And … they’re off! The races for political office this year include selecting the individual who will represent District 5 in the U.S. House of Representatives. Our district includes parts of four counties and, in Dallas, the Fifth takes in Oak Lawn, Turtle Creek, Old East Dallas, Lakewood, the M Streets, White Rock Lake neighborhoods, Lake Highlands, Casa Linda, Casa View, Northeast Dallas, Far East Dallas and Buckner Terrace.

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Pete Sessions is the current office holder. He lives here with his wife, Juanita, and two sons. Born in Waco, Sessions received his BA from Southwestern University in 1978. His professional experience includes serving as vice president for Public Policy at the National Center for Policy Analysis and as district manager for Southwestern Bell. Sessions was first elected to Congress in 1996.

 

His opponent, Regina Montoya Coggins, a local television commentator and former White House Aide, grew up in Albuquerque and relocated to Texas after high school. Montoya graduated from Wellesley College and later Harvard Law School. She is married to Paul Coggins, a novelist and currently the U.S. Attorney for the Northern District of Texas. The two settled in Dallas, and have a 13-year-old daughter.

 

For this year’s “Advocate Interview” — a largely unedited discussion with local newsmakers — we invited Sessions and Montoya Coggins to our offices to debate some of the issues affecting our community. In a departure from previous years, we will run the discussion in two parts. This month: healthcare and local environmental issues.

 

 

 

ADVOCATE: We thought we would start off with some healthcare questions because that seems to get people fired up these days. Just as a general broad idea for starters, it seems to me that everybody, whether they’re a patient, doctor or insurance carrier, is complaining about the way the healthcare system is set up these days.

 

What do you think the problem is, and what do you think the government should be doing about it — if anything?

 

 

 

SESSIONS: The healthcare system has been, for quite some time, not only a problem to physicians and insurers and patients and family members, but it has been in transition. And during transitions, many times things occur without the patients knowledge, without the doctors agreement, without the insurers completely playing along. Marketplace changes often do this; back in 1993, President & Mrs. Clinton recognized that same phenomenon was occurring and they injected themselves, mostly Mrs. Clinton, into a government-run healthcare system that was the essence of the President’s and Mrs. Clinton’s policy to have the government control and run and make decisions for healthcare. That was without a vote occurring, that was soundly rejected by the American public.

 

Since that time there have been a number of proposals, Republican and Democrat proposals, on ways to address the problems of healthcare without having a government-run system. That enunciated itself into several different plans — the Democrat plan, the Republican plan and then some others that are individual as opposed to the leadership plans. The Patient’s Bill of Rights, which was not the first but probably first big comprehensive plan, was put together and designed and developed by some Democrats and some Republicans — mostly physicians who were Republicans participated from our side. I participated in that endeavor with an eye towards trying to insure that the marketplace, the consumer and the doctors would be carefully protected. What occurred in this endeavor became known as the Norwood Dingell Bill. And what happened is that provisions related to lawsuits became the focus instead of the healthcare aspect and so that healthcare bill, which I voted for, has matured in several ways for the marketplace. It was not taken up by the Senate, the President had no action on it, but it caused some changes in the marketplace that today has some of the largest insurance companies re-evaluating their gatekeeping operations, another word for it is a second opinion. Literally a second opinion or an agreement by the healthcare provider (has been required before) they will give coverage. Leading healthcare providers today such as Aetna and others are dropping these second opinions, or gatekeeper options, and going directly to the wisdom of the doctor, and this is the direction that we want to go to.

 

We, I do, want to have a system that is the same or similar to the State of Texas where a person, when they go to their physician, if the physician makes a medical evaluation, then that medical evaluation would be (made) known to the insurance company. And if the insurance company disagreed with what the patient and the physician had agreed upon, then those changes would then go to what would be called an internal resolution process — an internal review where the insurance company would have a chance to re-evaluate and then make a decision. If internally they decided they were going to sustain their position, then there would be what’s called an external review. A professional panel of experts and physicians would look at the case, and make the decision based upon medical factors. These time frames are very short and they deal with emergency surgeries, they deal with long-term care, and what we’re doing is placing the decision process in the hands of medical professionals.

