State Sen. Kirk Watson has been the architect and the face of a campaign for a medical school and other health projects in Austin for just over a year. But the Austin Democrat worked quietly on a medical school for several years before he thrust himself into the spotlight last September at the urging of other proponents who felt he had the ability and moxie to get it done.

Now Watson has linked his goal of establishing a medical school to winning voter approval of a Travis County-wide property tax increase in November to support the endeavor.

Watson, 54, has taken on other daunting challenges in more than 20 years of off-and-on public life. He fought off testicular cancer, was mayor of Austin during a tech bust that started in 2000 and in 2002 lost a race for state attorney general.

Yet to hear him speak these days, nothing is more important and, perhaps, more career-defining than establishing a medical school at the University of Texas, as well as a new teaching hospital, comprehensive cancer-care center and other elements of what supporters call Watsons 10 in 10 10 health care goals to achieve in 10 years.

We have so many good people ready to do it that success is immensely possible, and to not do it and not get started on the path would be extraordinarily regrettable, Watson said last fall. This is big. Its going to be hard. But it needs to be done.

A watershed moment will come in November, when Travis County voters decide whether to increase their property taxes to help underwrite those goals. That question has been put on the ballot by Central Health, Travis Countys hospital district, at Watsons urging. He proposed the amount of the rate increase, a nickel per $100 of property value, before the districts board had publicly discussed any figures.

Moreover, it was Watson who helped make it possible for Central Health to hold a tax election. He authored 2007 legislation that gave the agency overseeing health care for the needy Travis County residents broader taxing, contracting and other powers than other hospital districts in the state.

Numerous civic, business and other groups have endorsed the proposed tax increase, but it has drawn criticism as well, including from some people who question Watsons ties to Central Health. For one thing, Central Health has paid Watsons law firm, Brown McCarroll LLP, $262,675 since May for legal work on the 10 in 10 plan and other matters. Four ethicists outside of Texas saw no conflict of interest but said Watson and others could have been more transparent.

Other players in the health initiatives, including officials of the University of Texas System and of the Seton Healthcare Family, say they encouraged Watson to take the lead on the medical school. Watson followed up with a speech a year ago this month at the Four Seasons Hotel unveiling his 10 in 10 plan.

Everybody was going off in different directions, said Kenneth Shine, executive vice chancellor of health affairs for the UT System. We said, We ought to create a community-based activity with people brought together from various entities. In the course of that discussion, we said, You know, the person who has the greatest credibility, the best organizational skills and great interest is Kirk Watson.

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Watson takes glory, risks on medical school