Interview with Ann Kitchen State Representative, District 48, State of Texas

State Representatives: An Overview

AO/Beck: Good Morning Representative Kitchen, it is truly an honor to spend a little time with you this morning. I had the good fortune of meeting you in Austin for the Texas Academy of Audiology meeting, and I thank you for spending a little time with me today.

Kitchen: Thank you Dr. Beck, it's a pleasure to visit with you and with everyone from Audiology Online.

AO/Beck: I must plead governmental ignorance. I recall learning about the state and federal governments way back in elementary and high school, but I really do not understand who's who or what's what. As we'e in Texas, let's start with - how many districts are there in the state of Texas?

Kitchen: In Texas, there are 150 House districts. Each district has it's own elected representative in the Texas House of Representatives, and they are elected every two years.

AO/Beck: And then there's the senate too?

Kitchen: Yes, the Texas Senate has 31 senators and they are elected every four years.

AO/Beck: So we have 181 elected state officials in the house and the senate?

Kitchen: Yes, plus the governor and the lieutenant governor who presides over the State Senate. The House also elects a Speaker who presides over the House of Representatives. The Governor, Lieutenant Governor, and Speaker are referred to as the Leadership .

AO/Beck: In terms of the committee structure, what are the differences between the state and federal governments?

Kitchen: Great question. There is at least one significant difference. In Washington, the committees are more partisan. In other words, the political party with the most representatives appoints the committee chairpeople and majority whip, who are obviously very influential in the decision making processes.

The degree to which partisan politics controls the committee structure is different in each state. Texas has traditionally operated in a nonpartisan manner - because the Speaker has appointed Committee Chairs from both parties and balanced the membership of committees. In Texas, the Speaker of the House appoints the committee chairs and the members of the committees in the house. The Lieutenant Governor appoints the Senate committee chairs and committee members.

AO/Beck: How many committees are you on at this time?

Kitchen: In the Texas House, every representative serves on two committees.

AO/Beck: And am I correct that the position representative is actually pretty much a part-time job?

Kitchen: Yes. The positions are part-time, and representatives are paid about $7000 dollars per year. Texans consider legislators to be citizen legislators, and in many respects, people serve because they are interested and they want to participate in the government as citizens. So, as you would expect, the vast majority of the legislators have regular jobs too.

AO/Beck: Are most of the legislators attorneys?

Kitchen: No, not really. There is a pretty healthy mix of business people, attorneys, retired folks, and several medical professionals - including a pharmacist and a doctor. But again, because the salary is so low, legislators have to have another way to make a living because they simply cannot survive financially on the paycheck they receive from the state. During the session, which is every other year, it's nearly impossible to actually have a regular job. We meet from January through May, every two years, and while we're in session, our work occupies the entire day, and many late nights too.

AO/Beck: How many bills are filed and acted on per session?

Kitchen: In the last session, there were approximately 6000 bills filed and we passed about 1000 bills.

AO/Beck: So what happens to the other 5000?

Kitchen: Bills die if they aren't passed. Legislators can file bills again during the next session and start the whole process over again. It is not uncommon for a bill to take more than one session to pass.

AO/Beck: How can you possibly stay on top of 6000 documents and the supporting paperwork, arguments and issues?

Kitchen: I can't - except, of course, the bills I am sponsoring. So, I have staff and procedures to help me sort through the maze and prioritize which bills to focus on. Because the time is so short and the volume is so high, the participation of health care professionals and associations is critically important to the decision making process. Often the practical impact of a particular bill may not be apparent - I rely on the health care professionals in my community to help me understand how bills really effect the work that they do. My job is to represent my constituents. So the more feedback I get from them, the better I am able to represent them.

AO/Beck: I suppose you must spend an awful lot of time on healthcare issues?

Kitchen: Absolutely. The big issues right now are prompt payment of claims to health care professionals, the high costs of prescription drugs, and of course, the availability of affordable health insurance via the workplace - for example, for small business owners. I sponsored several bills this past session to help address these issues - including co-authoring HB 1862, a prompt pay bill which ultimately was vetoed.

AO/Beck: I have to think funding these programs is a nightmare. I'm looking at some numbers in the November 2001 SmartMoney magazine. They say there are currently 70 million people in the USA who are eligible to receive benefits and services through the VA. They also point out there are 46 million people eligible to receive Social Security. I don't have the numbers for Medicare and Medicaid in front of me, but I know they are staggering.

Kitchen: Yes, well healthcare financing is a perennial problem, and we really don't have a great solution for either the high cost of care or for access to health insurance. The issue becomes how do you help those who cannot afford or don't have access to health insurance? One reason this is critically important is that prevention is much less expensive than treatment. For example, if people have access to preventive care and screening exams early on, we can save significant treatment money on the back end.

AO/Beck: I guess I'll go out on a limb here and agree with the concept, but I wonder if there are outcomes-based studies showing preventive programs really do work. In other words, with all the money and effort that have gone into educating youngsters about sex, drugs and alcohol, can we really say that abortion, drug abuse, smoking or alcoholism rates are down? I personally don't know the answer, but it appears to me that best intentions and millions of dollars spent have had little fruition regarding long term savings. I don't mean to say we shouldn't try to prevent problems, but I doubt that the government can effectively solve these issues. I think these are probably issues that have to be solved in the home. Having said that, perhaps we can re-visit the ideas of the governments' involvement in healthcare at our next meeting?

Kitchen: Of course some issues have to be addressed in the home and just throwing money at a problem does not solve it. But experience has shown that access to health insurance does make a difference. I would really enjoy discussing these issues with you further - I'll look forward to it.

AO/Beck: Thanks again Representative Kitchen. I have really enjoyed speaking with you. Let's get together again in the spring if your schedule permits that.

Kitchen: Thank you, too, Dr. Beck. I'll look forward to continuing our discussion then.