 

What we are finding in Texas as a result is about half the time insurance companies win this evaluation and about half the time the physician does. What I’m attempting to do, again still now working on the inside of my party in the healthcare bill, is to insure that we go through an internal and external review that is controlled by the physician, the patient’s physician. We would be going through this internal and external review, then allowing for recourse on the part of a patient — meaning by a lawsuit, if necessary. But I believe that it’s important for us not to, as Norwood Dingell does today, allow a lawsuit at any point during this process, meaning from the time the person walks in to (see the) doctor even up until the first internal review. I believe we’ve got to follow a process that would be clear from the threat of lawsuit and let the doctors call the shots.

 

This, unfortunately, is where healthcare has turned to — the lawsuit angle of who’s going to sue in order to achieve something, and I believe we’ve got to put the money directly back into healthcare.

 

 

 

MONTOYA-COGGINS: Pete is talking about another “process.” I’ve traveled extensively throughout this congressional district talking to people who’ve told me that they’re not being able to make their decisions as patients with their doctors. What is happening is, as has just been articulated, is another one of those systems where the bureaucrats, the insurance bureaucrats, make the decisions. (They) have so many opportunities to come back and not work with the patient, and you just heard a very extended process.

 

Think about your own lives, think if you had a situation where you had stomach problems or you had a problem where you don’t feel your heart is working the way it should, and you feel you need a certain kind of procedure and your doctor agrees with you — you’re the patient. What then happens if the insurance company disagrees? We go through the process Pete has just outlined. That is why we have to have the kind of change that we need to have in the Fifth Congressional District.

 

Too many people have come to me and have said, “Regina, we’ve got problems now with the high cost of prescription drugs.” A man in Fairfield who told me this very story: I’m afraid to retire right now because I don’t know where Social Security is, and I don’t know how I am going to be able to pay for the medication that keeps my wife and me living and having a good lifestyle? And this is the kind of response that they’re hearing — a large protracted kind of bureaucratic mess that goes on and on. How many different, I think we could almost call them toll booths, do you go to and someone says: Well, you need to go to another? How long have all of us been through bureaucracy knowing they say it’s going to be a short period of time, but in reality it will be days and days. If you have that stomach problem, maybe it’s some sort of a terrible form of cancer, what will days and days mean to you? It could mean your death.

 

 

 

ADVOCATE: How do you inject more responsiveness into the healthcare system without getting the government further involved, or is that okay? In terms of prescription drugs for example how you keep the cost down without government control?

 

 

 

MONTOYA-COGGINS: Sure, one thing that I would do immediately is make sure that Medicare covers the prescription drug — that’s the problem right now. We have so many middle-class Americans who are having to decide on a daily basis: do I take this pill or this regimen of pills? Remember, 80 percent of Americans, of elderly Americans over 65, are taking at least one prescription drug a day. Let’s include that in Medicare, it should have been included in the beginning. But, instead we are talking about the bureaucratic kinds of tollbooths that we just heard about. Well, let’s talk about the Prescription Drug Fairness Act, Why hasn’t that been passed, a real patient’s Bill of Rights? We need to get the decision making back to the patient and to the doctor, not to insurance bureaucrats.

 

 

 

SESSIONS: The opportunity that we have to discuss this is interesting. The fact of the matter is even among Democrats there’s not anywhere near a consensus. As a matter of fact, the Democrat Party is split into probably two major pieces where they cannot decide the correct way to do it. Just this week the Democrats have now dropped their provisions in the Leadership Bill that would talk about price fixing in essence or price controls that would take place. They have recognized that not only will that not work, but that it is going to cause huge problems with numbers of their members to vote on it, and it is a plan that could not pass. Price controls don’t work in Cuba, they don’t work in Russia, and they don’t work in the United States. Besides that, the Democratic Party could not get enough votes to do that. So the things that my opponent is talking about have no sense of reality. Sure we could’ve, should’ve, would’ve, done a lot of these things, but the votes do not exist even within the minority Democratic Party.

