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Texas Tort Reform Has Not Improved Health Care

Monday, October 24th, 2011

The organization Public Citizen has released a report analyzing the impact of tort reform on health care in Texas. It’s important to pay attention to this, because lobbying organizations pushing for more tort reform like to hold Texas up as a success story that other states, and the nation, should emulate.

Some background — in 2003, the state of Texas imposed a $250,000 cap on the amount of non-economic damages patients could recover from doctors. The law also shields emergency room doctors from malpractice suits entirely, since to win such a suit in Texas the plaintiffs have to prove the physician intended to harm them. Texas attorneys say this is an impossible threshold to meet, and they have stopped taking malpractice cases involving emergency room personnel.

You may think you’ll never sue anyone, but you never know. “Tort” refers to any personal injury, not just malpractice. People get ripped off by contractors or injured by products all the time. Many mesothelioma patients file their first personal injury suit in their senior years, since the results of exposure to asbestos sometimes take years to show up. But if you are seriously injured and live in a “tort reformed” state, you may be unable to be fully compensated for your injury.

But, you say, the cap is just on non-economic damages. It’s important to understand that “non-economic damages” are not just frivolous rewards to compensate injured people for pain and suffering. The difference between “economic” and “non-economic” damages are that the first are damages that can be documented at the time of trial — bills and estimates already received. The second are awarded to help the injured person pay for future expenses as he copes with his injury for the rest of his life.

The Texas law was written to remedy the allegedly “out of control” malpractice suits that were said to be the chief driver of out-of-control health care costs. In exchange for limiting the rights of citizens, Texas claims that tort reform has resulted in lower health care costs and an influx of new doctors into Texas, relieving their physician shortage.

Public Citizen says that’s hooey. The real-world data say that since 2003 –

  • Medicare spending in Texas has risen 13 percent faster than the national average.
  • Premiums for private health insurance have risen faster — 51.7 percent — in Texas than the national average.
  • Although there are more physicians practicing in Texas now than before 2003, the rate of increase per capita actually is slower than it was before 2003.
  • The number of primary care physicians in Texas per capita remains about what it was before 2003, and the number of doctors in rural areas actual has declined. The bragged-about influx of physicians have been mostly specialists moving to metropolitan areas.

Again, it’s important for you to understand this even if you don’t live in Texas. Chances are the same industry lobbying groups that sold tort reform to the Texas legislature has already been pressuring legislators in your state, and may already have succeeded in limiting your rights in state court. And there’s a push on for national tort reform as well.

These findings are not entirely new; other research organizations studying the results of Texas tort reform have reached similar conclusions. However, if you listened only to politicians, you’d think Texas has got all its health care problems solved. From the report:

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Rep. Michele Bachmann (R-Minn.), for instance, said during the national debate over health insurance reform that projects to study medical liability were unnecessary because “we’ve already had a pilot program. It’s called the state of Texas. The state of Texas did a wonderful job of lawsuit reform and actually saw medical costs come down. We know it works.”

Rep. Lamar Smith (R-Texas), a co-sponsor of legislation now pending in Congress to impose federal caps on medical malpractice awards, credited the Texas liability caps with increasing the number of doctors in the state, which, he said, “means Texans pay less to have better health care and more options.”

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Folks, what the politicians say is not true. Well, except in one respect — the rates Texas physicians pay for malpractice insurance has gone down. These savings have not been passed on to patients, but physicians are happy.

Dr. Bruce Malone, president of the Texas Medical Association, strongly refuted the Public Citizen report, saying that his organization had never promised health care costs would come down. Maybe not, but the politicians surely did. The physicians’ organization also said that since malpractice insurance rates were reduced, more money is available for care. Odd that all that extra money doesn’t show up anywhere in the data.