Chapter 21: Obstacles to Improving Healthcare in Texas

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Chapter 21: Obstacles to Improving Healthcare in Texas

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Dr. Jones reflects on the poor healthcare in Texas and on factors that prevent improvement. He discusses Leonard Zwelling, MD, who writes a controversial blog about cancer issues and MD Anderson and their points of agreement expressed in a blog post. Dr. Jones talks about the negative reaction that followed. After talking about a documentary about former Texas governor, Ann Richards, Dr. Jones notes the power of the media in creating a picture of leaders at the city and state level. He goes on to affirm that "No one talks about how Texas has one of the worst health situations." He explains the factors leading to this situation. Next, Dr. Jones explains how individuals are able to protect themselves from the reality of the healthcare situation by creating "bubbles" around themselves.

Identifier

JonesLA_04_20140501_C21

Publication Date

5-1-2014

Publisher

The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The University of Texas MD Anderson Cancer Center - Beyond the Institution; Controversies; Critical Perspectives; Understanding the Institution; On Texas and Texans; Politics and Cancer/Science/Care; Cultural/Social Influences

Transcript

Tacey Ann Rosolowski, PhD:

Right. What-I mean, this is a big question, so however you feel it needs to be answered in this context. What is your assessment of where the institution and maybe institutions in Houston are with addressing that disconnect between discovery and delivery? I mean, where are they now? And then the second part of the question would be, what would you advise as the steps that need to be taken to get movement going?

Lovell A. Jones, PhD:

I wrote an editorial with Len Zwelling. I don't know if you saw that editorial.

Tacey Ann Rosolowski, PhD:

No.

Lovell A. Jones, PhD:

(laughs) Len and I got together. He writes this blog constantly, and I wrote to him and I said, "You know, we share a lot of opinions, we disagree on some, but one of the unique things is that we remain friends. And I can be very strongly opinionated on some of the things you say, yet we realize that we can agree to disagree and move forward. That's a rare trait among people who are at the levels that we're at, or even any level, but mostly at the levels we're at, because either you're my enemy because you've done this and so forth." And so we sat down and we came up with this editorial that we said, "It's going to be interesting to see if anyone will print it." And Houston Chronicle did. And the key element we said, that there should be no more deaths.

Tacey Ann Rosolowski, PhD:

There should be-

Lovell A. Jones, PhD:

No more deaths from cancer. That should be our target. And here's how we can do it. One, everyone who is eligible to be screened in Houston should be screened. We have enough hospitals to make that happen. We have enough money to make it happen. And then those who are detected with disease should be treated, whether they can pay or not pay. If you really want to make an impact, that's what you can do. And we have enough facilities to make that happen. Oh, the blowback we got was just phenomenal. (laughs)

Tacey Ann Rosolowski, PhD:

Really?

Lovell A. Jones, PhD:

Oh, yeah.

Tacey Ann Rosolowski, PhD:

What were the themes in it?

Lovell A. Jones, PhD:

"You're a socialist." (laughs) "You're going to deny care for people who have worked hard and can afford to pay," and blah, blah, blah, blah. And I'm going, "Whoa." And then the leadership here got several individuals of color to write responses to say, "No one will talk about [unclear]." (laughs) So I said, "Len, I'll let you respond to this." (laughs) So he did. He said, "Listen, I was part of senior leadership, so I know what I'm talking about. I'm not talking about someone from the outside; I'm talking about someone from the inside. Yes, if you walk through the halls of the hospital, you'll see tremendous diversity, but if you climb up to the twenty-first floor, it stops. And those are the decision-makers." I'll send you a copy of it.

Tacey Ann Rosolowski, PhD:

Yeah, do.

Lovell A. Jones, PhD:

So, yeah, I've heard from a couple of people outside of Houston who said, "What's your next step? This is a brilliant idea." And I said, "It's a brilliant idea for every place other than Houston, or maybe even Texas." And at the time I had not seen the documentary on Ann Richards, but I saw it over the weekend, and I said, you know, if someone doesn't take a step to try and change it, then it's not going to happen, with the idea you may be blocked at the pass, but still making the attempt. And the reason I said that, the documentary, if you haven't seen it, was phenomenal on her. They had both her opponents and people supportive on it. But the one thing all of them agreed at the end is that-and that was my-I do a ten-minute radio spot on Wednesdays, "State of Minority Health in Houston," and I said to them the media has a strong bearing on our perceptions of what's right and what's wrong. And Ann Richards, even though in the four years she was governor, unemployment went down significantly, prison incarceration went down, crime went down, the economy went up, the media painted her as soft on crime, possibly a lesbian, an alcoholic, and the state was in the worse shape it could ever be in, and she lost, when none of those were true, not one iota. And no one got up to say the guy who was elected was elected on lies. So in Houston, that same sort of scenario takes place. No one talks about that we have one of the worst health situations in the country. Why? Because we don't want to discourage employers from coming in. But once they get here, they get into a situation. They can't pull out, but they get into a situation where they realize there are problems, and they have to turn their attention to addressing those problems, when they probably could have taken some of those resources to hire more people and expand the economy. They have to take some of those to address the problems that they didn't realize were happening. None of the officials who ran, neither Annise Parker or her opponent, Ben Hall, talked about health [unclear]. It was like, "This is a beautiful city," blah, blah, blah, blah. "Keep it this way." We have the largest medical complex in the world. We should not have one of the worst health rates in the world, at least in the United States. I mean, you look at Steven Kleinberg's [phonetic] report that he puts out every year, he talks about it. The idea that the mortality rate from breast cancer in African American women went up 30 percent in the last four years in terms of the gap between blacks and whites, that shouldn't happen. But no one's talking about it. It's like it doesn't exist. And so people shape their reality, and if they keep telling themselves it's not a problem, then it's not a problem. And if it's a problem for people you don't come in contact with often, I'm in my bubble and I can hobnob with whoever and not my problem. So that's where we are right now.

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