 

 

 

MONTOYA-COGGINS: The difference between the two of us is that I can’t look at the person who is 67 years old, having stomach problems, and say: well we couldn’t agree something in Washington so you deal with your problem. That’s the difference between our approach. I am a consensus builder, I am someone who can sit around a table like this and be able to bring people together, be able to bring that consensus, ’cause I’m fighting for the people of the Fifth Congressional District. I am not into this kind of partisan politics that we are talking about. I am into trying to resolve and come up with a solution for the people who are coming to me and saying:  Regina, we’ve got to do something about this high cost of prescription drugs.

 

I know that, my friends, for example, they’ll tell me: I know my friends who somehow have a program like a HMO that gets those reduced prices for them and yet I have to pay 20 percent more for my medication. Or there’s people who say: I can go to Mexico and Canada and get the same prescription drug cheaper. How can that be? I can’t look that person in the eye and say: well, because they can’t agree in Washington and there’s no consensus. Let’s make the consensus. Let’s be leaders in the Fifth Congressional District, not followers.

 

 

 

SESSIONS: Well, the leading takes place with putting not only in a priority matter, but also doing the right thing. For instance, we know that two-thirds of seniors are covered under a plan today to receive help in buying their prescription drugs. So essentially we have one-third of the people who are uncovered. Those are the people we should start with first. We should go to those people and help those that are in most need first, rather than a comprehensive plan for everyone. We need to aim at the problem.

 

Second thing: I openly believe that we should have parameters of keeping a balanced budget. It would be easy to say: let’s just spend as much money as it takes to solve the problem. The fact of the matter is that the government running this system would not be the right thing. Voters are going to see in the next few months we are going to play out the prescription drug plan that the Republican Party, the majority party, will have, which will involve a 40 billion dollar proposal to do things similar to Medigap where private insurers — the private marketplace — insures that these drugs are safe and available; it will be a great plan. And we will also pass a Patient’s Bill of Rights that will include keeping health insurers to where they want to provide coverage, where employers want to provide that, and a process that is good and fair for everyone. The essence of it is: as parents with children, we want to make sure that if our children are supposed to be have tubes in their ears, if that’s what the doctor says, that’s what we ought to have. If we have parents who are older and need the most leading edge chemotherapy treatment we want to make sure that whatever this country can produce as leading edge and available, not experimental, is available to everybody. I believe that our plan will not only do that but will enrich America’s healthcare system, which is the greatest in the world because we let the marketplace make the decisions and we have the opportunity to let the doctors use their trade and their tools of ethic.

 

 

 

MONTOYA-COGGINS: Now let’s go back to that 40 billion dollars Pete is talking about. This will be covering those people earning less than $15,000 a year, and talks about the other one-third that have the Medigap insurance and other forms of insurance. I go back to the people in the Fifth who tell me that Medigap insurance is very expensive on fixed incomes — these are people who are earning $15,000, $16,000  and maybe up to $50,000, the middle-class of America. These are the people who are saying we are the ones caught in the big squeeze right now because we can’t be able to continue paying for this Medigap coverage. which sometimes does not cover all these wonderful kinds of treatments or the kind of chemotherapy Pete is talking about.

 

That’s the problem and the issue. We have to come up with a program that addresses the issue of the 50 percent — it’s not just a third.  There are those people who can’t afford who might be covered by this, but it’s the other group as well that gets it up to almost 50  percent. Those are the kinds of numbers we are talking about when we say we’re having a situation with prescription drugs coverage and the lack thereof for these people. That’s what we have to talk about. And, the patient’s bill of rights — it’s interesting to see some of these people who are now advocating some these measures when they haven’t in the past, and it’s now time that we say: let’s get this patient’s bill of rights, a real one, passed for the people of the Fifth.

