Late one night several years ago, when I was practicing medicine in Lewisville, I was called to assist another physician with a complicated delivery. I rushed to the hospital to help, but things did not go well that evening. The baby did not survive.

Other than assisting in a time of crisis, I had played no role in diagnosing or treating this patient throughout her pregnancy or her labor. I had simply responded when the call for help went out during a crisis. But two years later, I was included in a lawsuit.

I learned, early in my career, how arbitrary and unjust our medical justice system could be.

Now, many years later, I find myself participating in the debates about major healthcare change, and rightfully so, liability is being discussed. Does medical justice reform have a role to play in the greater concept of healthcare reform?

Cost estimates are difficult to ascertain, but consider just the cost of liability insurance in the five years before I left active practice. Liability rates more than doubled from $25,000 in 1997 to $53,000 in 2002. Then, in 2003, Texas undertook major medical liability reform by capping noneconomic damages. Subsequently, liability insurance rates for an obstetrician/gynecologist in Dallas-Fort Worth fell to $37,000 in 2008. Clearly, this reform made a significant difference upon liability rates in Texas, but more importantly, it allowed physicians to return to the state or their practice.

When I was in Nome, Alaska, for a Chamber of Commerce function, a group of doctors came up to me and voiced excitement that Congress might pass a federal cap on noneconomic damages. They told me that they were eager for liability reform to pass, and soon. Because of high liability insurance rates, their hospital could not afford to employ an anesthesiologist.

I asked one doctor what type of practice he had, and he said, "Just like you, I’m an obstetrician." I asked him how he was practicing obstetrics without an anesthesiologist on staff, and he admitted that this was very difficult. Not only were they unable to offer epidural anesthesia during labor, but if a patient required a C-section, it required an emergency evacuation to an Anchorage hospital.

It is hard for me to understand how patient care was being served by continuing to allow the current system to prevent this hospital from hiring an anesthesiologist.

A perinatologist I met in 2003 recently had completed medical school, residency and fellowship, sub-specializing in the care of complicated pregnancies. Because this was deemed such a high-risk specialty, no insurance company in Dallas-Fort Worth would cover him.

Unwilling to risk his financial future, he started work as a computer analyst instead of opening a medical practice. After the Texas liability reform in 2003, he obtained coverage and practices today.

I have submitted to President Barack Obama on several occasions that Texas’ capping of noneconomic damages has worked. It has improved the climate for doctors in Texas, luring more to the state, especially in medically underserved areas.

Furthermore, this reform does not deny patients who have been legitimately harmed what is due them.

There are other strategies for lowering liability costs, and these should be explored. But we should not sacrifice what is clearly a working and winning strategy while we look at other options.

The Texas reform works well, and we should do no less for the people of the United States.

Rep. Michael C. Burgess, M.D., is a member of the House Energy and Commerce Committee. He is founder and chairman of the Congressional Health Care Caucus.


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