The November 2005 article “Hurt? Injured? Need a Lawyer? Too Bad!” ignores the tremendous benefits all Texans, but particularly poor Texans, have realized from Proposition 12. It fails to grasp that a liability system that catered to jackpot justice was harming patients and doctors alike. Because a few patients got unlimited court awards, the rest of us were left with limited health care, fewer options, and more miles to travel to get the care we needed.

Texas Monthly failed to report that prior to the passage of Proposition 12, a disturbingly high number of doctors had restricted their practice or left medicine altogether. The ranks of medical specialists, particularly neurosurgeons, orthopedic surgeons, and obstetricians, were declining. Hospitals across the state were turning away ambulances due to a critical shortage of doctors and nurses. Many hospitals could not obtain on-call coverage for emergency departments. Capital improvements and new patient services were being shelved. Nursing homes were going bare, unable to afford liability coverage.

The number of doctors practicing in Texas has grown dramatically since voters approved Proposition 12 two years ago. Not only has the state gained more than three thousand physicians, but we have also enjoyed a steady influx of much-needed specialists and emergency-medicine physicians.

And while the ranks of Texas physicians are on the rise, the liability rates they pay are on the decline. All five of the state’s leading physician liability carriers have announced rate cuts this year—most of them by double digits—producing nearly $49 million in annualized premium reductions. The compounded savings for doctors from January 2004 to the present far exceeds $100 million. No other state in the nation can make that same claim. Perhaps that is why in May, the American Medical Association removed Texas from its list of states in crisis. Texas is the only state ever to be removed from that list.

Under the new law, injured patients are still going to court and collecting large awards. Plaintiff’s lawyers are still renting highway billboards and buying television ads that encouraged patients to sue their doctor. Proposition 12 was a trade-off in which the people of Texas opted for reasonable court awards in exchange for the improved prospect of having a doctor available to treat them when they are sick or injured.
Howard Marcus, M.D.
Chairman, Texas Alliance For Patient Access
Austin

Your article fundamentally misrepresented one of the most important public policy issues that was debated and addressed by the Legislature in 2003—how to balance the importance of providing access to health care for all Texans against the need to adequately compensate patients who were injured by a doctor or other health care provider. Rather than discussing the facts that convinced the Legislature and the voters that a constitutional amendment was needed to limit excessive awards for noneconomic damages in health care cases, the article focused on the political process and suggested that a limited number of high-profile people and organizations influenced the legislative process for their own interests.

What Texas Monthly failed to report was that prior to the passage of Proposition 12, which allowed the limit on noneconomic damages, many Texas physicians had restricted their practices or left medicine altogether and that hospitals across the state were having difficulty getting coverage of their emergency departments and other critical services because of the shortage of doctors. Increased liability insurance costs also were making it more difficult for hospitals to make capital improvements or provide needed patient services.

Rather than focusing on the political process and suggesting that the public was not fully informed about Proposition 12, Texas Monthly would have served its readers better by explaining the facts and rationale that convinced the Legislature and the public that strong action was needed to address a serious problem with our civil justice system that was jeopardizing access to health care in the state. Texas Monthly also should have informed its readers of the positive impact that this reform is having on the state’s health care delivery system and that access to care is improving.
Charles W. Bailey
Texas Hospital Association
Austin

I don’t agree with Mini Swartz’s idea that tort reform is only hurting the ordinary people. Too many of the “ordinary people” have abused the system. Unscrupulous lawyers have fueled the fire.

Tort reform in Texas is heading in the right direction. True, there will be some incidents that may not be fair, but as a whole, our state needs to clean up its act. People are abusing the system through frivolous lawsuits and the idea that “If others can do it, why shouldn’t I.” The standards for litigation have fallen to the point that greed runs the show.

I know people who think that suing is a way of life, and in their minds, it is money in their hands. They figure if they sue enough people or companies, the odds would favor them. The courts should be aware of all lawsuits filed by an individual. That might stop some of this legal robbery.
Hana Case
Santa Fe, Texas

Boys’ Club

My guess is that the three boys learned much less than they admitted to [“State of Dysfunction,” November 2005]. Having attended Boys State in 1971 in much the same state of mind as the three from Austin, I discovered for the first time that the most vocal rarely reflect the general consensus. No doubt, there are always the stump standers more than willing to shout out their personal opinions and dare an opposing view, but the reality is that these guys missed a chance to meet many, many more who likely did reflect points-of-view much closer to their own. They forfeited a chance to rally like-minded students, and most disappointing of all, they allowed a vocal few on the far end of the political spectrum deny them a chance of a lifetime. Life is full of front-line intimidators, and if you decide to cut and run before you even finish the dance, you don’t deserve to be invited!
Moore Matthews
Fort Worth