by education at 51 percent. Immigration as a primary issue of political discussion will not likely cause a major increase in turnout by Hispanics but can be a dangerous issue in the negative. Anti-immigration rhetoric that is perceived as veiled racism is a Republican mistake that cannot be repeated. Currently both political parties have taken an attitude to “let sleeping dogs lay”.

Although the vast majority of Hispanics are pro-life, up to now community or political activism to the greater community on this issue has been mute. In recent times, for example, most Hispanic voters have not applied a pro-life litmus test to candidates but that could change. The stepping up of the Catholic Church in denouncing public support of abortion and the growing presence of Hispanic evangelical protestants could spell trouble for the pro-life advocate, Kay Bailey Hutchison. Governor Perry is in a favorable position to garner at least the evangelical Christian vote in both the primary and general election.

One of the fastest growing segments of the population in Texas is the Hispanic small business owner. Governor Perry was the author of the state franchise tax which is really an income tax on small business. Although many Hispanic small businesses are exempt because they have revenues of less than $1 million, this is already become a major focus of attack of the Hutchison campaign on the record of the incumbent. On the other hand, Kay Bailey Hutchison, voted for the stimulus bill which a majority of Americans and even more so of Texans see as being a waste of taxpayer dollars.

Both Governor Perry and Senator Hutchison need to pay more attention to South Texas then they have in the past. Republican Senator John Cornyn has spent considerable time developing close relationships with local elected Democratic mayors and legislators from South Texas. Even when he has disagreed with local politicians on issues like the construction of the border wall which was going to be an unstoppable federal mandate, he went out of his way to get funding for levee repair and new international bridge construction. His activism should serve as model for the two candidates. Hutchison has shown a compassionate side to the poor in South Texas in the past but has never engaged the Rio Grande Valley to the same extent as Cornyn. Governor Perry has in the past made statements about conditions or situations about the border without consulting local leaders. This is a faux pas that must end.

In my opinion, the most important issue that the Republicans should address if they wish to garner Hispanic support is education. Texas remains one of worst states with a fifty percent dropout rate of Hispanics who enter high school and one of the lowest rates of Hispanics under the age of 25 who attend college.

Governor Perry has been an advocate for school choice and voucher programs in the past but not consistently. At times he has called for vouchers and distribution of state wide resources to create a statewide equitable school system but then when faced with budget problems hastily retreated from those positions. The incumbent has not been a major player in the potential development of a Tier 1 university or medical school in the Rio Grande Valley which is one of the few major metropolitan areas in the country with a population well over 1 million without these facilities.

Senator Kay Bailey Hutchison has been a strong advocate for improving school curriculum in math and science. She supported a temporary voucher program for students displaced by Hurricane Katrina to attend private schools and also vouchers for students living in Washington DC. Her record on education has been one that favors school prayer, vouchers, and education savings accounts but has consistently voted against more federal subsidies or mandates to local schools.

If either Rick Perry or Kay Bailey Hutchison wants to win the support of Texas Hispanic voters, they will need to develop a clear and concise education plan to change the status quo for Hispanic education. This commitment will need to be more then just a minor side issue, but must reflect a political will to make responsible but significant financial investments and system changes to convert a failed education system to one that makes Texas a leader in education rather then a disgrace. All Texas families need to be given choices on which schools their children will attend, school systems must involve communities and families more and be held more accountable. Finally, in situations where private schools or religious institutions or other public school districts can provide better learning opportunities at lower cost per student then a failed public school then students must given vouchers to attend these schools just as they do in Washington DC.

Thanks for reading Contempo Magazine blog which discusses issues for McAllen, the Rio Grande Valley, and America from a conservative Hispanic point of view. Tony Magaña grew up in McAllen Texas, attended Texas A&M University, served as an officer in Army Reserve, and holds a doctorate from Harvard University. The co-founder of Contempo Magazine has participated in Valley business for over 20 years. He is a member of the National Association of Hispanic Journalists and also writes for the American Daily Review. Follow him on twitter http://twitter.com/contempomagazin

Copyright 2009, Dr. Tony Magana. Some rights reserved.
To reproduce or distribute, visit: drtonymagana.icopyright.com

by Dr. Tony Magana

The rationing system Obama does not want to talk about does raise a reasonable fear in America’s elderly.

