Guest Speech by John Oceguera
First, I want to thank you for taking the time to read this document—not just as medical professionals, but as advocates, and as members of the Iranian American community, and as leaders committed to the health of Nevada.
Today, I want to ask something bold of you: to expand your mission of healing beyond the walls of your clinics, hospitals, and practices—into the halls of Carson City and beyond. Into the realm of public policy.
We’re Talking About Power
Not political power for its own sake, but the power to shape a healthier future for your patients and communities. The power to protect your values, to speak up when science is ignored, and to ensure that your voice—your Iranian American physicians’ voice—is heard in decisions that affect healthcare in Nevada.
I’m talking about building a political coalition—a strategic, unified network of physicians—especially Iranian American physicians and allies—who can speak with clarity, integrity, and unity in our state legislature.
Why Now?
We’re at a critical moment in medicine—and in public life.
Across the U.S., and right here in Nevada, we see legislation being written and passed by people with no medical training—legislation on public health, reproductive rights, prior authorizations, scope of practice, vaccine mandates, telemedicine, and more.
You face overregulation—but remain underrepresented. Generally, you are not even in the room when decisions are made about your profession, your ethics, and your patients.
But that can change.
You—as Iranian American medical professionals in Nevada—have the credibility to lead. To mobilize. To influence the laws that shape how you care for our communities.
So what Is a Political Coalition?
A political coalition is a structured alliance—a professional network of physicians and healthcare advocates who work together to influence policy, legislation, and public discourse.
This is not about partisanship—it’s about professionalism and purpose.
It can include:
- Iranian American physicians across specialties,
- Broader medical associations in Nevada,
- Medical students and residents,
- Allied health professionals,
- Patient advocacy groups aligned with your mission.
It doesn’t have to start big. But it must start deliberately.
Goals of the NIMA Coalition
- Legislative Influence — Shape, propose, and support legislation that upholds medical integrity and patient-centered care.
- Policy Watchdog — Flag and respond to harmful or misinformed legislation—before it’s too late.
- Unified Advocacy — Organize capital visits, publish expert opinions, testify publicly, and run awareness campaigns.
- Public Education — Elevate medical voices and restore public trust—especially in times of disinformation.
- Protect Medical Ethics — Guard the physician-patient relationship from political interference.
- Defend Physician Autonomy — Push back against excessive insurance control, unfair licensing laws, and systemic barriers.
How Do We Build It?
Step 1: Form the Core
Start with a core leadership team—8 to 12 Iranian American physicians from various specialties and regions of Nevada.
Their role:
- Define mission and values,
- Draft guiding documents
- Build initial partnerships across the state.
Step 2: Set Legislative Priorities
You must be focused. For the next session, choose 2–3 issues that matter most to your community and patients.
Step 3: Build Relationships in the Legislature
In Nevada, access matters. Relationships matter.
You must:
- Meet with lawmakers personally,
- Invite them into your clinics,
- Offer yourselves as trusted medical experts,
- Show them that you are solutions-driven, not politically motivated.
You don’t need 100% agreement — you need mutual respect and collaboration.
Step 4: Mobilize Our Base
NIMA must activate our physician network statewide.
You need:
- Email and social media platforms,
- Rapid-response teams for key legislation,
- Regular advocacy briefings, training, and mentorship.
Your members need to understand that advocacy is not optional—it’s a form of care.
Step 5: Fund the Mission
This work needs resources. From staffing and legal advice to communications and organizing—we must invest in your future.
Consider forming:
- A 501(c)(4) for issue-based advocacy, or
- A Nevada-based Political Action Committee (PAC).
NIMA members already give generously to humanitarian causes—now you must invest in your collective voice here at home.
Case Study
The 83rd Legislative Session was a busy time for Nevada Native American Tribes. Tribal healthcare was a major focus of the Session as SB 97 (Tribal seat on the Silver State Health Insurance Exchange) and SB 312 (establishment of the Tribal Health Authority Council and presumptive eligibility for Medicaid) advanced and have been approved by Governor Lombardo.
Senate Bill 312
Senate Bill 312 is groundbreaking legislation, focusing on improving health care access for American Indians in Nevada. It introduces several measures to enhance Medicaid eligibility and create a Tribal Health Authority Council. Inspired by the work of Angie Wilson and the Joint Interim Committee on Health and Human Services, the bill was a focus during the legislative session. Tribes collaborated extensively with the stakeholders and legislators to move SB 312 through the legislative process, including making sure any fiscal impacts of the bill were addressed and resolved.
Key provisions of the bill include the creation of the Tribal Health Authority Council. The membership of the Council includes directors of health care facilities operated by Indian tribes and representatives from the Indian Health Service and state agencies. The Council will elect a Chair and Vice Chair and will meet quarterly, with members allowed to participate remotely. The Council will advise the Department of Health and Human Services and the Governor on health matters concerning Nevada Tribal Members. The Council will assess health care quality and accessibility for Nevada Tribal Members and update plans to improve access and eliminate barriers. The bill establishes the Account for Tribal Health to fund the Council’s activities, including the funding of the Council’s Coordinator position. Lastly, the Council may request the drafting of up to two legislative measures (BDRs) related to its scope.
SB 312 also authorizes Nevada Indian tribes to determine if a person is presumptively eligible for Medicaid. The Department of Health and Human Services (DHHS) will provide resources, training, and technical assistance to tribes for accurate determinations. The Director of DHHS will collaborate with the Council to develop a proposal for reinvesting federal funds received under Medicaid.
The creation of a Tribal Health Authority was a major win for tribes in Nevada and that only happened because the tribes collaborated, organized, contributed, and made sure their voices were heard at the Legislature.
The Challenges Ahead
Let’s be real. You will face:
- Political polarization, where medical advocacy is misinterpreted,
- Inertia within our own circles: “I’m too busy” is a familiar refrain,
- Opposition from other lobbyists.
Why This Matters
You see the real-world harm of bad policy every day—from unaffordable medications to ER overcrowding to disinformation-fueled public mistrust.
You cannot treat the disease of poor governance with silence.
You must prescribe advocacy.
If you don’t speak up, others will—and their agenda may not align your with science, ethics, or equity.
Closing: The Time Is Now
In medicine, you intervene early—before the damage is irreversible.
This is your moment to lead. To use your knowledge, credibility, and cultural strength for the public good.
So I ask you—not just to listen to what I am saying, but to act.
Build a Coalition
Bring your white coats to the legislature, not just the clinic.
Heal systems—not just symptoms.
Let’s remind Nevada Legislators that when Iranian American physicians speak together, they speak with the voice of science, of compassion, and of truth.
Thank you. I am available for questions.