Author Archives: waterlooatx

In 1993, I was the medical director for the first health plan to provide a managed care model for the Texas Medicaid population.  This program started in Travis County and included management of the limited mental health services covered by Medicaid through an HMO network model.  Within the first few months of the program, I was madeContinue reading “Homelessness in Austin Part 4 – Substance addiction and rehabilitation”

On May 1, 2021, residents of the City of Austin voted to reinstate and expand an ordinance banning camping, loitering and panhandling in specific areas of Austin, and at certain times.  Opponents of the ordinance have argued that it will not end homelessness in Austin.  This is true.  Until we address the root causes of homelessness, the numberContinue reading “Homelessness in Austin Part 3 – Mental Illness and Chronic Homelessness”

Any city, and particularly a large and growing city, needs to acquire land and other property for city services and operations.  Most of these properties operate for the benefit of the citizens of the city, and they are often a good deal for taxpayers.  The City of Austin is no different.  But the City of Austin also ownsContinue reading “I am an Austin Taxpayer – and I own what?”

From the mid-1990s to the second decade of the 21st century, violent and property crimes decreased significantly in the United States.  Austin enjoyed the same decrease in crime rates for the most part, until the last few years.  Now the violent crime rate in Austin is higher than the national average (although still low for metropolitan areas), andContinue reading “Crime and Punishment in Austin and Travis County – a roadmap for reform”

On May 1st, 2021 Austinites will vote on a new ordinance to roll back the ordinance that replaced the ordinance that replaced the ordinance banning camping on public property without a permit.  The special election item, Proposition B, will be on the ballot as the result of a petition signed by over 26,000 Austin residents andContinue reading “Homelessness in Downtown Austin Part 2 – Why you should vote YES on Proposition B on May 1, 2021”

Updated 3.10.2021 One of my first posts was What to do in a pandemic? At the time I posted in October, we were about 7 months into the Covid-19 pandemic, and things were a mess. I got most things right, and we have some clarity about some other things. I also got some things wrong.Continue reading “What to do in a pandemic – what I got right and what I got wrong”

The biopharmaceutical industry spends about $150 billion dollars on research and development every year, more than 15% of their annual revenue.  Only a few high-tech companies put more money into research and development than the biopharmaceutical industry.  This investment has resulted in an impressive number of new drugs approved in the last 10 years, including 53 approvedContinue reading “Biopharmaceutical Manufacturer Research and Development – Is this why we pay so much for prescription drugs?”

We are in the third month of vaccine administration for the Covid-19 pandemic, and everyone continues to scramble for their spot in the vaccination queue.  Texas ranks 48th among the states in the per capita vaccination statistic, despite receiving lots of vaccine.  I am over 65, and can’t find anyplace to get a vaccination anywhere nearby.  I know someContinue reading “Pandemic update 3: What do we do the next time?”

I originally wrote this post in February 2021, just a few months after voters approved a 22% property tax increase to pay for Project Connect. Later in 2021 news outlets reported that the projected price of Project Connect had increased from $7.1 billion to over $10 billion. Then last month, August 2022, officials from CapMetroContinue reading “Project Connect. Where are we going?”

I have said that I believe that prescription drugs are the best value in healthcare.  I believe this is still the case, but the rise in the cost of prescription drugs recently has put that value proposition at risk. In the article “A Primer on the Cost of Prescription Drugs” I laid out some of theContinue reading “A proposal to control prescription drug costs”