Molly Ivins July 13

AUSTIN — Poor Reyn Archer, Texas' new commissioner of health, is already stuck with "controversial." Well, yes, it is his fault — or, more precisely, his record — but much of that was long ago and far away. People do change and grow, and there's considerable evidence that Dr. Archer has. Besides which, his public-health specialty is tuberculosis, and with the new, stronger TB strain now endemic in South Texas, we need all the help we can get.

Archer's "controversial" past stems from his stint as point man on family planning during the Bush administration. He was and is staunchly pro-life, but in those days, he also opposed the legalization of contraception and enforced the Reagan-era "gag rule" (a policy later dropped that forbade anyone other than doctors from discussing abortion with pregnant women at tax-supported clinics). He also made some fairly daffy statements about women (he once said that when he was in private practice, "if they did not bend to my will, I would tell them to go elsewhere"), on which he has since corrected himself.

You can tell by talking to Archer that one reason he has gotten himself into hot water over the years is that he doesn't express himself terribly well. Don't get me wrong: Compared to Gib Lewis and some other noted manglers of the Mother Tongue, the man is a model of clarity. But just as a minor example, he said, "I desperately believe everybody needs to be part of this dialogue."

He probably meant fervently rather than desperately, but at least his meaning is clear, which is more than we can say for many members of the Lege. His 1992 boner, "The American people don't think family planning should be used as a method of birth control," was just a slip of the tongue: He meant to say abortion, not family planning, but you can understand that family-planning folks were upset and confused.

"There was a lot of polarization in the community on both sides, and I sort of got into the middle of that," said Archer. In truth, Archer contributed generously to the polarization, but that's an old story. He has spent the past six years working on public health with Project HOPE, with an emphasis on TB.

Although his own medical specialty is obstetrics-gynecology and he does not actually have a public-health certification, his experience is probably worth as much as formal certification.

He also spent 18 months in Kazakhstan. "Making a pittance and living among those who had very little restored me as a human being." He is capable of making it sound as though he thinks poverty is an ennobling experience, but I suspect if he were a trifle more articulate, his real meaning would be clear — that because someone is poor does not mean he or she is morally inferior.

Reyn Archer's whole moniker is William Reynolds Archer III, and, yes, he is the son of the Houston congressman who is head of the House Appropriations Committee and the guy most in charge of where government money goes. What's more, Archer and his dear old daddy often discuss medical policy. Hey, it can't hurt.

Since the thinnest part of our health-care system is in the Valley, where community clinics are often the only health-care available, Archer could, like, maybe talk to his dad about why cutting funding for those clinics is a bad idea. He said, "Even at the national level, there is concern about transition funding for those clinics."

Reyn Archer wants to set up cooperative programs with the Mexican government at the state and federal levels to track TB cases to make sure people with the disease complete their treatment. Since a large portion of that population washes back and forth across the border, there's no use trying to get control of the disease by working on just one side. Archer says it is not an epidemic, although there are very high rates — for example, 50 per 100,000 in Zapata County. There aren't many people in Zapata to begin with, so we're not talking about a lot of cases. And, he notes, part of dealing with TB is providing adequate nutrition for families since the disease will reappear if a former patient's general level of health falls low enough.

Like many a good Republican, he's a firm believer in local community involvement and control rather than a top-down approach. But he's evidently serious as a stroke about letting everyone in on the debates over health-care policy — family planners welcome. Archer has the unhappy chore of succeeding the widely respected Dr. David Smith — a new job is always easier if your predecessor was a turkey. But based on his attitude and the ideas we've heard so far, I'd say there's no reason to panic about the guy: He just might work out very well.

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Molly Ivins is a columnist for the Fort Worth Star-Telegram.

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