More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
Wendell Potter

Wendell Potter

GET UPDATES FROM Wendell Potter

Lone-Star State 'Reform' a Texas-Sized Distortion

Posted: 04/ 4/11 10:11 AM ET

When Republicans talk about how the American health care system should be reformed, they typically mention two things: allowing insurance firms to sell policies across state lines, which I wrote about last week; and malpractice reform.

Former House Speaker Newt Gingrich, who is considering another run for the White House, has touted malpractice reform as one of the primary "solutions" he would pursue if elected president. He claimed during a GOP-sponsored panel last week that malpractice reform would nearly eliminate unnecessary care that results from all those tests doctors order and drugs they prescribe just because they fear being sued. "The cost of defensive medicine today," he claimed, "is $800 billion a year."

Newly-elected Republican governors, like Bill Haslam in Tennessee, are also pushing malpractice reform at the state level. They contend that such reform -- favored by businesses and medical associations -- would not only bring down the costs of health insurance premiums, it would also bring doctors flocking to their states to practice.

They often cite Texas as a role model. In 2003, the Lone Star State enacted the sort of malpractice reform now being called for by many Republicans nationwide. Several other states, including California, have also enacted malpractice reforms. The various laws and proposals all have one thing in common: a cap on how much a patient could recover from the courts if harmed because of errors made by doctors or hospital personnel.

But a closer look at what has happened in Texas raises doubts about many of the claimed benefits of malpractice reform.

Over the last decade, health care spending and individual out-of-pocket health insurance expenses have actually risen faster in Texas than in the rest of the country, says Alex Winslow, executive director of Texas Watch, a nonpartisan organization that advocates for consumer and patient rights.

At the same time, the number of people without insurance in Texas has continued to climb. In fact, according to the U.S. Census Bureau, Texas leads the country in the number of residents without health insurance. One out of every four Texans is uninsured, compared to about one in six in the nation as a whole.

While some doctors have indeed moved from other states to Texas, the state still ranks 41st in the number of doctors per capita. Texans continues to face an acute shortage of primary care physicians in particular, especially in rural areas.

Some other stats from Texas Watch: Family health insurance premiums have risen almost five times faster than income, and Medicare spending has risen 16 percent faster than the national average since Texas capped noneconomic damages at $250,000. And four of the country's 15 most expensive health markets as measured by Medicare spending per enrollee are in Texas.

I asked Alex Winslow, what he thought about Tennessee Governor Haslam's proposal to repeat the Texas experience in Tennessee. Here's what he said:

Tennessee families should not be forced to endure the same pain that Texas families have faced for the last eight years. In Texas, we have learned firsthand what happens when you severely restrict the rights of patients. Insurance companies and some corporate medical providers get richer while patients struggle to keep pace with soaring medical costs and inadequate access to care without doing a single thing to deal with the epidemic of medical errors. If Tennessee lawmakers are serious about reforming health care, they should focus on the real problems of cost, access, and quality and not be distracted by the insurance industry's talking points.


Winslow correctly notes that the insurance industry is a leader in the effort to get malpractice reform implemented in both Washington and the states. Keep in mind that insurers also sell policies for doctors to protect them from litigation. They have a vested interest, just as the doctors do, in getting lawmakers to cap damages.

If they are successful, the rest of the country will likely look more like the Lone Star State. They say everything's bigger in Texas. That includes medical bills.

This was also published by the Center for Public Integrity at publicintegrity.org.

 
 
 

Follow Wendell Potter on Twitter: www.twitter.com/wendellpotter

When Republicans talk about how the American health care system should be reformed, they typically mention two things: allowing insurance firms to sell policies across state lines, which I wrote about...
When Republicans talk about how the American health care system should be reformed, they typically mention two things: allowing insurance firms to sell policies across state lines, which I wrote about...
 
