Study: tort reform has not cut health care costs in Texas

A new study found no evidence that health care costs in Texas dipped after a 2003 constitutional amendment limited payouts in medical malpractice lawsuits, despite claims made to voters by some backers of tort reform.

The researchers, who include University of Texas law professor Charles Silver, examined Medicare spending in Texas counties and saw no reduction in doctors' fees for seniors and disabled patients between 2002 and 2009. A 2003 voter campaign in Texas, and some congressional backers of Texas-style tort reform in every state, however, argued that capping damage awards would not onlycurb malpractice lawsuits and insurance costs for doctors, it would lower costs for patients while boosting their access to physicians.

Tort reform is a controversial topic likely to be resurrected by Republicans and doctors' groups who hoped to make it part of the 2010 federal health care law.

[visit Texas Injury Lawyers' website]

The researchers' findings come after a report last fall in which the Ralph Nader-founded consumer group Public Citizen said it found Medicare spending in Texas rose much faster than the national average after tort reform. Critics of that study said that tort reform leaders never promised health care spending would decline and noted that caps on damage awards brought steep drops in malpractice insurance rates for doctors and large increases in new doctors coming to Texas.

Another study yet to be published on physician supply and tort reform, also by Silver's group, agrees that malpractice suits and payouts sharply dropped after tort reform. But that study strongly disputes claims of a mass exodus of Texas doctors before tort reform and huge increases afterward.

On the question of health care costs, Silver's group focused on the federal government's Medicare program, which makes up 20 percent of the $2.5 trillion spent on U.S. health care.

That group — consisting of two Republicans, a Democrat and a foreign national, according to the researchers — analyzed data at the county level in Texas, said Tom Baker, author of a 2005 book, "The Medical Malpractice Myth," and a professor of law and health sciences at the University of Pennsylvania.

"This is a very highly regarded study, and this team is highly regarded," Baker said. The study was paid for by the researchers' universities, Silver said, and the paper was published this month in the Journal of Empirical Legal Studies.

"Their results didn't surprise me at all," Baker said.

[read full story at Statesman.com here]

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source: Statesman (Roser, 6/20)

Texas paper urges increase in cap on government liability

San Antonio -- Public employees, like everyone else, have accidents in the course of their duties. The public has a right to recover damages for property, physical injuries or loss of life when those accidents occur. Tort law is supposed to protect the public in cases of loss or harm.

That was the idea behind the Texas Tort Claims Act, a measure passed by the Legislature in 1969. Prior to the act, Texans could not recover damages in cases in which government employees were performing their duties.

Lawmakers also recognized that taxpayers deserve protection from frivolous and excessive lawsuits. So, additionally, the act limits the circumstances in which a governmental entity is liable for compensatory damages and caps those damages.

As Express-News staff writer John Tedesco reported, however, the caps — now $250,000 per individual — often don't allow members of the public to fully recover actual damages. That shouldn't be the case.

In one incident cited by Tedesco, a police officer answering a non-emergency call and driving 80 mph on Blanco Road without his siren or lights activated struck Vanessa Samudio. Samudio suffered major injuries, including permanent brain damage.

Samudio's medical bills alone totaled $235,500. That doesn't take into account intangible losses, such as a decreased quality of life or pain and anguish. Yet with the force of the Texas Tort Claims Act behind the city, she agreed to settle the case for $227,500.

The current $250,000 cap has been on the books since 1987. To keep up with inflation, the cap would need to be more than $500,000 to have the same purchasing power in 2012.

One solution would be for lawmakers to raise the cap to an appropriate level. Another would be to treat tort cases involving governmental liability in the same way as medical malpractice, with no limit on actual damages, but with caps on non-economic damages.

Such reforms would not burden taxpayers — the vast majority of governmental liability cases are settled well below the cap. They would, however, give Texans the opportunity to seek the compensation they are due in those rare cases where the actions of a government employee cause an extraordinary economic loss.

