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Gov. Rick Perry: Tort reform must be part of health care reform

By: Gov. Rick Perry
OpEd Contributor
August 13, 2009

To hear federal officials tell it, they've got all the answers on health care and it's up to the rest of us to sit, wait and embrace whatever solution -- if any -- they may eventually provide.

I find this troubling, since states have shown they know a thing or two about solving problems that affect their citizens.

Texas, in fact, stands as a good example of how smart, responsible policy can help us take major steps toward fixing a damaged medical system, starting with legal reforms.

Just six years ago, Texas was mired in a health care crisis. Our doctors were leaving the state, or abandoning the profession entirely, because of frivolous lawsuits and the steadily increasing medical malpractice insurance premiums that resulted.

Two thirds of our state's counties had no practicing obstetricians, and for pregnant women that meant long trips in cramped cars and higher fuel bills. Sixty percent of our counties had no pediatricians, which often meant delayed, or denied, health care for sick children.

And 24 counties in the Rio Grande Valley had no primary care doctors at all.

Each of those factors made it more likely that patients in underserved areas would postpone seeking care, which meant minor issues became major issues, and illnesses that could have been treated simply, easily and economically in the doctor's office turned into severe health crises that had to be treated in the emergency room.

And the situation was worsening with every passing day. By 2002, 13 of the state's 17 liability insurance carriers had left Texas, leaving less competition and leaving doctors with insurance bills that were seeing double-digit increases, if they could get insurance at all. That same year, applications for medical licenses plummeted to the lowest level in a decade.

This being Texas, instead of throwing money at the problem or debating endlessly, we identified the root causes and decided to do something about it.

In 2003, I declared the medical liability crisis an emergency item, and the legislature responded, passing sweeping reforms that protected the patient, but also shielded doctors and hospitals from unscrupulous trial lawyers eager to make a quick buck at the system's expense.

We capped non-economic damages at $250,000 per defendant, or up to $750,000 per incident, while placing no cap on more easily determined economic damages, such as lost wages or cost of medical care due to injury.

We ended the practice of allowing baseless, but expensive, lawsuits to drag on indefinitely, requiring plaintiffs to provide expert witness reports to support their claims within four months of filing suit or drop the case.

These measures were supported by the people of Texas, who in September of 2003 approved a ballot measure, Proposition 12, authorizing all of these changes.

Changes were seen immediately, and continue to be felt. All major liability insurers cut their rates upon passage of our reforms, with most of those cuts ranging in the double-digits. More than 10 new insurance carriers entered the Texas market, increasing competition and further lowering costs.

As a result, Texas doctors have seen their insurance rates decline by, on average, 27 percent.

The number of doctors applying to practice medicine in Texas has skyrocketed by 57 percent. In 2008, the Texas Medical Board received 4,023 licensure applications and issued a record 3,621 new licenses.

In all, in just the first five years after reforms passed, 14,498 doctors either returned to practice in Texas or began practicing here for the first time.

And our reforms finally brought critical specialties to underserved areas. The number of obstetricians practicing in rural Texas is up by 27 percent, and 12 counties that previously had no obstetricians now have at least one. The statistics show major gains in fields like orthopedic surgery, pediatrics, neurosurgery and emergency medicine.

The Rio Grande Valley has seen an 18 percent growth in applications to practice medicine, adding about 200 doctors to this critically underserved area.

And what about the money that used to go to defending all those frivolous lawsuits? You can find it in budgets for upgraded equipment, expanded emergency rooms, patient safety programs and improved primary and charity care.

Success stories like ours need to be told, and need to be remembered as we continue this national debate.

Instead of handing down "one size fits all" mandates on how it's going to be, Washington should be enabling states to set their own agendas, and solve their own problems, when it comes to health care.




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Reader Comments

All comments on this page are subject to our Terms of Use and do not necessarily reflect the views of the Examiner or its staff. Comment box is limited to 250 words.

Texan for Truth

Aug 12, 2009

Perry is the man with the plan. 4 more years!

 

Victoria

Aug 13, 2009

And people wonder why although I live in AL now I am quick to point out I am a native Texan.

 

Former Texan

Aug 13, 2009

So... the governor didn't read Atul Gawande's New Yorker article: [http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande]... According to the Good Doctor, overuse of medicare services (by physicians) is the major problem. Why else would El Paso have lower expenditures than McAllen? Given the choice between research and The Party Line, "The Good-Looking Governor" chooses The Party Line. No surprise. He takes after his predecessor.