 

 

 

ADVOCATE: One more quick question about healthcare before moving on to another topic. Am I hearing that you’re not necessarily disagreeing about where you should end up?

 

 

 

MONTOYA-COGGINS: His is not nearly comprehensive enough — he is leaving the middle class members of the Fifth Congressional District without the kind of adequate coverage that they need. I’m glad that we are having a little Band-Aid approach, but I am saying that the problem is so big right now a Band-Aid doesn’t work anymore. And it’s time that we had the leadership on this issue.

 

 

 

SESSIONS: Now you’re talking about prescription drug coverage.

 

 

 

MONTOYA-COGGINS: I’m talking about all the issues, Pete.

 

 

 

SESSIONS: Now you know that the healthcare plan does not … it’s not just designed for one group of people. There is nothing in the healthcare plan that would say it’s for one-third, and for you to suggest that I am working on something that is not comprehensive — it’s just simply not true.

 

 

 

MONTOYA-COGGINS: Pete when you were mentioning about the problems of this one-third, that is what you are focusing on and you said we have to start somewhere. You don’t have a comprehensive plan.

 

 

 

SESSIONS: That is prescription drug coverage, Regina, not healthcare coverage. That’s prescription drug coverage.

 

 

 

MONTOYA-COGGINS: And I’m saying to you Pete that is just the tip of the iceberg. We could go through every single aspect where people are not getting the kind of coverage that they need. You began this whole discussion today talking about how we can have more bureaucracy. How we can insert more places where people have to have decisions made by a bureaucrat in Connecticut? That’s what I heard you say and that’s what I’m hearing people in the Fifth Congressional District say you’re doing to them.

 

 

 

SESSIONS: Absolutely not. It is a quick process that works in Texas today and you know that.

 

 

 

MONTOYA-COGGINS: Pete when we’ve got people who have life threatening kinds of diseases who are trying to say to me … I can’t look them in the eye and say: don’t worry about this process we’ll be able to get it done very quickly for you, and we’ll take care of you. Let them work with their doctors immediately.

 

 

 

SESSIONS: This process, by in large, is working very well in Texas and I am proud of what’s happening and I believe our healthcare plans can be very very successful.

 

 

 

MONTOYA-COGGINS: Pete you’re out of touch with the Fifth Congressional District if you think that.

 

 

 

ADVOCATE: Let’s move on to another topic. We’ve got that one pretty well surrounded. Also a potentially health related issue: We are really under the gun in Dallas right now because of our ozone levels  and we’ve got to come into compliance or we’re going to lose highway funding — maybe even have the federal government step in and impose controls that most people in Dallas don’t want. Do you regard the ozone levels as a public health risk and what kind of air cleanup plan in Dallas do you favor?

 

 

 

SESSIONS: As an elected official representing Dallas County and other counties, we tend to work not only with EPA but also other local officials who have been empowered and are responsible. There’s a 12- or 14- member county board that is responsible for making sure that regional mobility plans are worked on. We direct money coming out of Washington; Eddie Bernice Johnson, Martin Frost, Dick Army, Ralph Hall, Max Sandlin, Kaye Granger and I are a part of not only this decision making but working with the mobility task force.

 

Primarily what we try to do is make it easier and better for transportation up to including the widening of 75. making that better, and the light rail that is taking place. We’ve worked extensively on extending these quarters further out north and west, north and east. We are going to continue doing those things that make transportation easier and better.

 

There are a lot of factors that come into play (with air quality measurements). Just two years ago we had huge fires in Mexico directly as a result of the drought that played significant impact on the number of days, over 28 days, we were impacted by this haze. It counted against us. I think that’s unfair. I don’t think that was a reality of something we contributed to. I think there are people who recognize that if you are doing everything possible, up to and including public transportation and light-rail, that you’re going to make your circumstances better.

