Promises Made, Promises Kept: Liability Reform Delivers Increased Access to Care in Texas
When medical liability reform was proposed in Texas in 2002, promises were made to patients that the system would be reformed to provide greater access to quality medical care for all.
In 2002, Governor Rick Perry stated that he was committed to ending the medical liability crisis, by “reigning in abusive lawsuits, improving patient protections and reforming insurance regulations—to ensure patients have access to the best care possible.”
Key points from a special report by the Texas Civil Justice League, “Liability Caps Deliver Increased Access to Health Care,” show just how well those promises were kept.
In 2001 Texas issued new licenses to just over 2,000 physicians, the lowest number in the prior ten years. By contrast, in 2008 Texas licensed more than 3,600—the highest number in its history—and since passage of the medical liability reforms in 2003, more than 21,640 new physicians have successfully sought and received licenses to practice in the state.
In the Rio Grande Valley, more than 220 new physicians have opened practices, many in critical medical specialties hardest hit by the liability crisis. Doctors are also flocking back to counties such as Victoria, Nueces, and Jefferson along the Texas coast, each of which experienced a rapid decline in the number of physicians in 2001 and 2002.
Texas hospitals have used more than $100 million per year in savings on liability insurance, which they are using to hire medical staff, improve and expand facilities, enhance efficiency and patient safety, and deliver more charity care; up about $500 million per year since 2003.
New Medical Liability Program May Lead to More Rapid Resolution of Claims
As readers of PPN’s newsletter know, our current medical liability system is broken and does not serve the needs of patients. Meritless lawsuits burden our legal system, causing it to be costly and too slow for those with legitimate claims.
But a new program in New York, funded in part by a $3 million grant from the federal Agency for Healthcare Research and Quality, is providing hope to some looking to fix that state’s broken system.
The new program, called judge-directed negotiation, purports to eliminate much of the complexity of traditional litigation. At the onset of the lawsuit, a judge with expertise in medical matters becomes the point person for that case. A single judge supervises the entire process and brings the parties together as often as necessary to discuss the case and help broker a settlement.
Some believe that Judge-directed negotiation provides a more rapid resolution to medical liability cases and helps deserving patients reach closure – typically settling a case in six to nine months, instead of the average three years.
The $3 million grant to the New York program will allow expansion from New York City to Buffalo, and is one of seven grants announced last year. To read more about the grant program, click here.
Thirty Years Later, Indiana Liability Reforms Under Fire
A thirty year record of success in Indiana doesn’t seem to deter personal injury lawyers, who this month launched a legal challenge to the state’s limit on non-economic damages.
Julie Reed, general counsel of the Indiana State Medical Association, spoke out in favor of the current law in a recent article in American Medical News.
“The cap eased the medical liability crisis in the 1970s and continues to provide stability for doctors,” Reed said. Before the law, some doctors stopped doing certain high-risk procedures because they could not find insurance coverage, she said. Others left the state.
“There is no question that the law… gave us the exact stability we needed and helped shore up and ensure [insurance] coverage was available. It stemmed the tide,” Reed said.
The Litigation Center for the American Medical Association and the State Medical Societies filed a joint friend-of-the-court brief with the Indiana State Medical Association in support of the current limit of $1.25 million in total damages for liability cases. You can click here to read more about the challenge to Indiana’s long-standing liability laws.
Physicians Say Liability Concerns Increase Hospital Stays
Patients visiting emergency rooms across the country are being admitted at higher rates, and discharged less frequently. And it’s certainly not the infamous hospital food that’s enticing them to stay.
Medical liability is a key reason physicians admit more emergency department patients and discharge them less, say two studies in the October Annals of Emergency Medicine.
In one study, a survey of 849 emergency physicians and patients found that 11 percent of physicians reported liability concerns as a primary driver for admitting patients with potential acute coronary syndrome. A second study showed that discharge rates for congestive heart failure patients in 27 emergency departments in New Jersey and New York between 1996 and 2010 dropped from 24% to 9%.
Dr. David Newman, an emergency physician and director of clinical research in the at Mount Sinai School of Medicine in New York, said physician concerns about medical liability will continue until the medical liability crisis is addressed at the federal level.
“The lack of action taken to repair our broken malpractice system has led to an increase in fear,” he said. “The longer we leave this problem unaddressed, the more legal-medico fears will drive decisions.”