 

7th Generation Texan, 5th Generation Corpus Christian

Aug 13, 2009

I'm happy "Former Texan" is a FORMER Texan. Anyone who would quote anything from "www.NEWYORKER.com" doesn't deserve to live in our great state!

 

Aug 13, 2009

California has had the $250,000 "pain and suffering" cap for over 30 years.

Rate hikes in malpractice insurance average about half the increase in other states. The cap works.

My own Blue Shield health insurance in California is only $100/month.

 

Texan by choice

Aug 13, 2009

Rock on Governor Perry!

 

Political Jules

Aug 13, 2009

Former Texan is a worthless blowhard and destined to stay a former texan. You are a disgrace and should never be allowed back into our great state.

Gov. Perry, GREAT JOB!

 

Stupid Texans

Aug 13, 2009

You folks in Texas are a bunch of out of touch bafoons! You think someone that criticizes your state like "Former Texan" is a "disgrace, should never be allowed back, & doesn't deserve to live there". You are all a bunch of fools.

What are y'all gonna "rise up again"? We'll squash you like we did before!

 

Wishin' I was a Texan

Aug 13, 2009

Former Texan's comment merely reinforces Gov. Perry's point that States should find solutions for themselves, rather than imposing nationwide mandates that may or may not work on an individual basis. It's like giving the same prescription to every patient that walks through the door. If Former Texan was more interested in the truth, they might have been able to see that themselves.

 

Former Texan

Aug 13, 2009

Wishin, I hope that "individual basis" doesn't mean "exclusion", "pre-existing condition", or "excessive out-of-pocket costs". Not every individual has access to affordable healthcare; my family's situation suggests otherwise... I recommend the New Yorker article to all Texans who aren't afraid of a healthcare analysis that is short on talking point perpetration, and long on ACTUAL ANALYSIS OF A PROBLEM. (It's a big article, but Texans love big things, don't they?).

 

Former Texan

Aug 13, 2009

From the Article... Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?... “Practically to zero,” the cardiologist admitted... “Come on,” the general surgeon finally said. “We all know these arguments are b------t. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

 

Former Texan

Aug 13, 2009

From the Article... Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?... “Practically to zero,” the cardiologist admitted... “Come on,” the general surgeon finally said. “There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

 

Former Texan

Aug 13, 2009

Former Texan
Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?... “Practically to zero,” the cardiologist admitted... The general surgeon finally said doctors... were racking up charges with extra tests, services, and procedures.

 

Former Texan

Aug 13, 2009

Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars... The general surgeon finally said doctors... were racking up charges with extra tests, services, and procedures.

 

Former Texan

Aug 13, 2009

Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down?... “Practically to zero,” the cardiologist admitted... The general surgeon finally said doctors... were racking up charges with extra tests, services, and procedures.

 

Former Texan

Aug 13, 2009

Former Texan
Several years ago, Texas passed a tough malpractice law that capped pain-and-suffering awards at two hundred and fifty thousand dollars. Didn’t lawsuits go down? “Practically to zero,” the cardiologist admitted... The general surgeon finally said doctors... were racking up charges with extra tests, services, and procedures.

 

SaveCongress

Aug 13, 2009

The Constitution brilliantly allows for competition between the states--but states' rights have been all but usurped for decades.

Please help elect congressmen who will get the federal government out of states' business!

 

A True Texan

Aug 13, 2009

I am behind Governor Perry all the way. He has led our State to be in much better shape than most. Are the rest of them #1 in jobs created? Why are so many people moving to Texas..They know a GREAT STATE when they see it. True Texans are PROUD to be TEXANS and I'm sorry that you do not all have the PRIVILEDGE to live in such a Wonderful State..

 

Texan Pride

Aug 14, 2009

You got to love Rick Perry!!!

 

Dave F

Aug 14, 2009

Former Texan,
You need to either:
1) get that nasty keyboard bounce fixed or
2) realize that saying the same thing 5 times does not inherently make it right

Heard about the Texan who moved to DC. Raised the IQ in both states (whatever) 10 points.

 

Former Texan

Aug 15, 2009

Former Texan
My comments weren't displaying, so I sent them multiple times. My apologies... I note that most of my family hails from Texas (the Frenchtown and Ship Channel areas of Houston), and all three siblings attended college in Texas. I can assure you, we never supported the last two governors, and Perry's memes are a perfect reason why. His understanding of the issue boils down to partisan talking points. Pain-and-suffering caps didn't equalize the Medicare expenditures of El Paso and McAllen, which the New Yorker article clearly explains.

