Behind every politician there are men and women working in the wings, who can make calls, fix problems, raise money, punish enemies. In Rick Perry’s world, one man stands above them all: Mike Toomey.

Use our interactive to understand the budget hole federal lawmakers have dug by not updating the Medicare funding formula, Texas physicians’ response to the problem, and the cost of varied proposals to fix it.

With the Senate set to debate the state budget this week, Ben Philpott of KUT News and the Tribune reports that several outside groups want to shape the conversation.

Physical therapists are pushing a bill to allow them to treat patients without a physician referral. The measure faces stiff opposition from physician groups, which say it could present a health risk to patients.

Rural hospitals are one step closer to being able to directly hire doctors — something they say is necessary to attract new doctors to rural areas, but is not currently allowed by Texas law.

Lawmakers today heard heated testimony on a number of bills targeting hospitals' ability to hire physicians.

A controversial budget proposal would concentrate the money the state spends on graduate medical residencies into the doctors’ first three years of training — regardless of how long their residencies take to complete.

Lt. Gov. David Dewhurst and Sen. Jane Nelson, R-Grapevine, introduced two bills Wednesday they believe will save the state money by increasing "healthy patient outcomes."

In Texas, nurse practitioners’ livelihoods are tied to physicians: By law, they can’t treat patients without a doctor’s permission. That means if they want to open their own practice, they must petition, and pay, a doctor to grant them “prescriptive authority” — to essentially keep an eye on their work and, in some cases, to be held liable for it. Doctors say this is as it should be. Nurse practitioners and their allies say doctors don't want the competition and charge them enough to run them out of business. “It borders on an immoral situation,” says state Rep. Wayne Christian, R-Center.

The Texas Medical Association's leadership body voted this weekend to support vaccinating not just young girls but young boys for the human papillomavirus. But organization officials were quick to note that the vote did not include making such vaccines mandatory, which Gov. Rick Perry tried to do for Texas schoolgirls in 2007.

House lawmakers passed the Senate version of long-awaited health care reform on Sunday night. And Texas leaders were quick to fire off on it.

Texas' senior care industry — still reeling from federal Medicare cuts — may face another financial blow, as the state considers reducing Medicaid provider rates to balance the budget in the face of a $10 billion-plus shortfall.

Early returns show the four-way scrum for the Texas House seat of outgoing state Rep. Dan Gattis, R-Georgetown, isn't as close as some had predicted. Orthopedic surgeon Dr. Charles Schwertner is way up.

The number of Texas physicians who use electronic medical records has been on the rise for the last four years, according to a Texas Medical Association study.

Three challenges stand between Texas and the era of electronic medical records: convincing doctors to use them, figuing out how to safely share and protect them and finding a way to pay for them.

In rural counties, recruiting doctors is the single biggest health care challenge. Twenty-seven counties have no primary care physicians.

Should Texas medical schools be responsible for relieving the state’s primary care shortage? Advocates for family physicians think so. They want state lawmakers to reward medical schools that groom young doctors for family medicine — and penalize those that don’t.