SENATOR HUTCHISON DISCUSSES THE FARM, NUTRITION, AND BIOENERGY ACT OF 2007

As I travel in my State, I hear the complaints, and have for the last number of years, about lack of health care in our rural areas. It is one of our largest issues in this country today. I want to talk a little bit about our situation in Texas because the amendment before us is modeled somewhat on the law that did provide medical malpractice reform in Texas.

Before 2003, according to the Texas Department of Health, 158 counties had no obstetricians, 24 counties had no primary care physicians at all, and 138 counties had no pediatricians. Texas ranked 48 of the 50 States in physician manpower for our population. Why were we having such trouble? Because the cost of providing health care before 2003 was unsustainable, largely due to increased litigation activity which drove the medical malpractice insurance rate so high that doctors were being driven out of Texas. In fact, the insurance companies also left Texas because the claims were so high.

In 1991, Texas averaged 13 claims per 100 physicians. By 2000, Texas averaged 30 claims per 100 physicians. Of these claims, there was a disproportionate growth in noneconomic damages, damages such as pain and suffering. It was this growth, in contrast to awards of economic damages such as lost wages and medical care costs, that really spurred the increase in the medical malpractice premium. In 1991, noneconomic damages averaged 35 percent of total verdicts. By 1999, they averaged 65 percent. So the noneconomic damages--the pain and suffering damages--really doubled just in that 8-year period, not even taking into account the economic damages, which are certainly warranted damages when there is any kind of malpractice.

From 1999 to 2003, the average malpractice premium increase in Texas was almost 74 percent. The Texas Medical Liability Trust, which covered about one-third of the State's doctors in 2003, increased rates by 147.6 percent between 1999 and 2003. We are talking 4 years. In the Rio Grande Valley, physicians in general surgery and OB/GYN practices ranked sixth and seventh in the Nation for the highest premiums in 2002. The impact of litigation on Texas's health care system was undeniable and unsustainable.

Medical liability reform came about in 2003. There were bold changes in the tort system in an attempt to restore access to care. We have seen a dramatic change. According to the Texas Medical Board, physician applications for State licensure have doubled from 2003 to 2007. The Texas Medical Board reports that since passing liability reform in Texas, Texas has experienced a gain of 195 OB/GYNs, 505 pediatricians, 169 orthopedic surgeons, 554 anesthesiologists, 36 neurosurgeons, 497 emergency medicine physicians, and 37 pediatric cardiologists. Prior to reform, Texas had five liability carriers. Since reform, Texas has added 3 new rate-regulated carriers and 13 new unregulated insurers. The five largest insurers announced rate cuts in 2005, with an average premium reduction of 11.7 percent. These reductions produced $48 million in annual premium savings.

Medical liability reform does work. We have attempted, on the floor of the Senate, for many years to have a national medical liability reform, even just focusing it on OB/GYN doctors and emergency room doctors because there are shortages all over the country of these kinds of services. There are shortages of physicians who are willing and able to perform these services because of the high medical malpractice insurance rates.

Everyone in our country, and certainly in the Senate, wants to make sure that if there is a medical error that causes an injury to a baby, to a mother, to anyone who is getting health care, certainly there should be penalties. There should be payment for economic damages. There should be payment for loss of wages and payment for pain and suffering. But if you have lawsuits where the pain and suffering start driving it rather than the economic damages and it starts to encroach on the ability of doctors, even if they have a clean record, to afford the rise in liability premiums, then I think we have to take a look.

It is particularly acute in our rural areas, where we have so many farmers, which is, I am sure, why Senator Gregg brought forward this amendment. I think it would be a great amendment to the farm bill to provide better access to health care for our farmers in this country. That is why, I am sure, Senator Gregg chose this bill, because we have not had the opportunity to address medical malpractice reform since we made the attempt last year in the Senate, which was utterly unsuccessful, to be honest.

Because the problem has gotten worse in many States and because the record in Texas after medical liability reform has caused so much better care, more access to care, and more satisfaction with care in Texas since the reform, I would like to see that model able to be reproduced around our country and especially in our rural areas, which is the subject of the bill before us today.

I yield the floor.

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