Runaway Diffusion: Institutional Capture in Texas

In this episode, we speak with Joe Figliolia, author of the Manhattan Institute’s new report on institutional capture inside the Texas Medical Association, and Dr. Lisa Ehrlich, who has seen that reality up close. We revisit the AAP’s 2018 Rafferty policy, walk through Texas SB 14, and note the latest news of a Texas doctor losing her license under the new law. From Ignaz Semmelweis to the mechanics of trade guilds, 501(c)(6)s, and runaway diffusion, we trace a recurring pattern: when ideology replaces evidence, institutions fail—and vulnerable patients pay the cost. We close with a reflection on Five Days at Memorial and what happens when no one in the room is allowed to say “stop.”Links & References * Deep Dive — Texas Medical Association / Institutional Capture • Article page: https://manhattan.institute/article/the-anatomy-of-institutional-capture-gender-medicine-policy-and-the-texas-medical-association* AAP / Jason Rafferty (2018) Policy Statement• AAP journal page: https://pubmed.ncbi.nlm.nih.gov/30224363/* Texas Law — SB 14 (Final Enrolled Text)• Official Texas Legislature PDF: https://capitol.texas.gov/tlodocs/88R/billtext/pdf/SB00014F.pdf* Texas Doctor Licensing News • Texas OAG Press Release: https://www.texasattorneygeneral.gov/news/releases* Ignaz Semmelweis (history of hand-washing and medical resistance)• NPR/PBS feature: https://www.pbs.org/newshour/health/ignaz-semmelweis-doctor-prescribed-hand-washing* Trade Guild (definition)• Britannica: https://www.britannica.com/topic/guild* 501(c)(6) Overview• IRS: https://www.irs.gov/charities-non-profits/other-non-profits/irc-501c6-organizations* “Runaway Diffusion” • Diffusion of Innovations (Everett Rogers reference gateway): https://journals.sagepub.com/home/sgo* Book — Five Days at Memorial (Sheri Fink)• Publisher page: https://www.penguinrandomhouse.com/books/213878/five-days-at-memorial-by-sheri-fink/If you value this work, don’t just listen—subscribe, share, and drop a comment. Algorithms push what audiences engage with, and your support is what keeps evidence, accountability, and dissent in the public square. Thank you for listening, and we’ll see you next time on Informed Dissent.Thanks for listening to Informed Dissent! This post is public so feel free to share it. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit informeddissentpodcast.substack.com/subscribe