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Don't Use Texas as Model for Tort Reform, Advocacy Group Warns

Cheryl Clark, for HealthLeaders Media, December 18, 2009

Congress shouldn't look at Texas tort reform as a model to control national healthcare costs because "Texas has one of the worst healthcare systems in the United States," warns Public Citizen, a national consumer group.

In its report, "Liability Limits in Texas Fail to Curb Medical Costs," the patient advocacy group said Texas reforms, which place a $250,000 per defendant cap on pain and suffering awards similar to that in California, have not held down costs, as some in Congress have touted.

"Members of Congress have conjured the supposed benefits of the Texas law out of thin air," said David Arkush, director of Public Citizen's Congress Watch division. "The only winners have been the insurance companies, and, to a lesser extent, doctors."

Since the liability cap took effect in 2003, "Texas has either failed to improve or grown even worse compared to other states on almost every measure" in healthcare, including its cost of care, rate of uninsured, and access to care. "Texas has regressed," the group reported.

The findings draw  statistics from the Dartmouth Atlas of Healthcare, the U.S. Census Bureau health insurance data, and surveys from the Agency for Healthcare Research and Quality.

Officials for the Texas Medical Association and the Texas Hospital Association disagree vehemently.

"This report is completely erroneous," says William Fleming, MD, president of the TMA. "The goal of tort reform was never cost containment. It was to improve access. This report is an apples and oranges comparison."

Before tort reform in Texas, the state was plagued by a physician shortage, especially in rural areas, he says. Throughout the state, high-risk specialists, such as neurosurgeons and obstetricians, were hard to find.

"There were no neurosurgeons in the Rio Grande Valley, and people who needed brain surgery had to come to Houston. Often they died en route," Fleming says.

"There were many counties in the state that had no obstetricians, and women had to travel hundreds of miles for prenatal care," says Amanda Engler, spokeswoman for the THA. Many obstetricians had stopped delivering babies because of exorbitant malpractice costs. Now, these areas are better able to successfully recruit, she says.

Pam Udall, spokeswoman for the TMA, adds that the number of primary care doctors grew 7.76%, which was faster than population growth in Texas during the three years after reforms took effect.

And in the last three years, the number of primary care doctors "has outpaced population growth by 33%, an incredible accomplishment being that Texas is the seventh fastest growing state in the nation and far and away the most populous of the fast-growth states," she adds.

Fleming says that before tort reform in Texas, there were only two medical malpractice companies willing to insure doctors. Now there are 10.

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