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Alex Winslow
Alex Winslow
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Costs Up, Access Down, Medical Errors Unabated. Should TX Really Be Our Health Care Model?

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Health care reform has been dominating the headlines for months now. The special interests headed by the insurance industry are doing everything they can to take advantage of the confusion on Capitol Hill over the direction health care reform should take by trying to infuse anti-patient provisions that are designed to lock patients out of the courthouse into the debate.

This is a tried and true tactic for these interests. I’ve seen it happen in Texas where we have been on the front line of a decades-long struggle to preserve and restore our legal rights.

The insurance interests’ plan is to insert Texas-style, anti-patient provisions in the guise of “reform.” Regardless of the hype coming out of these special interests, policymakers should be wary of using Texas as a model.

When insurance lobbyists in my state rammed through legal changes designed to severely limit the legal rights of Texas patients, we heard high-falutin’ rhetoric promising dramatic improvements in the cost, access, and quality of health care.

What has actually happened?

  • Texas health care costs have increased faster than the national average
  • Health insurance premiums for Texas families have jumped 92% since 2000
  • Texas ranks near the bottom in per-capita physicians
  • Rural and under-served areas in Texas continue to struggle to attract new physicians
  • Texas has the nation’s highest rate of uninsured

Hardly a ringing endorsement of Texas as a model for the rest of the country.

Lowering costs for both the overall health system, as well as individual families, is necessary, but it won’t be accomplished by stripping patients of their rights. According to the Congressional Budget Office, the entire cost of the medical liability system accounts for only 1.36% of overall health costs – more a rounding error than a panacea. The focus should be on preventing malpractice, not sweeping it under the rug.

As for costs for families, why would we use Texas as an example when Families USA recently found that since 2000 health insurance premiums for Texas families increased 92% – more than 4.5 times faster than income? This during a period of rising deductibles and falling benefits.

As for access to care, the Census Bureau has reported that with 24.5% of our citizens without health insurance, Texas has the nation’s highest rate of uninsured. Also, the American Medical Association has found that Texas ranks 43rd in the number of doctors per capita, and that more than half of Texas counties have an acute shortage of primary care physicians.

As proof that under-served areas continue to have trouble attracting new doctors, our Republican legislature, along with Republican governor Rick Perry, were compelled to raise taxes this year to fund projects designed to attract physicians to rural areas. This tax hike came six years after so-called tort “reform” was enacted with the promise of improving access to care.

Finally, there is no doubt that medical facilities are enjoying significant savings because patients harmed by medical negligence have had their rights severely restricted. However, there is no evidence that these savings are being used to lower overall health costs. To the contrary, in the three years after Texas imposed arbitrary restrictions on patients’ access to the courthouse, we have seen overall Medicare spending increase 16% faster than the national average, according to data compiled by the Dartmouth Atlas of Health Care. In fact, 10 of the 15 health markets with the highest Medicare spending per enrollee are in states in which the medical and insurance industries successfully lobbied for severe limits on patient rights. Four of the nation’s most expensive health markets are in Texas.

According to the highly regarded Institute of Medicine report “To Err Is Human,” 98,000 Americans die each year as a result of medical errors, and the CDC has found that another 99,000 Americans succumb to hospital-acquired infections every year. Ending the epidemic of medical errors by preventing these needless deaths is a far better way to reduce health care costs than stripping patients of their legal rights.

The reality is that none of this has been or ever will be fixed by taking away the legal rights of patients. Unless we move beyond the insurance industry’s talking points and enact real reforms that force competition in the insurance market, strengthen safety standards, and restore accountability, we will continue to be plagued by an inadequate healthcare system that does more for insurance companies than it does for patients.