 
  • Comments
  • 49
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Recency  | 
Popularity
photo
alongst
too often denied to speak
09:25 AM on 04/10/2011
Tort Reform has done wonders in our state of Texas. Doctors are pouring in- some counties that haven't had an OB/Gyn doc in decades now have them, thanks to doctors fleeing the states without reform. The lawyers have screamed, L1ed and done everything they can to undo it since it threatens their yachts, Porsches and Hawaian vacation homes.
It's all about the money- and the lawyers are acting like leeches whose host has been taken away.
03:22 PM on 04/08/2011
I work in the medical malpractice insurance business and believe that Texas has seen some positive results b/c of their med-mal insurance reform. They have seen an influx of physicians throughout the state, and physicians have seen their insurance rates decline. You can compare the medical malpractice insurance rates by state here: http://mymedicalmalpracticeinsurance.com/medical-malpractice-insurance-rates.php

Is the tort reform legislation perfect in Texas? Absolutely not......
We have seen patient rights become restricted, and that's something the Texas Legislature needs to address. As we move forward and try to figure out how to keep healthcare costs in check, we all need to keep in mind that there is not one solution to fix everything. We need to tackle this problem by problem, and according to doctors and healthcare professionals all over the country, medical malpractice insurance reform is one of them.
photo
HUFFPOST SUPER USER
Wayne Caswell
Consumer Advocate & Founder of Modern Health Talk
03:57 PM on 04/05/2011
Elderly parents live with my baby boom neighbors. One recently had a hip replacement. During the hospital stay, a medical aid tried moving the patient himself and “dropped her” on the floor. The fall caused severe pain for weeks and a second operation at additional cost, but no incident report was filed. It was being covered up. I advised them to seek legal advice, but their attorney said, “no recourse is possible in Texas due to Tort Reform.” Sigh.
photo
HUFFPOST SUPER USER
wikwox
So there I was, playing the piano....
05:22 PM on 04/04/2011
"Tort Reform" has long been on the Republicans Just Keep Lying List, it has not worked in Texas or California. It will not work in the rest of the country either and they know it. Hence the need to just keep lying, the faster the better.
HUFFPOST SUPER USER
Boston Doc
MD in private practice
05:57 PM on 04/04/2011
Why are you saying that it 'did not work' in Texas?

Potter is spinning numbers and facts.

Just because the healthcare costs keep rising in Texas does NOT mean that the tort reform has failed. There is more to healthcare costs than tort law. Same argument applies to raising health insurance costs.

Many Texans are uninsured because there are many independent contractors and enterpreneurs, and illegal aliens. Hence, many have no insurance.

Potter says that Texas still suffers from doctor shortage. Don't you think that the reform has the potential to at least alleviate the shortage? When I review job offers, I always review state malpractice laws and medical malpractice insurance rate before I consider the offer.
photo
HUFFPOST SUPER USER
Suntio
Amat victoria curam.
08:00 AM on 04/06/2011
Oy, where do I even start? Did you READ the article? Do you listen to the Republicans? They offer tort reform as one of the 2 solutions to rising healthcare costs, the other being selling across state lines. They claim that tort reform LOWERS the costs of healthcare, but facts from Texas prove otherwise. If tort reform doesn't lower costs, why do it?
HUFFPOST SUPER USER
Boston Doc
MD in private practice
06:28 PM on 04/04/2011
It has worked in Texas. It improved the access to medical care. Here is a NYTimes article about that:

http://www.nytimes.com/2007/10/05/us/05doctors.html
06:38 PM on 04/04/2011
And the quality of those Docs is going up right?

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?printable=true
HUFFPOST SUPER USER
dojone
nada
06:45 PM on 04/04/2011
This information is over three years old and more recent studies have shown that Malpractice premiums have continued to climb unabated. The fact that there are more physicians, does not mean improved access.
photo
MNKen
Eschew Obfuscation
03:54 PM on 04/04/2011
"Over the last decade, health care spending and individual out-of-pocket health insurance expenses have actually risen faster in Texas than in the rest of the country." "At the same time, the number of people without insurance in Texas has continued to climb."

Both of these are issues primarily that affect the middle class and the poor. So why do you think the Republicans will care about them?
HUFFPOST SUPER USER
Boston Doc
MD in private practice
03:02 PM on 04/04/2011
As a practicing physician, I know that the costs of defensive medicine are real. I practice defensive medicine every day.

