Steven DziobakUnited States
Sep 16, 2025
I want to begin by making clear my fundamental objection to the MD Health Pathways proposal. My concern is not with the value of telehealth services themselves, but with the way this program has been structured and introduced.
This is an opt-out program, not an opt-in program. That means 240,000 Garland residents (roughly 80,000 homes) will be automatically enrolled and billed for a service that they did not request, and for which they were not given the chance to voice their opinions in a meaningful public forum before we committed the City’s resources. In my view, that is not how government should operate.
The financial implications must also be made clear:
• $50,000 annually will be contributed by MD Health Pathways into an escrow account for future program costs.
• $25,000 annually will also be contributed by MD Health Pathways into a low-income assistance fund.
• $80,000 in IT and software support costs and $8,000 for billing inserts will also be covered by MD Health Pathways, not by the City.
• Meanwhile, Garland households will be charged $6 per month, gradually increasing to $9 per month by year seven.
• Return on Investment: 240,000 people, approximately 80,000 homes with a 15% opt-out equals 68,000 homes at $6 per household equals $408,000 monthly or $4.9 million annually.
(Please let me know if the numbers are off and I will make corrections, but this is not my issue)
Yes, this telephone-based healthcare service may answer routine health questions, may reduce unnecessary ER visits, and may improve community health in the long run. Those are worthy goals. But they must be balanced against two critical principles: resident choice and fiscal responsibility.
I do not believe this program was constituent-driven. It was not built out of grassroots participation. It is being imposed from the top down, with residents given no real say until after the framework was already decided. That is my critical objection.
That said — I respect the process, and I respect the vote of this Council. While I remain opposed to the opt-out structure and the way this was introduced, I will honor the decision of this body. Now that all voices have been heard and the vote has been taken, I will do all within my power to assure the program’s success. My commitment is to the people of Garland — to make certain that if this program moves forward, it does so with the greatest transparency, accountability, and benefit to our residents.
Video Link (.40): https://garlandtx.new.swagit.com/videos/353115
This is an opt-out program, not an opt-in program. That means 240,000 Garland residents (roughly 80,000 homes) will be automatically enrolled and billed for a service that they did not request, and for which they were not given the chance to voice their opinions in a meaningful public forum before we committed the City’s resources. In my view, that is not how government should operate.
The financial implications must also be made clear:
• $50,000 annually will be contributed by MD Health Pathways into an escrow account for future program costs.
• $25,000 annually will also be contributed by MD Health Pathways into a low-income assistance fund.
• $80,000 in IT and software support costs and $8,000 for billing inserts will also be covered by MD Health Pathways, not by the City.
• Meanwhile, Garland households will be charged $6 per month, gradually increasing to $9 per month by year seven.
• Return on Investment: 240,000 people, approximately 80,000 homes with a 15% opt-out equals 68,000 homes at $6 per household equals $408,000 monthly or $4.9 million annually.
(Please let me know if the numbers are off and I will make corrections, but this is not my issue)
Yes, this telephone-based healthcare service may answer routine health questions, may reduce unnecessary ER visits, and may improve community health in the long run. Those are worthy goals. But they must be balanced against two critical principles: resident choice and fiscal responsibility.
I do not believe this program was constituent-driven. It was not built out of grassroots participation. It is being imposed from the top down, with residents given no real say until after the framework was already decided. That is my critical objection.
That said — I respect the process, and I respect the vote of this Council. While I remain opposed to the opt-out structure and the way this was introduced, I will honor the decision of this body. Now that all voices have been heard and the vote has been taken, I will do all within my power to assure the program’s success. My commitment is to the people of Garland — to make certain that if this program moves forward, it does so with the greatest transparency, accountability, and benefit to our residents.
Video Link (.40): https://garlandtx.new.swagit.com/videos/353115
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