By STATE REP. JOE NIXON
Copyright 2004 Houston Chronicle Austin Bureau
May 7, 2004, Page 43A

All across Texas there are signs that passage of Proposition 12 and House Bill 4 are delivering on the promise of healing our health-care delivery system. Just six months have passed since Texans passed Prop. 12, and early indications offered in testimony recently before the House Civil Practices Committee are remarkably positive. The goal of increasing access to health care is being realized.

Both Prop. 12 and its underlying legislation, HB4, were designed to avert a growing crisis in the Texas health-care system. Too many lawsuits against health-care providers were driving up the cost of practicing medicine, resulting in reduced access to health care. Last year, only four medical liability insurers remained in Texas after 13 insurers fled a state they claimed was too litigious. Many higher risk medical specialists, such as neurosurgeons and obstetricians, were leaving Texas or simply ending their practices here because of the high cost of malpractice insurance. In short, too many Texans were at risk of losing access to health care.

But testimony offered recently in a hearing held by the House Civil Practices Committee shows that the healing process for our health-care system has begun.

Christus Health, a not-for-profit Catholic health system with hospitals throughout Texas , is projecting a $20 million savings on its liability costs this year. Christus has earmarked these savings for patient services, expanding its already high level of charity care. Christus officials say the $20 million savings is a direct result of recently passed lawsuit reforms.

An OB/GYN group in Fredericksburg announced it would again deliver babies. The three doctors had stopped the obstetrical portion of their practice due to an inability to pay the malpractice premiums for that portion of their medical practice. Expectant mothers in that area of Texas no longer will have to travel to San Antonio for prenatal care and to deliver their babies.

The two neurosurgeons in Bryan will continue their practice in that community. These were the only neurosurgeons in Brazos County . They had already announced their departure, but because of the relief in premium expense, they will stay.

Four new anesthesiologists have agreed to move to Beaumont . Four nursing homes, two in Austin and two in San Antonio , are able to continue to provide a home and health care to 600 elderly Texans.

In short, the lawsuit momentum against health care providers has stopped and the early signs are it is turning around.

The state's largest carrier, Texas Medical Liability Trust, lowered its rates on Jan. 1, by 12 percent and a smaller carrier, Continental Casualty Co., cut its rates by 11.5 percent. The nation's largest physician insurer, The Doctors Co. , wants to expand its market share in Texas . Planned rate increases by other carriers have been put on hold.

Essentially, every doctor in Texas is either paying less malpractice premiums today or avoiding the pre-Prop. 12 scheduled increase in premiums. Texas Insurance Commissioner Jose Montemayor stated this was clear evidence of the beginning of a downward trend. Not only have rates begun to stabilize but 10 new insurance carriers have applied to enter the Texas medical liability market. That's additional good news for doctors desperate for rate relief and a reversal of the trend that forced 13 of 17 medical liability underwriters from Texas . New competition will have the effect of driving prices down. With more choices and lower prices, health-care providers will benefit from this healthier and more competitive malpractice insurance market. This has and will continue to translate directly into increased access to health care for Texans.

The president-elect of the Texas Trial Lawyers Association stated it is unlikely that the volume of future lawsuits will ever exceed one-half to two-thirds of pre-reform levels. This is an indication that many past suits should have never been filed at all and that the reforms in HB 4 are working to discourage the filing of non-meritorious lawsuits.

In contrast, Oklahoma doctors are seeing their insurance rates double this year; and despite passing comparatively watered-down reforms in Florida , its physicians are being hit with a 50 percent rate hike. Thankfully, this is not the story in Texas .

In Texas , happily, the early news is very good. The full effects of the reforms passed by the Legislature and approved by the voters have not yet been realized. It is early. The huge spike in the number of suits filed before the reforms became law has not worked its way through the system. Disturbingly, one carrier is trying to bypass the increased regulatory supervision of the Texas insurance commissioner because of a federal law loophole. Continued monitoring is needed to ensure that the enacted legal reforms translate into increased access to health care. Nonetheless, the early signs are that the Texas health-care system is recovering and the prognosis is good. That's good for doctors, hospitals and other health-care providers, and its good news for the people of Texas.

Nixon, R-Houston, sponsored House Bill 4.