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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.
- Charity care rendered by Texas hospitals rose 24-percent in the six years following the passage of lawsuit reform as the state’s non-profit hospitals saw their charity care costs increase 36-percent. 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.
HB 4 (the 2003 medical liability reforms) has a track record of improving access to medical care.
- 2001: Texas licensed 2,088 new doctors, the fewest in a decade.
- 2008: Texas licensed 3,621 new doctors, the highest of number of any year on record.
- Overall, Texas has enjoyed a 59% greater growth rate in newly licensed physicians in the past two years compared to two years preceding reform.
- El Paso: 76-percent greater than pre-reform.
- San Antonio: 55-percent greater than pre-reform.
- Houston: 32-percent greater than pre-reform.
- 18,252 new physicians have been licensed in Texas.
After years of decline, the ranks of medical specialists are growing.
- Texas has added 218 obstetricians in the past six years.
- Post reform: The number of obstetricians practicing in rural Texas has grown by 27%.
- Twenty-two rural Texas counties have added at least one obstetrician since the passage of Proposition 12, including ten counties that previously had none.
- 52 counties have seen a net gain in obstetricians since reform, including 23 medically underserved counties and 21 partially medically underserved counties.
- Post reform: gain 212 orthopedic surgeons. This represents a 15% increase in the number of Texas orthopedists in the past six years.
- Forty-six Texas counties have seen a net gain in orthopedists since the passage of reforms including nine—Blanco, Burnet, Cherokee, Hopkins, Lavaca, Milam, 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 48 neurosurgeons in the past six years.
- Thirty-eight Texas counties now have a neurosurgeon including six counties—Brazoria, Hays, Montgomery, Lamar, Medina and Randall—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.
- Seventeen of the 22 Texas counties that have added a neurosurgeon since the passage of reforms are partially medically underserved.
- Twenty-three rural counties have added at least one emergency medicine physician and 18 counties added their first ER doctor.
- Fifteen rural counties have added either a cardiologist or cardiovascular surgeon, including 11 counties that added their first heart doctor.
- Twenty-four counties have added at least one general surgeon and 11 counties added their first general surgeon.
- The statewide number of pediatric specialists and geriatricians has 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 220 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. Ninety-percent of Texas doctors have seen their rates slashed 30-percent or more.
- Thirty 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: 35.2-percent, and $372 million in rate savings plus five renewal dividends totaling an additional $147 million.
- APIE: 42.1-percent, and $148.4 million in rate savings
- Medical Protective: 36.62-percent, and $126.2 million in savings
- The Doctors Company, 30.75 percent, and $26.5 million in rate savings plus $1.1 million in renewal dividends.
- Advocate MD: 29.5-percent, and $40.3 million in savings
- Joint Underwriting Association (JUA):16.72-percent, and $16.85 million in rate savings)
- Medicus: 11%, and $651,000
Cumulative liability cost savings since January 2004: $879 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.
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: 1/19/2010 Print this page
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