Gov. Rick Perry chose a South Texas county that he said had been at the epicenter of the medical malpractice lawsuit "crisis" to commemorate the 10th anniversary of legislation capping how much juries could award plaintiffs.
Speaking at the doctor-owned Doctors Hospital at Renaissance on Monday, Perry said the changes, commonly known as tort reform, expanded access to healthcare and made Texas an attractive destination for physicians.
"I'm just continually surprised that some people still want to argue that tort reform didn't work," Perry said, flanked by doctors in white jackets.
But Perry was in Hidalgo County along the Texas-Mexico border where access to healthcare remains a paramount concern and the benefits of tort reform with regard to healthcare access are difficult to discern.
"Texas doctors were faced with awful choices—stop providing the critical services their patients desperately needed, shut down their practice altogether or leave the state," Perry said. "It was a crisis that was precipitated by a system that fostered an unrelenting stream of lawsuits. Particularly in the Rio Grande Valley, physicians were rare who had not been sued."
The Texas Medical Association, which lobbies on behalf of doctors, released a survey at the event indicating that doctors believe the state's professional liability climate has improved.
According to the Texas Department of State Health Services, the number of direct care physicians in Texas has increased 24% since 2003 to 42,716 in September 2011, while the state's population grew 16% during the same period.
The measures passed in 2003 capped the noneconomic damages that could be awarded in medical malpractice lawsuits against doctors at $250,000, among other provisions.
Most affected were high-risk specialties such as neurosurgery. Dr. Carlos Cardenas, a gastroenterologist who introduced Perry, said prior to tort reform this area that served almost 1 million people had nearly no neurosurgical coverage.
Records from the Texas Medical Board indicate that in May 2003, before the reform took effect, there were three neurosurgeons in Hidalgo County. That number was unchanged in May 2013. But the number of medical specialties represented in the county has increased substantially, according to medical board records.
Still, Hidalgo County was an interesting choice for Perry to speak about healthcare access. The county on the Texas-Mexico border has the highest rate of people without health insurance among urban counties in the entire country at 38.9% and Texas has the highest uninsured rate among states, according to the U.S. Census Bureau. State data show that the ratio of population to number of direct care physicians in Hidalgo County was effectively unchanged from 2003 to 2011, the most recent available year.
The state as a whole still has a shortage of primary care physicians and another TMA survey released last year showed that fewer Texas doctors are accepting new patients who are covered by Medicaid or Medicare, the government-run plans for the poor and elderly.
The number of medical malpractice lawsuits has fallen drastically since tort reform, but attorneys who took those cases say the law made the economics of most cases unworkable. To prove such cases plaintiffs have to hire costly medical experts.
"The volume of people that we have a chance to listen to has not gone down, but the number of cases that we take obviously has dropped significantly," said Jay Harvey, a personal injury attorney in Austin.
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