Short Takes On News & Events

Candidate Perry’s Prescription: Medical Malpractice Reform

By Marilyn Werber Serafini

August 26th, 2011, 4:17 PM

Just a few weeks into his campaign, Texas Gov. and presidential candidate Rick Perry isn’t talking a whole lot about health care, except to criticize President Obama for last year’s law. And he’s not considered a health care expert. But he’s is passionate on one point: Fixing the nation’s health care system must include a major reform of the medical malpractice system.

Photo by Darren McCollester/Getty Images

In 2009, Perry and fellow GOP presidential competitor Newt Gingrich wrote in a Washington Post op-ed that Texas has successfully controlled health care costs, and at the same time has improved quality by enacting tort reforms in 2003. “Fewer frivolous lawsuits have attracted record numbers of doctors to the state as medical malpractice insurance premiums dropped by half,” they wrote.

They also mention Christus Health, a large Catholic nonprofit system with a significant presence in Texas, which reduced its liability defense payments from about $100 million in 2003 to $2.3 million last year. The savings went to expanding health-care services in low-income communities.

The 2003 law Perry enacted capped noneconomic damages — court awards for pain and suffering – at $250,000 per defendant. There is no cap on economic damages, such as medical expenses.

Republicans and physicians have long argued that massive court awards make it difficult for doctors to obtain malpractice insurance coverage at affordable prices – or at all — and that they increase health care costs by prompting them to practice defensive medicine. Consumer advocates and trial lawyers, though, have countered that capping awards infringes on the rights of individuals to be properly compensated, that the caps don’t do much good in holding down costs.

Perry wrote in an op-ed in the Washington Examiner in 2009: “In 2003, I declared the medical liability crisis an emergency item, and the legislature responded, passing sweeping reforms that protected the patient …. We ended the practice of allowing baseless, but expensive, lawsuits to drag on indefinitely, requiring plaintiffs to provide expert witness reports to support their claims within four months of filing suit or drop the case.”

But Jon Greenberg of New Hampshire Public Radio today debunked some of Perry’s claims on tort reform on the Politifact website: “The wholesale transformation that Perry describes is not backed up by the numbers. Perry said Texas has 21,000 more doctors thanks to tort reform. That’s flat out wrong. Texas has only about 13,000 more doctors in the state and the historic trends suggest that population growth was the driving factor. We rate his statement False.”

What else might “Perrycare” have to offer Americans? “Rick Perry believes the best way for the federal government to improve health care is to stimulate job creation so more Americans are covered by employer-sponsored health plans,” according to his campaign website. “Creating jobs will also reduce the strain on public safety net programs like Medicaid, saving taxpayer dollars.”

4 Responses to “Candidate Perry’s Prescription: Medical Malpractice Reform”

  1. Ben D says:

    Jon Greenberg’s Politifact piece is rife with errors of the calculation variety – his percentages are off, he’s reading from the wrong lines, and he compares the 12,788 “active instate” doctors to the 2003 line for “total” doctors to achieve his percentage calculation, which is obviously wrong. I also assume he is also familiar with the difference between a net increase and a gross increase – doctors, after all, have been known to retire, and many of the new additions to Texas replaced aging on site staff – but he gives no indication of this.

    But setting aside those mistakes in the numbers, it really behooves him to have contacted the individuals featured in this lengthy New York Times story about the same issue, which reflects the opposite impression regarding the impact of tort reform in Texas. I have yet to meet a single expert in the health policy field who believes that the increase here was simply about population growth.

  2. Kim Slocum says:

    If we require any proof that malpractice is one of the great “red herrings” in our national debate about health care cost growth, we need only look at Texas. Despite the widely touted reform of malpractice awards, the state still has among this highest rates for health care insurance in the country–well above the averages seen in most states with more traditional machinery for handled medical malpractice cases. There may be good reasons to reform malpractice but reducing the cost of health care is not one of them.

  3. Kim Slocum: You are correct. The real reason for making health care liability reform is not for reducing the cost of health care — although there may be some long-term savings once defensive medicine is wrung out of the system. The real reason is for increasing access to health care, especially in underserved areas, rural areas, emergency rooms. That’s what we’ve seen in Texas.

    Steve Levine
    VP, Communication
    Texas Medical Association

  4. Shirley Svorny says:

    The problem with eliminating liability is that, like any liabilty, medical professional liability protects consumers. Court awards are not random, insurers review the validity of claims before they defend physicians, lawyers generally shy away from defending invalid claims. Studies show that most court awards make sense. Most cases settle because everyone knows what the courts will decide, the signals are so clear. Medical professional liability insurance company underwriting identifies high-risk physicians, charges them experience-rated premiums, limits what some of them can effectively do, oversees the introduction of new procedures, and rewards risk management efforts. State medical licensing boards don’t protect consumers, they are protected by a combination of hospital and HMO liability, malpractice underwriting, and other forces.