Thursday, November 2, 2006

Updated: Physicians in Texas: Numbers Growing, Or Not?

Charles Silver (Texas) has a useful post at TortDeform about the purported increase in physicians practicing in Texas.  His conclusion:

In sum, the 2003 Texas reforms transferred a lot of wealth from malpractice victims, their families, employers, and health insurers to physicians and their liability insurers. This was the main object of the 2003 reforms, and the reforms achieved it. But the reforms have not increased physician supply, which grew at a sub-par rate in the post-reform years. The facts show yet again how wealthy and concentrated interest groups use the political process to advantage, at the expense of groups whose members are anonymous and dispersed.

Update: The comments discussion at TortDeform is worth following.

http://lawprofessors.typepad.com/tortsprof/2006/11/physicians_in_t.html

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A better summary would be:

Losers: Lawyers, ex-post malpractice victims without economic damages (i.e., those with minor injuries), their families, employers, and health insurers

Winners: Physicians, malpractice insurers (who are mostly non-profit mutual insurance societies made up of physicians), ex-ante patients, their families, employers, and health insurers

Silver is measuring data at its most noisy (what's the effect on OB-GYNs, ER doctors, and neurologists who are most affected by malpractice litigation?), isn't accounting for the lag time for new doctors to come into the state, much less confounding variables. The ratio of Texas doctors/US doctors to Texas population/US population dropped over the relevant "crisis" time period (in other words, the number of Texas doctors grew slower than the number of US doctors, even as Texas population grew faster): it's curious that Silver uses the raw counting numbers to make his point, because in his earlier paper he criticized reformers who didn't account for population growth in measuring the total volume of malpractice claims.

Silver's conclusion also contradicts basic economics: he acknowledges that physicians do better economically under reform, but then seems to argue that this will have no effect on supply. If he's going to argue the laws of supply and demand don't apply here, he needs better evidence than a fifteen-data-point single-variable chart that doesn't even use the best measure of the issue.

Posted by: Ted Frank | Nov 2, 2006 12:53:19 PM

The discussion continues over at Tort Deform.........

What’s Up Doc Revisited: A Reply To Ted Frank (American Enterprise Institute)

http://www.tortdeform.com/archives/2006/11/yo.html#comments

Posted by: Cyrus Dugger | Nov 6, 2006 4:43:12 PM

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