In 2003, Texas health care was in full-blown crisis. There were not enough physicians, particularly in high risk, hospital-based specialties, such as obstetrics, neurosurgery and trauma. Pregnant women in 154 Texas counties had no local obstetrics care. The nearest doctor providing labor and delivery services was sometimes more than 100 miles away. In trauma situations, patients needing neurosurgery were being flown from Beaumont to Galveston or Houston, losing valuable time and lessening their chances of achieving a full recovery.
This shortage of physicians was partly due to an unrestrained health care liability system. All over the state, but particularly in rural areas, hospitals could not maintain traditionally high-risk services such as labor and delivery because physicians were leaving the state for other locales that weren’t quite as litigious or were hanging up their stethoscopes altogether.
In response to this crisis, the Texas Legislature and voters acted decisively. They approved a set of landmark reforms in House Bill 4 and Proposition 12 to rein in the state’s health care liability system.
The turnaround in physician workforce and improved access to care was almost immediate. The number of pediatric subspecialists – the doctors who care for children with complex and serious conditions – has increased more than 300 percent since 2003. The number of emergency doctors in rural areas has increased 64 percent, outpacing rural population growth by nearly a factor of 10. Thirty-five rural counties have added at least one obstetrician, including 16 counties that previously had none. All these numbers translate to better access to care for Texans.
In 2015, Texas again needs this kind of decisive action.
Hospitals are once again struggling to maintain certain services and, in some cases, struggling to stay open at all. Already this year, 10 rural hospitals have closed, leaving their communities without ready access to a hospital and the physicians who practiced there.
But this time the cause is not medical malpractice. It is unsustainable uncompensated care costs resulting from a growing number of uninsured Texans.
Several bills introduced in this legislative session would create a private health insurance option for more than 1 million uninsured, low-wage working Texans. Such a practical and fiscally responsible option would reduce the number of uninsured in Texas and reduce hospital uncompensated care. It would also engage consumers in their own health and wellness and require personal responsibility and accountability for health care choices.
Texas has an enviable medical malpractice environment and it attracts physicians from all over the country to practice in our communities. But, unless our state leaders act on increasing access to health insurance and reducing uncompensated care, the irony may be that there won’t be hospitals for these physicians to practice in.
A solution exists. Texas just needs to adopt it.