 

Steve

Aug 15, 2009

I am a physician. I have been practicing for 25 years. I live in a state that does not have tort reform. I have been sued numerous times, never successfully. Each lawsuit is more ridiculous than the next...all are basically attempts to extort money out of me and my malpractice insurance company. If I tried such extortion I would be thrown in jail. But the trial lawyers get away with it every day. If the federal government thinks that they can reform the healthcare system without tort reform they have lost touch with reality. If they think I or any other physician will stop ordering every test on every patient, and risk losing our life savings, home and all our belongings, they are crazy.

 

Guest Physician

Aug 16, 2009

I am a physician. Tort reform is an absolute MUST. I can't believe Obama wants everyone else to take part in helping out with healthcare reform and costs BUT NOT the Lawyers?! They should help out also. Doctors definitely have changed the way they practice just in order to defend themselves against litigation. Malpractice insurance has gone OUT of control. Problem is, even with a $250,000 cap, I don't think that will change the way I practice medicine. We just need better checks and balances against FRIVOLOUS lawsuits. Someone needs to come up with a plan!

 

asharp

Aug 20, 2009

Guest Physician - if you have not done so already you should join sermo.com, the largest online community for physicians and share your thoughts with your colleagues there as well.

 

Charles H. Williams, M.D.

Aug 20, 2009

August 23,2008 my esophagus was perforated while undergoing an elective esophagoscopy. Was hospitalized for 21/2 months,renal failure and 4 wks of dialysis, two thoracotomies. Following discharge required continued tube feedings (all told,4 months) and home care for three months at a cost of $40.00.00. out of pocket. Claim against the physician is not practical. I have no recourse for recovery of this expense. Put yourself in my place.

 

Illinois Needs Tort Reform

Aug 21, 2009

Dr Williams...if I understand it, the Texas solution would not preclude you from litigating to recover related medical expenses (economic damage) from your medical providers...the cap is on non-economic damage. If there's another reason for your assertion that "claim against the physician is not practical" then unless you explain, it doesn't seem relevant to the issues discussed in the article.

 

Sharon S

Aug 21, 2009

Ok, I'm not a Texan, but love Texas! I didn't see anything wrong with the article that many Texans did, although it seems to me that the author came to the wrong conclusion with his statement "What a Texas town can Teach us about health care." He gives an example of one town's Medicare expenditures as an example of "explosive trend". What? One town? I think not. Actually it proves how Tort Reform has kept cost down in all other Texas towns. There will always be exceptions, but that doesn't make the rule! Also, most likely many come from other areas of the state to take advantage of their wonderful facilities. Very faulty thinking to use a couple of examples to try to make a point/conclusion about Health Care.

 

Sharon S

Aug 21, 2009

ahhh...sorry, should have made clear referring to New Yorker article.

 

Doc99

Aug 24, 2009

Hat's off to Texas for doing obviously one thing right. Here in NY, the Speaker of the Assembly, arguably the most powerful man in the state, is also a member of the firm of Weitz&Luxenberg, a firm made famous litigating for asbestos plaintiffs. He's also said that NY would have tort reform over his dead body. No wonder many of my colleages have relocated or are thinking of relocating to Texas.

 

RJ

Aug 27, 2009

Former Texan: I’ve read the New Yorker article; it address the MICROeconomic effects of medical business plans. The Gov’s piece addresses the MACROeconomic effects of tort reform. Far from being mutually exclusive, they are, in fact, complimentary, as they focus on different facets of the problem which both need to be addressed.

 

Dr. Tom

Sep 21, 2009

Great to see that Texas solved their malpractice crisis with reasonable caps.In PA we have a trial lawyer for Governor and the crisis is still alive in PA. Over 40 hospitals have closed maternity services and trauma centers that were forced to close in 2002 are still shut down. Texas should be thankful to their Governor and legislators for solving the access to care crisis. There's no hope for tort reform on a national level. In 2008 Democrats in Congress received $2,570,040 from the trial lawyers while Republicans got $119,750. Also the Secretary of Health and Human Services is a former lobbyist for the Kansas Trial Lawyers Association. Obama pledged not to be beholden to special interests, another lie.

 

Jan 11, 2010

projeksiyon

 


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