The “complete lives system” is being contemplated as the ultimate medical rationing strategy to be used by the Obama administration to deal with the scarcity of medical resources. This concept was described in minute detail by Dr. Ezekiel Emanuel in an article published in the British medical journal, Lancet, in January of this year. The priorities for receiving care would fall on younger people who have not yet lived a complete life, prognosis for recovery, saving the most lives, lottery, and “instrumental value principles”.

The most important tenet of Dr. Emanuel’s proposal is the prioritization of younger people who without the aid of society will not get a chance to complete “unfulfilled” projects. Right to life advocates would think upon hearing this, that this principle would therefore call for the cessation of abortion and improvement of prenatal care. However, a strange twist of logic is injected into the theory regarding fetuses and young infants. Because society has invested little effort and cost in children until they are adolescents, young children and infants are of little value.

On the other end of the spectrum, the elderly are considered near the end of the road whose major project accomplishments are now past. In his article, Dr. Emanuel admits the complete lives system “discriminates against older people” but says it is not an invidious discrimination because eventually, unless one dies sooner, every person will experience the same treatment.

Albeit, the most controversial aspect of the rationing plan deals with how the disabled are scored in terms of where they would would go on the priority ladder. Those with disabilities would be given a priority score that was created by a multiplier fraction and the number of productive years they have left to live. For example, a blind person’s multiplier might be 0.6 as compared to 1.0 for a person with no disabilities such that medical treatment with scarce resources for blind people would only be made available 60% of time as compared to 100% of time for the non-disabled. On other occasions, Dr. Emanuel has written the the care for those with dementia should include restrictions on the use of expensive technology because there is no possibility of future productiveness.

This week the British astronomer and physicist, Stephen Hawkins, received the Presidential Medal of Freedom. Hawkins was born with neuro-muscular dystrophy which is a progressive disease leading to almost complete paralysis. By 1974 he was unable to feed himself or get out of bed and by the 1980s had lost his ability to speak yet he has made historic contributions to our understanding of the universe and mathematics. Under the plan put forward by Dr. Emanuel, how many Hawkins will never get the chance to help society?

Dr. Emanuel concluded his paper by saying that the allocation system must be considered legitimate and the route to achieving this legitimacy should involve public discussion and revision. Yet he also said that although the rules once established could make for “procedural fairness” they could not assure “justice”.

Some on the right have compared the rationing concept and withholding of treatment put forth by Dr. Emanuel as being similar to the German Aktion T4 euthanasia program carried out under the Nazi regime. Although much of the rhetoric of that time dealt with what we now call “ethnic cleansing”, the truth is there are similarities in the wording and concepts of that terrible era and the “complete lives system”. The Germans killed off the youngest and the oldest based upon their inability to lead “useful lives”.

At the time, Dr. Emanuel wrote this piece he was the Department of Bioethics, The Clinical Center, National Institutes of Health, Bethesda which is an official arm of the federal government. Now he is also a key adviser to the President on health care issues and reform.

To be fair, he is a man clearly of almost unequaled accomplishment, dedication, and intellect into the field of medicine. He has devoted considerable effort and developed deep expertise into the realities of death and limited resources which are challenges we cannot ignore. His “complete lives system” does represent a way to attempt to quantify these difficult resource allocation decisions in a way that is reproducible and fairly dispensed but also unfortunately seems to lack a sense of humanity by defining human life so coldly.

At the time of this writing there is a lot of personal attack being directed towards Dr. Emanuel for his writings but I believe this is being misdirected. The real anger should be directed to the Obama administration for not being honest with the American people that this is very likely to be the rationing system to be used. Mr. Obama seems to be ignoring the advice that Dr. Emanuel gave that there needed to be a public discussion of this issue not a denial that it exists.

Thanks for reading Contempo Magazine blog which discusses issues for McAllen, the Rio Grande Valley, and America from a conservative Hispanic point of view. Tony Magaña grew up in McAllen Texas, attended Texas A&M University, served as an officer in Army Reserve, and holds a doctorate from Harvard University. The co-founder of Contempo Magazine has participated in Valley business for over 20 years. He is a member of the National Association of Hispanic Journalists and also writes for the American Daily Review. Follow him on twitter http://twitter.com/contempomagazin

Copyright 2009, Dr. Tony Magana. Some rights reserved.
To reproduce or distribute, visit: drtonymagana.icopyright.com

 By Dr. Tony Magana

We know a good portion of the population will take advantage of preventive services once they are adequately explained but what about those who do not? Should society put in incentives for participating in preventive care and create punitive responses for those who do not?

