Tort Reform, Physicians, And Medicare In Texas

It is quite amazing how when you decide to run for President, all of your past political successes and failures are scrutinized in the public spotlight. Texas Governor Rick Perry has come under scrutiny – thankfully, I might add – for his health care policies in the state of Texas.

Governor Perry has been very vocal about his 2003 tort reform and the effect it has had on physician recruitment in Texas. But I think that the only doctor that would approve of this statement might be a spin doctor.

Has Governor Perry’s tort reform in Texas changed the health care playing field? Or has his health care agenda been a miserable failure in more ways than one? Does any of this bode well for his role in national health care reform should he become President?

The proposed goal of tort reform is theoretically simple: malpractice reform lead to lower costs, which then fosters more physicians coming to Texas, and more people having health insurance. At least that’s the line we keep receiving from the spin doctors.

Public Citizen, a national non-profit consumer organization, recently released a study on the effects of Perry’s “legendary” tort reform. I have summarized a number of their findings, adding my own comments along the way.

1. Tort reform has not decreased health care costs for anyone except physicians (via a 74.1% decrease in malpractice payments) and medical liability insurers. The TMA supported the legislation. Welcome to the presence of Big Medicine. Wait, there’s more …

2. Tort reform has not increased the number of physicians in Texas. Perry reported an influx of 21,000 new physicians. In the seven years prior to 2003, the per capita number of doctors was increasing at a rate of 9.3%. In the seven years following 2003, the rate dropped to 4.2%. These physicians are also not practicing in under-served areas.

3. Medicare costs in Texas have increased 42.7%, with the national increase at 37.8%. Medicare Part B spending was 40% higher in Texas than in the rest of the country. But it’s not just Medicare, because …

4. Health insurance premiums (as a whole) have increased at a faster rate in Texas than nationally. Since 2004, health insurance premiums have risen 13.1% faster in Texas than the nation as a whole.

5. Texas has had the highest number of uninsured people in the country, and it is getting worse. In 2003, 23.6% of Texans lacked health insurance; by 2010, this number had risen to 24.6%.

6. In Texas, 62% of primary care doctors no longer accept new Medicare patients. I can understand the debate over reimbursement rates. But did you know that when you choose not to accept Medicare patients, you also free yourself from the Stark laws that prevent physician self-referral? Intriguing coincidence?

So who benefited from the 2003 tort reform, Governor Perry? It is probably pretty safe to say that it wasn’t the health care consumers of Texas.

Photo credits: baslow