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Fed agency: Texas ranks at bottom for health care

Posted by attorney Christopher Zachar

AUSTIN, Texas -- Texas ranks worst in the nation in health care services and delivery, according to an annual scorecard issued by the Federal Agency for Health Care Research and Quality. In nine out of 12 categories, Texas rated weak or very weak. The only area where Texas earned the average ranking of good was in maternal and child health care measures. Out of a possible 100 points, Texas earned 31.61, while Minnesota, the highest ranking state, scored 67.31.

The Agency identified 155 areas where it could compare the quality of health services across the country, such as infant mortality and obesity rates. Researchers used that data to generate both national and regional averages for each area, and they then compared each state to the national and regional averages to generate a score.

Stephanie Goodman, spokeswoman for the Texas Health and Human Services Commission, said Thursday that the report goes far beyond what state agencies control, but she said it demonstrates the need to improve access to preventive health care. "Late last year Texas received approval for a new effort that will help fund innovative local projects," she said. "Hospitals and other health care providers have come together to form regional partnerships, and they'll soon be sending the state their plans for making better use of Medicaid funds to expand access to preventive services and reduce the need for expensive emergency room care."

Texas scored particularly poorly in the home health care category, with the study finding that the state provided little support to the elderly and disabled who chose to live at home. Texas also ranked weak or very weak in preventive, acute and chronic care delivery. The state's scores slipped from last year in treating cancer and diabetes patients.

The poor state of the Texas health care system has particular relevance as state lawmakers begin to consider how to respond now that President Barack Obama's federal health care overhaul has been upheld by the U.S. Supreme Court. Republicans, who control every statewide office and represent a majority in the Legislature, have rejected the new federal law, which calls for almost every eligible U.S. citizen to get health insurance. Some have pledged to block any effort to expand Texas Medicaid, which is a joint state and federal program, in order to get more people insured.

Democrats have called on the state to close tax loopholes to raise more money for both health care and education programs.

Very Interesting Facts

In 2003, Texas lawmakers enacted legislation limiting the amount of money juries can award patients who win malpractice lawsuits against doctors and hospitals. The legislation capped non-economic (pain and suffering) damages at $250,000 in lawsuits against doctors and $750,000 against hospitals.

Texas, the lawmakers reasoned, “stands as a good example of how smart, responsible policy can help us take major steps toward fixing a damaged medical system, starting with legal reforms." As a result of the 2003 tort reform law, malpractice liability insurers reduced their rates in Texas and, according lawmakers, the number of doctors applying to practice medicine in the state “skyrocketed."

True? hardly

When you look at how Texas stacks up with the rest of the country in terms of physician growth in direct patient care, tort reform appears to have given Texas ZERO leg up in competition with others states for doctors. In fact, according to statistics compiled by the American Medical Association and other physician organizations, Texas has actually lost ground when it comes to the number of doctors practicing in the state since tort reform was enacted. Big time.

In 2008, the number of physicians in patient care per 10,000 civilian population in the United States was 25.7. At just 20.2 doctors per 10,000 people, Texas ranked near the bottom of the 50 states. In fact, only nine states fared worse. In 2000, three years before tort reform, Texas was still bringing up the rear, but not as badly. Back then, 11 states fared worse than the Lone Star state. Even more revealing, the number of doctors in patient care increased 13.2 percent nationwide from 2000 to 2008. It increased only 12.8 percent in Texas. The rate of growth was actually greater in 41 other states and in Washington, D.C. than it was in the Lone Star state.

Advocates of tort reform have long claimed that one of the reasons for escalating health care costs is the “defensive medicine" doctors practice, such as over-treating and prescribing more medications and diagnostic tests than necessary, out of fear of being sued. Well, if Texans believed their own health insurance rates would go down once tort reform made defensive medicine less prevalent, they have by now been disabused of that notion. The chances of a Texas family saving a few bucks on premiums would actually be greater if they moved to another state.

In 2010, the average premium for family coverage in Texas was $14,526. That’s $655 higher than the U.S. average. Those numbers seem to indicate that doctors have not passed on their own insurance savings to their patients and that they are not practicing medicine any less defensively than before tort reform was enacted.

Not only are Texans paying more for their own insurance while doctors are paying less for theirs, their chances of getting employer-subsidized coverage is less than it would be if they lived in another state.

The Dallas Morning News, citing statistics from the Agency for Healthcare Research and Quality and other sources, reported that a smaller percentage of employers in Texas offered coverage to their workers last year than in the U.S. as a whole (51 percent and 53.8 percent, respectively). And the Texans who do have coverage through the workplace are contributing far more out of their own pockets for that coverage than people who live in most other states. In Texas last year, the average employee contribution toward company-sponsored coverage was $4,500. The U.S. average was much lower: $3,721.

Another statistic Texas lawmakers are not likely to mention when talking about the benefits of tort reform is the number of Texans who are uninsured. The U.S. Census Bureau reports that Texas continues to be the state with the highest percentage of its residents without coverage, a whopping 25 percent last year, compared to about 16 percent nationwide. It was dead last in 2003 and it is dead last now.

Tort Reform is just bad for consumers. It is nothing more than a protectionist measure for big business, at the expense of the victims who are injured or killed by the negligence of others. Tort Reform has provided ZERO benefits to the states that have enacted some form of it, and as shown above, has in many cases made states worse

Always, say NO to tort reform.

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