One of the key issues of health care reform on which most Democrats and Republicans agree is the idea of more coverage for preventive health services. The goal of encouraging patients to do things like stop smoking, change their diets, and get routine screening is from the government’s point of view a way to cut down on health expenditures and from the patient’s point of view to improve the quality of life.

Medical studies have shown that there are disparities in American society as to who currently receives preventive services. Lower income, racial minority status, and and lower education would seem obvious contributing factors to the casual observer of whether people in the United States receive preventive services. However, a study looking at poor African-Americans in both rural and urban settings found about a ninety percent compliance with preventive measures could be obtained by making patients aware of the services and having them develop a relationship with a primary care physician. Still about ten percent of the population who was at risk for developing severe complications from untreated or undiagnosed conditions did not take advantage of preventive care.

In 2005, the state of West Virginia created a special “enhanced” Medicaid program that offered more benefits than the standard program but with a hitch. Patients who enrolled in the new plan had to agree to comply with a “Health Improvement Plan” and a “Member Responsibility Agreement”. Patients are required to read materials and attend educational classes. They must keep all appointments and follow goals set to improve their health such as stopping smoking and losing weight.

West Virginia’s approach has created significant controversy since the plan’s inception. Some medical ethicists and the prestigious New England Journal of Medicine editor voiced concerns early on in the program that “children would be penalized by their parents errors” or that vulnerable patients who would be denied care. Ethicists note that putting doctors in the position of reporting non-compliant patients to the government was inappropriate while proponents noted that physicians were given great lee way in determining whether patients were compliant.

In April, now three years into the program, a research team from West Virginia University reported that only about 10% of the eligible population had taken advantage of the enhanced plan although they said they found “wide spread support for the concept of people taking personal responsibility”. One potential contributing factor to the failure to have large enrollments was that a majority  of people who did not enroll were only notified about the new program by mail many of whom it turned out had very poor reading skills.

A recent analysis by Dennis Smith at the Heritage Foundation revealed that those who did enroll in the enhanced program were often afflicted a serious chronic illness, usually smokers, and had a pessimistic attitude towards their future health. So far it is too early to tell whether the program will save a certain amount of money or dramatically improve patient outcomes over the basic plan. However, one fear that those who stayed with the basic plan would suffer more severe medical consequences with less benefits has not been realized.

Now more then ever, America is realizing that health care is a collective enterprise and no longer an individual concern. If we are asking everyone to contribute by way of taxes then is it not only fair to expect everyone to be reasonably compliant in participating in preventive services? Assuming that we should all pay more taxes initially to jump start preventive care according to the President’s plan, then should not those who are going to benefit have to contribute their compliance?

How should society deal with potentially hundreds of thousands of people benefiting from tax payer dollars but refusing to take their blood pressure medicine, check their blood sugar, exercise, or lose weight? How many times will we pay for a drug addict to go through rehab? Should persistent smokers who have had heart attacks and receiving care through the public programs not have to face some consequences?

Introducing reasonable requirements for medical compliance from people with chronic conditions for their own benefit as well as a means to control the overall medical costs of our society in my opinion would likely help garner more support for health reform. Those who wish to not participate in preventive measures certainly have the right to do so but since society can force citizens to pay for their care by taxes it should have the ability to say that coverage will be reasonably conditional on cooperation with the system.

Thanks for reading Contempo Magazine blog which discusses issues for McAllen, the Rio Grande Valley, and America from a conservative Hispanic point of view. Tony Magaña grew up in McAllen Texas, attended Texas A&M University, served as an officer in Army Reserve, and holds a doctorate from Harvard University. The co-founder of Contempo Magazine has participated in Valley business for over 20 years. He is a member of the National Association of Hispanic Journalists and also writes for the American Daily Review. Follow him on twitter http://twitter.com/contempomagazin

Copyright 2009, Dr. Tony Magana. Some rights reserved.
To reproduce or distribute, visit: drtonymagana.icopyright.com