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source: My San Antonio (4/7)



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Oklahoman criticizes trial lawyers' response to new tort reform law

The Oklahoman (11/2) editorialized, "Effective Tuesday, the state entered the modern age of tort reform with legislation its supporters hope will better position Oklahoma to recruit physicians and encourage business relocation. Time will tell if either goal is realized."

The Oklahoman said that predictably, trial lawyers responded "with growling threats to challenge the constitutionality of tort reform bills. Such challenges are what led Texas to enact tort reform through constitutional amendments rather than statutes." The same thing "may need to happen" in Oklahoma "if the trial bar releases the hounds."

Texas' tort law has failed to reduce health costs, attract doctors

A national report released Wednesday says the 2003 Texas law that limited damage awards in malpractice suits has caused health care spending to rise and has not significantly increased the number of doctors in Texas.

The report comes as Gov. Rick Perry has touted the benefits of the law on the presidential campaign trail, boasting that it has added 21,000 Texas doctors — a claim the report disputes. Supporters of the law also urged Congress to enact a similar provision for the nation as part of the federal health care law that passed in March 2010. That provision was not included.

The 24-page report by Public Citizen, "A Failed Experiment," says that using Texas as a model would benefit doctors and insurers — not residents.

The report claims that Medicare spending in Texas has risen faster than the national average, and so have private health insurance premiums. It also says that, contrary to Perry's claims, the per capita increase in the number of doctors practicing in the state has been much slower since the state passed the so-called tort reform law than it was before the law.

Organizations that support the 2003 law — the Texas Medical Association and the Texas Alliance for Patient Access — disputed the report's assertions on the number of physicians who have come to the state. As for health care costs, "we never said consumer costs would go down," Jon Opelt, the alliance's executive director, said Wednesday.

Before the state limited damage awards that patients and their families could collect in malpractice cases, doctors were leaving the state in droves, and malpractice insurance rates were about double what they are today for most doctors, said Dr. Howard Marcus, an internist at Austin Regional Clinic. Marcus, a member of the medical association and chairman of the alliance, said that it took several years for tort reform to have an effect and that since 2007, Texas has licensed 60 percent more new doctors each year than it did before tort reform.

The report by Public Citizen, a nonprofit consumer advocacy group, examines the number of direct patient care and primary care doctors in Texas between 1996 and 2010. It says that in the seven years before the lawsuit limits, the per capita number of doctors increased by 9.3 percent. In the seven subsequent years, the increase was 4.2 percent.

Perry's 21,000 figure was disputed by a PolitiFact check, which Public Citizen cited. PolitiFact said that Perry was counting all physicians licensed in Texas — the number actually practicing was 12,788 — since 2003. Experts said most of that increase was due to population growth, not tort reform.

Marcus said that Public Citizen erred by using a seven-year range before and after the 2003 law took effect. He said that it took until about 2007 for the law's effects to be felt, adding that it would be better to examine 2007 to 2011 and compare those years with the period before the tort changes.

Perry spokeswoman Allison Castle said Wednesday that tort reform has greatly expanded access to care, especially in underserved rural areas. For example, she said, the number of obstetricians in rural areas of Texas has grown by 27 percent.

Castle added that from 2003 to 2009, Texas premiums for employer-sponsored health coverage increased at a lower rate than the national average and 27 other states.

The Public Citizen report counters that doctors in rural areas of Texas have decreased by 1 percent since tort reform after increasing by 23.9 percent in the seven years before the 2003 law.

It also says that health care coverage is unaffordable to more Texans since the law took effect. In 2010, 24.6 percent of Texans were uninsured — the highest rate in the nation — compared with 23.6 percent in 2003.

Regarding Medicare costs, the Public Citizen report says that proponents of lawsuit limits say that doctors would order fewer tests and practice less "defensive medicine" if they didn't have to fear as many lawsuits. "In fact," the report says, "Medicare diagnostic testing expenditures in Texas not only increased during this time frame (2003 to 2007), but rose 25.6 percent faster than the national average."

Marcus and Opelt said many factors drive such costs and that they have no bearing on changes in the medical malpractice law.

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source: www.statesman.com (Roser, 10/12)