Eliminating defensive medicine would HELP to bend the costs curve down. Noone claims that tort reform is the magic pill for balooning healthcare costs. Bill for medical services is likely to increase because of aging population and new medical technology. However, nationwide malpractice reform would help in at least curbing the growth.

From my own perspective, here is the model of a reform which would stop me from practicing defensive medicine:

1. Jury by medical peers, or special medical malpractice court system.
As it is now, my fate in a malpractice court is decided by laypeople. Jurymen do not have sufficient education to make these sort of decisions. I want my case to be decided by someone who knows science, medicine, AND my medical field.

2. Caps on pain and suffering.
As it is now, sky is the limit, and the lawyers know it. Why sue for only 2 million, if you can sue for 20 millions? Why not 50? This is absurd.

3. Looser pays the costs of the lawsuits. Expediting the legal process.
As it is now, it is a win-win game for lawyers to sue, because even if their case has no merit, they can give the doc an offer doc cannot refuse: "Doc, I will either drag you through courts for decades, or you settle'. This has to stop.
This user has chosen to opt out of the Badges program
03:54 PM on 04/04/2011
Thank you for continuing to practice.
I know the costs of defensive medicine from a different perspective - that of the patient. I can't tell you how many hours I've waited in emergency rooms, in excruciating pain, because yet another test was needed in order to prove what my doctors already knew was the case. Malpractice suits don't just hurt doctors.
What people need to understand is that there are inherent risks in medicine. I've had several botched surgeries - yes, they were painful, and yes, I was angry about it, but I never even considered suing. If tort reform doesn't happen, you're going to see fewer and fewer qualified doctors, and more and more patients needlessly suffering in hospital waiting rooms.
05:25 PM on 04/04/2011
Sorry Doc you're wrong. Your ideas don't solve the problem at all except from maybe your personal perspective.
HUFFPOST SUPER USER
Boston Doc
MD in private practice
05:39 PM on 04/04/2011
Tell me why I am wrong.

Defensive medicine has become part of my practice. I spend taxpayer's money every day to cover my a**. I don't get paid more for ordering extra tests and consults, but I am insulated from the extra costs which I am causing. I do it because it gives me peace of mind, and heck it's 'free', so why the hell not.


I have 12 years of medical education and 1 year of practice under my belt. What do YOU have to tell me that I'm wrong?
photo
HUFFPOST SUPER USER
Jerry Vasquez
A Unapologetic liberal
02:00 PM on 04/04/2011
Given that Texas is as red as you can get, anything coming out of that state is at best, dubious.
If a Texan is telling a tale no doubt it is a whopper. Republicans have wasted what little credibility
they had left.
01:24 PM on 04/04/2011
Bait and switch. That is the platform of the right. Convince "average joe" to vote against his own best interests and advance the profits of corporations and the wealthy.
photo
HUFFPOST SUPER USER
becky bradshaw
"In a time of universal deceit, telling the truth
01:06 PM on 04/04/2011
Thousands of people die each year from malpractice. With current Texas law, the insurance companies are limiting the rights of victimized patients to receive compensation. Texas law limits punitive damages, removing significant consequences for negligence.
12:32 PM on 04/04/2011
Mr. Potter:

I eagerly await your columns here in the Huffington Post; I love them.

You write about something of great concern to all Americans: lowering costs of healthcare.

One thing I haven't seen adequately addressed anywhere is lowering the costs of the actual treatments insurance companies pay for.

I believe the cost of healthcare with Obama's plan will probably sink us. What most people don't realize is that we could "cover" every man, woman and child in this country, if less expensive, more effective treatments were utilized—treatments like those I feature in my recently published book, "Honest Medicine." The treatments I write about have been used successfully for 25-90 years to treat life-threatening conditions, such as MS, lupus, rheumatoid arthritis, Crohn’s disease, liver disease and pediatric epilepsy. (The treatments are: Low Dose Naltrexone for autoimmune diseases, the Ketogenic Diet for pediatric epilepsy, intravenous alpha lipoic acid for terminal liver disease and some cancers, and Silverlon for non-healing wounds.)