 

Dallas is a growth area. As a growth area we have a lot of people who are moving here who are coming into conflict with needing to use transportation and vehicles. This is something that has been widely discussed. I am working with … I think we have a bi-partisan understanding about how this is going to be accomplished.

 

There’s an issue, MTBE, which is this gasoline additive, that is certainly a big national issue. I believe the administration is addressing that. They understand the parameters related to that. It may be that through technology and time, we go directly to ethanol as the answer instead of MTBE. But just for us to suggest there is a magic bullet to solve this problem, in fact, is not truthful. So it will take us continuing to work together. I am very concerned about the air and water and soil we have, and will continue to work with the experts in these areas. I believe this is one thing members of Congress work very well on together, and we have same or similar ideas, not only about what the problem is, but what the solution is. Likewise this being worked on very effectively with all these county judges and regional mobility task forces.

 

 

 

MONTOYA-COGGINS: It is definitely a problem for our area to know that we may have haze coming from different areas … but again I guess as a mother I hear from too many of my friends who have children who have asthma. It is a real problem for them particularly in the summertime. Just before this interview began we even talked about some of the little haze that we see up going north. Something that from this vantage point, eight stories up, you can already see the problem.

 

So we can criticize other countries for the problems that they have had and how they have effected us. It’s time for us now to say we have to come up with a comprehensive plan that protects our children that deals with these health issues. It is well and good now that we’re hearing there are some plans that Pete is talking about. He has, in the past, talked about abolishing the EPA and not having that kind of real comprehensive (agency for) our environment. But I’m here to tell you that when we talk about our environment, it has to be comprehensive.

 

We also have to include monies for the urban parks that we have as well. These are all health issues, safety issues, people are saying to themselves: we’ve got to create that kind of environment where our children will be able to breathe the air, be able to drink the water — and not have a situation where it’s a little bit too late because we are arguing about other things that we should have been dealing with a long time ago. This will be a priority for me if elected to Congress.

 

 

 

SESSIONS: I would like to go back — my opponent has said I criticized another country, but in fact I did not say that. I said that as a result of the drought that occurred in Mexico … . I don’t think it does any good to criticize anybody related to drought areas or circumstances that happened as a result of drought. But, I think that it is a reality that we are dealing with some weather patterns — that the drought sometimes in Mexico, New Mexico, Texas and Oklahoma do have an impact on the type of conditions that we see in Dallas.

 

 

 

MONTOYA-COGGINS: Then we should deal with the weather patterns and we should come up with a comprehensive plan instead of saying:  oh it’s a problem with this occurring, we’ll kind of deal with it,  maybe we’ll come up with a plan. Let’s figure out something right now and let’s do something comprehensive. Let’s increase the monies for urban parks. Let’s make sure that we have the funding for DART. Those are the priorities that we have to be talking about.

 

 

 

SESSIONS: Well, let me then remind my opponent that there are lots of parks that are under way that are being funded right now,  including the Trinity River corridor. I think we get the correct amount in Dallas in funds as compared to other cities’ transportation dollars. Have you solved this thing? You talk about doing something — what do we do?

 

 

 

MONTOYA-COGGINS: I would have voted for the urban parks initiative, that you voted against, to make sure that we have those funds. I’m glad that the leadership in our district has done that for us. We needed the other kind of leadership helping us.

 

 

 

SESSIONS: As you well understand, the money goes well outside of Texas. To get the designation for Dallas, Texas, which is what I’ve done — that way it comes home here as opposed to going to New York or somewhere else.

 

 

 

MONTOYA-COGGINS: Well if you’re not voting for it, how can it come here? I will make sure that I fight for the Fifth Congressional District.

 

 

 

ADVOCATE: It’s an isolated issue, and Pete brought it up, about MTBE. Neither of you have actually said whether or not you would continue to use it, or whether you believe that we should stop using it.

