David Dewhurst

Ten years ago this week, the Texas Legislature took decisive action to improve access to healthcare and reduce frivolous medical liability lawsuits filed by personal injury trial lawyers. In passing medical liability reform, Texas strengthened the underpinnings of our economy, caught the attention of quality doctors from across the country and set a standard that our nation would be wise to emulate. Those tort reforms have been great for Texas.

Before 2003, more than two-thirds of the state’s trauma service areas experienced per capita loss in patient care physicians, largely because the threat of medical liability suits made insurance excessively expensive thus dramatically increasing the cost to practice medicine in Texas. Responding to citizens concerned about one of the lowest doctor-to-citizen ratios in the country, we spent the 2003 Legislative Session crafting free-market approaches to lowering costs of liability insurance for doctors in order to make sure every Texan had access to health care.

The resulting legislation, House Bill 4, capped the potential non-economic damages in medical liability cases, essentially halting frivolous lawsuits that were burdening specialists such as obstetricians, neurosurgeons, and others. This was especially necessary since, at the time, two-thirds of Texas counties had no obstetricians, 60% of counties had no pediatricians, and 24 counties in the Rio Grande Valley had no primary care physicians. HB 4 also empowered the Texas Medical Board to better protect patients against those physicians who do commit medical errors.

The legislative battle was fierce, with opponents dragging out debate for days, but HB 4 ultimately passed the Texas Senate with an overwhelming bipartisan majority of 27 of the 31 state senators. That following November, the citizens of Texas affirmed our efforts to increase access to care by approving Proposition 12, the accompanying constitutional amendment.

Almost immediately after passage of HB 4 in 2003, medical malpractice liability insurance rates dropped more than 40%, which led to increased competition, more physicians applying for Texas licenses, and more access to care for Texas families. Since that time, more than 30,000 new physicians have been licensed to practice medicine in Texas. I'm especially proud that these reforms increased the number of doctors in traditionally underserved counties like Hidalgo and Cameron.

Looking back now, our legislative success in 2003 and its positive impact on our state is proof that government can improve health care when it institutes free market reforms then gets out of the way. In Texas, this approach enabled hospitals and other health care providers to spend more in treatment, prevention and the delivery of health care services and less on out of control liability insurance costs. This also led to increased investment in medical facilities, more health care jobs and a better quality of life for our citizens.

All in all, we'd say the battle for tort reform was not only worth the effort, but also set an example that our elected leaders in Washington would be wise to follow. If the Texas model were to be adopted by our sister states, it could offset some of the tragic consequences of the passage of Obamacare.


David Dewhurst

David Dewhurst is the Lieutenant Governor of Texas.