TEXAS: Testing Ground For HMO Malpractice Law
As Congress debates the various patients' rights bills, many look to Texas as a test case for a pioneering provision that allows patients to sue their health plans. The New York Times reports that "the spotty early evidence does not support a lot of the dire warnings on Capitol Hill about a landslide of litigation." To date, not one lawsuit has been filed in Texas, although several are reportedly pending. While opponents and proponents admit that more time is required before the laws' effects can be definitively determined, early evidence highlights the main outlines of the debate.
The HMO malpractice bill went into "effect on Sept. 1, 1997, leaving little more than a year for patients to suffer injuries, contact lawyers and prepare suits." Despite the absence of suits, some Texas doctors say the possibility of legal action has already resulted in "a much better attitude on the part of HMOs." But while critics charge that this law will cause the return of defensive medicine and increased premiums, recent statistics "suggest otherwise." Full-service HMOs in Texas reported "an increase of only seven-tenths of 1% in the amount spent on medical expenses for each member per month from the end of September 1997, compared with a 4.5% increase in the previous six months." These numbers are significantly lower than projections from the Congressional Budget Office which suggested that similar federal legislation would "add 1.2% to insurance premiums" and another study by the Barents Group that said a liability provision could cause premiums to rise by 8.6% and cause 1.8 million people to lose their health insurance (Cropper, 9/13).