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Improving access to medical care is critically important to all Texans.
- This is especially true for children, pregnant women, the aged, the poor, those in an emergent condition and those in rural Texas.
Charity care has greatly increased since the passage of the 2003 reforms.
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Charity care rendered by Texas hospitals rose 24-percent in the three years following the passage of Prop. 12. But for the 2003 reforms, this $594 million increase in charity care expenses would have left many Texas hospitals with the stark choice of turning away charity care patients or closing their doors altogether. The state’s non-profit hospitals saw their charity care costs increase 36-percent in this same time frame.
HB 4 (the 2003 medical liability reforms) has a track record of improving access to medical care.
- In 2002, Texas produced the fewest newly licensed physicians in a decade (2,038).
- This year, the state licensed a record 3,621 new doctors.
- Texas has netted a 31-percent greater growth rate in newly licensed physicians in the past two years, than in the two years preceding reform.
- The physician growth rate in El Paso is 76-percent greater than pre-reform.
- The physician growth rate in San Antonio is 55-percent greater than pre-reform.
- The physician growth rate in Houston is 32-percent greater than pre-reform.
After years of decline, the ranks of medical specialists are growing.
- Seventy-six Texas counties have seen a net gain in emergency physicians (PDF) since the passage of reforms five years ago, including 39 medically underserved counties and 30 counties that are partially medically underserved.
- Texas saw a net loss of 14 obstetricians in the two years preceding reform. Since then the state has experienced a net gain of 192 obstetricians.
- Twenty-four rural Texas counties have added at least one obstetrician since the passage of Proposition 12, including twelve counties that previously had none.
- Since Prop. 12, 52 counties have seen a net gain in obstetricians, including 23 medically underserved counties and 21 partially medically underserved counties.
- Texas experienced a net loss of 9 orthopedic surgeons from 2000 to 2003. Since tort reform, the state has added 220 orthopedic surgeons. This represents a 12.2-percent growth in the number of orthopedists in the past five years.
- Forty-six Texas counties have seen a net gain in orthopedists since the passage of reforms including seven—Blanco, Cherokee, DeWitt, Hopkins, Lavaca, Somervell and Starr—that previously had none.
- Eleven of the counties that have added an orthopedist are rural and eleven are medically underserved.
- Twenty-six counties that have added an orthopedic surgeon are partially medically underserved.
- Texas has added 49 neurosurgeons since the passage of tort reform. This represents a 12-percent growth in the number of neurosurgeons in the past five years, compared to no growth in the two years immediately preceding tort reform.
- Thirty-six Texas counties now have a neurosurgeon including five counties—Brazoria, Fayette, Fort Bend, Lamar and Medina—that had none at the passage of HB 4.
- Four of the counties that have added a neurosurgeon are medically underserved and two of those—Fayette and Lamar—are rural.
- Sixteen of the 22 Texas counties that have added a neurosurgeon since the passage of reforms are partially medically underserved.
- The statewide number of pediatric specialists has more than doubled in the past five years after showing virtually no growth in two years preceding reform.
Doctors are bringing critical specialties to underserved areas.
- Since the passage of reforms, the Rio Grande Valley has added 214 physicians. The growth rate of the physician workforce in both counties has outpaced population growth.
- Jefferson, Nueces and Victoria counties saw a net loss of physicians in the eighteen months prior to tort reform. Currently, all three counties are producing impressive gains; adding much-needed specialists and emergency medicine physicians.
Premiums are stable and reduced
- All major physician liability carriers in Texas have cut their rates since the passage of the reforms, most by double-digits. Texas physicians have seen their liability rates cut, on average, 27-percent. Eighty-five percent of Texas doctors have seen their rates slashed 30-percent or more.
- Twenty-four rate cuts have occurred in Texas since the passage of the 2003 landmark reforms.
Reductions in premiums since the passage of Prop. 12 and respective savings:
- Texas Medical Liability Trust: 34.5-percent, and $275 million in rate savings plus four renewal dividends totaling an additional $105 million.
- APIE: 33.9-percent, and $72.55 million in rate savings
- Medical Protective: 30.18-percent, and $96.94 million in savings
- The Doctors Company, 30.75 percent, and $8.395 million in rate savings plus $1.1 million in renewal dividends.
- Advocate MD: 29.5-percent, and $13.15 million in savings
- Joint Underwriting Association (JUA):16.72-percent, and $2.899 million in rate savings)
Cumulative liability cost savings since January 2004: $574 million.
- Roughly half of the state’s doctors are now paying lower liability premiums than they were in 2001.
Competition in the Health Care Liability Market Increasing
Since the passage of Proposition 12, Texas has added:
- Four new admitted, rate-regulated carriers: Advocate MD of the Southwest, Medical Liability Insurance Company of America, Medicus Insurance Company and the Physicians Insurance Company.
- Twenty six risk retention groups, captives, surplus lines and other unregulated insurers.
- Texas physicians can competitively shop their policies.
- Thirteen percent of the commercial physician liability market is being insured by companies new to Texas since February, 2003.
Claims and lawsuits in most Texas counties have been cut in half.
Changing HB 4 will hurt access to medical care.
- CHRISTUS Spohns’ Westside Corpus Christi clinic serving the indigent and its Diabetes Excellence Program are funded by the hospital’s medical liability savings. Take away the savings and the programs are jeopardized.
- Driscoll Children’s Hospital in Corpus Christi used its liability savings to open satellite clinics in the border cities of Brownsville and McAllen. Take away the savings and the programs are jeopardized.
- Kelsey-Seybold Clinic in Houston is using its liability savings to fund an electronic medical record. This electronic medical record will eliminate sources of medical error due to illegibility, monitor for medication allergies and alert the prescribing physician about drug interactions. It will also allows results to be graphed to show doctor and patient trends over time and will reduce the cost of health care through more efficient handling of medical information. This $20 million electronic medical record investment would not be possible without the savings achieved by medical liability reform. Kelsey-Seybold treats 1.1 million patient visits a year in the Houston area.
Related Informantion
Last Published: 2/9/2009 Print this page
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