 

 

 

SESSIONS: Well, this was a program that was begun as a result of what they believe is the right thing to do. I’m not attacking anybody. We’ve now found that there are some problems with its use as a result of where it comes out of exhaust and where it settles in water. We found out that there are some tanks that leak this additive. This was something that was handled entirely by EPA, and EPA has re-evaluated, as they would do properly. They have now made a determination after pushing California and forcing California and prodding California — they’ve backed off and said now there’s a two-year process that they’re going to start not to have the additive in the gasoline. But that was something that was entirely done by EPA and EPA has now done the proper evaluations to find out what its impact is.

 

 

 

MONTOYA-COGGINS: If this is such a big issue in California then it’s a big issue in Texas. And, we should have had the discussions with the EPA on how then we can eliminate that if it is the case that it is creating the kinds of problems that have been in California here in Texas as well. What I will pledge is that I will have the town hall meeting and I will pledge that I will have the kinds of regional meetings with the EPA to discuss those very issues. And, it will be a priority item for me because I’ve had too many people say to me: my child has asthma and can’t breathe. I cannot allow kids to have to wear gas masks in the summertime in Dallas because the environment isn’t one they feel safe in — or are safe in. That’s my pledge.

 

 

 

ADVOCATE: I’m just sitting here as a regular person. I look out window here and see that the air is bad, and I have friends that are worried about asthma and all that, but I’m really trying to get back to this: How hard is it really to get something done, or even just talked about, when you’re one person out of 435?

 

 

 

SESSIONS: Well, first of all it was a consent decree in the first place. It was thought to be an answer and in fact it is an answer. MTBE by the substance does help. But once it then filters out as a result of the use by millions of cars and then finds itself in a chemical compound that finds itself in water, well, it turns out that it wasn’t such a great idea after all. What they had in the lab and what they tried to do I think worked. I am not trying to defend the administration. I’m trying to defend people who genuinely believed, based upon what they had done, that they were doing the right thing. Now that we, only recently — and this is in the last two months — that Secretary Browner, who I am not defending but I am not attacking, went to California with new studies. It takes some time before you see what it is. We have re-formulated gas here in Dallas. We are under, theoretically, the same process that occurs in California where they’re seeing where it goes in the water. It was a consent decree, it was an agreement, it was a great idea, it was based upon some bit of agreement between the industry and between the State of California about how they would go about attacking their problem. The fact of the matter is that it is not working out as well as we want. It’s not a matter of one, or 10 or even 435 members of Congress to decide this. It is a matter for us to decide what the scientist can come up with.

 

There is now a plan to back this out. But without the MTBE you have more pollution. So it’s not like do away with MTBE, it is a matter now of transmitting and transforming. I believe the answer is ethanol, and taking the MTBE out and coming up with a process to put ethanol in our gasoline. It just takes some period of time to do that. I don’t think there is a delay at all. I think it’s a process of getting plants on line, of getting the major oil companies to begin this process. But I think they’ve realized that we better go steady with ethanol also in a larger laboratory environment — I think that’s the sense. It’s not a matter to just take MTBE out or add ethanol, it’s a matter of: let’s see how this works. And the leading scientists that we have not, only in industry but also the EPA, are saying that they need time.

 

 

 

MONTOYA-COGGINS: That’s the difference between the two of us.  Pete will just say: let’s throw our hands up and say we’ll take care of it. And I would say: why didn’t we have Secretary Browner here in Dallas? We know we have these kinds of issues — why aren’t we having that kind of high level discussion about a high level problem?  It’s not them, it’s not “they” that fix it, it’s us in the Fifth Congressional District. We can take care of these issues if we choose to lead on something — that’s the difference.

 

I come from a business background, that is where I’ve had my experience, and I’ve been the head of a non-profit in this city and in this nation as well. And when you have a problem like this you don’t just wait for someone else to resolve it for you. To say: we’ll take care of it for you. We are at that point where we have to take care of it for ourselves, it’s for our children.

 

 

 

Next month: Sessions and Montoya Coggins discuss public education, and tell our readers a little about their families and views on other issues.