However, because these are not big blockbusters for any pharmaceutical company, most doctors don’t know about them. But all four have lots of science and studies behind them—and even more important—lots of patient-based evidence. Also, each treatment has many patient advocates (and, in some cases, several physician advocates, too) who are working hard to tell the world about them.

I hope someone with influence (like you) will take a look at this angle. I think it could help solve our problems.

Julia Schopick
HonestMedicine.com
photo
HUFFPOST BLOGGER
Wendell Potter
Analyst at the Center for Public Integrity, author
02:15 PM on 04/04/2011
I agree with you. This is indeed an area I will focus on in the future.

Thank you for your comments and your support.

Wendell Potter
03:15 PM on 04/21/2011
Mr Potter. God Bless you. It's about time the "good people" of this country had folks as "clever" as those lined up against us. Our family and friends are so grateful to you and "for" you too. We're resolved to be better consumers and citizens going forward. You give us hope that we stand a chance.
HUFFPOST SUPER USER
Boston Doc
MD in private practice
04:44 PM on 04/04/2011
What is the scientific evidence behind the efficacy of treatments?
11:55 AM on 04/04/2011
What? Conservative policies aren't doing what they claim they are?

How can this -be-?

Let's face it, folks, practically none of the current conservative policies actually address their stated goals.
photo
roberttsf
Preconceived notions don't count as facts
03:31 PM on 04/04/2011
While Texas remains 41st in health care coverage, this article ignores the miriad of other factors that contribute to this statistic. Huge droves of both documented and undocumented workers frequent Texas hospitals for their free health care each year through medicaid. These people are lumped into the "uninsured" catagory. Additionally, Texas has one of the highest self employment rates in the nation. The self employed often forgo the health insurance to pour more money into their businesses. It is a misnomer to simply say that this was a republican initiative and its failing without looking at the whole picture.
photo
Angel1999
Microbiologist & Historian
05:31 PM on 04/04/2011
Can you provide a single metric in which this policy has succeeded? Have medical malpractice insurance costs gone down? Are doctors, as a result, charging less or ordering fewer "unnecessary" tests?
Democrat in the South
Empathy, the most important word
11:37 AM on 04/04/2011
Republicans were hell bent on reforming welfare during the Clinton Presidency and before. So Clinton reformed welfare, and now 15+ years later under mostly Republican rule, the country is so-called "broke" ( turns out just "broke" for 98% of the country, plenty to go around for the wealthiest Americans ) and is in the worst recession/depression since the Great Depression? America came within a hair of causing a global depression at the end of republican rule?

Again, WHAT was the reason for welfare reform?

We should listen to republicans why?

Looks like we've been concentrating on "REFORMING" the wrong things. Corporate welfare reform is what REALLY needs reforming. Funny, you never hear republicans screaming about the REAL bankrupters of the American economy.
11:34 AM on 04/04/2011
You and your silly facts. Sadly until everyone in Middle American is bankrupted by their insurance company no one will listen. By that time all the people in power will have insurance in Dubai anyway.
photo
HUFFPOST SUPER USER
skipling
Barking is almost as good as napping.
11:31 AM on 04/04/2011
I live in Texas. I can tell you that the health insurance outlook here is bleak. And the statistics for the uninsured are a scandal.
I am glad someone is finally calling them out for this. It needs much more publicity, as do the failure of Conservative policies in general here.
photo
alongst
too often denied to speak
09:28 AM on 04/10/2011
Usually, to get insurance, you have to have a job.
I'm sure your outlook is bleak.
photo
HUFFPOST SUPER USER
skipling
Barking is almost as good as napping.
10:59 AM on 04/10/2011
That is an ad hominem attack and you are reported.
photo
HUFFPOST SUPER USER
skipling
Barking is almost as good as napping.
11:54 AM on 04/10/2011
I have been employed -- in the health insurance field-- for years. I happen to do volunteer work with many non-profits here, including those who provide health care for the poor, homeless and women.
You are insulting and wrong.