In an August column appearing in the San Francisco Examiner, Texas Governor Rick Perry wrote: "Just six years ago, Texas was mired in a health care crisis. Our doctors were leaving the state, or abandoning the profession entirely, because of frivolous lawsuits and the steadily increasing medical malpractice insurance premiums that resulted."
But Texas has since joined 24 other states by enacting reforms that include a reasonable limit on non-economic damages for pain and suffering of up to $750,000 per incident. This essential reform does not limit compensatory awards for calculable lost wages and medical expenses, but it does balance the interests of patients and care providers while helping to ensure access to necessary care.
Now, according to Governor Perry, doctors' insurance rates have declined by an average of 27 percent while the "number of doctors applying to practice medicine in Texas has skyrocketed by 57 percent. In . . . just the first five years after reforms passed, 14,498 doctors either returned to practice in Texas or began practicing here for the first time."
Today's public benefits fail that test, as urban scholar Joel Kotkin of NewGeography.com and Chapman University told the Los Angeles Times in March: "Twenty years ago, you could go to Texas, where they had very low taxes, and you would see the difference between there and California. Today, you go to Texas, the roads are no worse, the public schools are not great but are better than or equal to ours, and their universities are good. The bargain between California's government and the middle class is constantly being renegotiated to the disadvantage of the middle class."
These judgments are not based on drive-by sociology. According to a report issued earlier this year by the consulting firm McKinsey & Co., Texas students "are, on average, one to two years of learning ahead of California students of the same age," even though per-pupil expenditures on public school students are 12% higher in California. The details of the Census Bureau data show that Texas not only spends its citizens' dollars more effectively than California but emphasizes priorities that are more broadly beneficial.
Heading for a city with greater opportunities? It'll cost you. One measure of a region's economic health is the relative price of moving-truck rentals.
It has been said that people vote with their feet. They pick up and go to where the jobs and opportunities are.
The hard part is that it costs more -- a lot more -- to move to where the jobs and opportunities are than to move to where jobs and opportunities are limited. My favorite measure for this doesn't come from the Bureau of Labor Statistics. Nor does it come from any other agency of the federal government.
It comes from U-Haul, the truck and trailer rental company. It has on-the-ground evidence and prices its rentals accordingly. Go to its Web site, and you can learn quickly where people are going. You can also learn where they are leaving.
How will you know this? Simple.
If lots of people are trying to go where you want to go, it will cost a lot more than renting equipment to go to the place everyone is trying to leave. Just as there is a law of supply and demand, there is a law of arrivals and departures. Finding a moving truck will be expensive where departures outnumber arrivals. It will be cheap in places where arrivals outnumber departures.
Suppose, for instance, that you are living in Las Vegas. With a recent unemployment rate of 13.4%, things are tough there. In fact, it's a tough time in what is traditionally a rough time of year for Las Vegas. Skeptics should check a travel Web site like Expedia. When I did, a three-night stay at the four-star Rio was $60 a night, barely more than a roadside motel. You could stay at the five-star Bellagio for $199 a night.
Admittedly, this was a Sunday to Wednesday stay, not a weekend, but it gives you an idea of why the unemployment rate is so high: People aren't traveling, vacationing or gambling as much these days.
So what does it cost to leave Las Vegas?
Try $1,880 if you want to rent a 26-foot U-Haul truck, fill it with your worldly goods, and drive it to San Antonio. (In these comparisons, Nov. 3 was selected as the moving date.) But if you wanted to leave San Antonio (August unemployment rate: 7%) and move to Las Vegas, it would cost you only $437 for the same equipment.
That's quite a difference.
The difference is substantial even for cities that aren't hurting nearly as much. To move from Seattle, with an unemployment rate of 8.8% in August (well below the national average of 9.8%), to San Antonio would cost $1,404, but only $858 to move from San Antonio to Seattle.
The 'Texas premium'
I found similar price differences for other cities. Want to move from Chicago (9.7% unemployment) to Houston (8.4% unemployment)? It will cost you $1,970. But it will cost only $449 to make the trip from Houston to Chicago. Los Angeles (11.8% unemployment) to Houston was $2,051, while Houston to Los Angeles was only $555.
San Francisco (10.7% unemployment) to Dallas (8.3% unemployment) will cost you $1,988. But the opposite will cost only $689. Boston to Dallas was $2,134, while Dallas to Boston was only $634.
Miami (10.8% unemployment) to Austin, Texas (7.2% unemployment), will cost $1,706. But the reverse will cost only $827. Similarly, Phoenix to Austin will cost $1,490, while Austin to Phoenix will cost only $654.
We might call these differences the "Texas premium" because regardless of location -- East Coast, West Coast or somewhere in between -- the migration appears to be to Texas. U-Haul is lowering the price drastically for anyone who is willing to move the equipment back.
To be sure, all the differences aren't as extreme. If you want to move from hip but hurting Nashville (9.8% unemployment) to hip and growing Austin, for instance, it will cost $998 -- but it won't cost much less to move from Austin to Nashville, $826.
In a time when lots of people are feeling powerless, there is a big message here: There is still a lot we can do for ourselves. We can make decisions. We can, and do, move to places where life looks better.
Questions about personal finance and investments may be e-mailed to email@example.com. Questions of general interest may be answered in future columns. More columns by Scott Burns can be found on MSN Money and at AssetBuilder.com.
A full accounting of medical malpractice reforms shows the benefits would be $242 billion a year.
Earlier this month, the Congressional Budget Office (CBO) said medical-liability reforms could save about $11 billion annually. This assessment is a gross underestimate of the potential benefits of reform and was intended to give cover to congressional Democrats who say malpractice-liability costs are trifling. But a full accounting shows the benefits would be a hefty $242 billion a year, more than 10 percent of America's health expenditures.
Last year alone, damage awards for medical-malpractice claims reached $5.9 billion. Adding in legal costs, underwriting costs, and administrative expenses, total med-mal tort costs were nearly three times higher — $16 billion. From 1986 through 2002, the average insurance payment for a malpractice claim more than tripled to $320,000. The average jury award for medical liability was $637,134 in 2006.
Getting sued is now part of the job description for physicians. Each year, up to 25 percent of them face lawsuits. Doctors are found innocent in 90 percent of cases, but they lose even then — average defense costs per claim approach $100,000. Fear of lawsuits causes most doctors to practice "defensive medicine," meaning they order unnecessary tests, referrals, and procedures to protect themselves against allegations of medical negligence.
A recent survey of doctors published in the Journal of the American Medical Association found that 93 percent of physicians admit to practicing defensive medicine. A 2008 survey by the Massachusetts Medical Society found that about 25 percent of medical procedures are defensive in nature.
Defensive medicine wastes patients' and doctors' time and costs $191 billion annually, according to the best scholarly research. Such waste drives up the cost of medical care and the price of health insurance. In fact, by making health insurance more expensive, defensive medicine adds at least 3.4 million Americans to the rolls of the uninsured, and reduced productivity and annual output by more than $41 billion in 2008. To ease the burdens of malpractice lawsuits, jury awards should be capped for impossible-to-quantify "pain and suffering," so-called non-economic damages.
According to my study "Tort Law Tally," capping awards in med-mal lawsuits cuts losses an average of 39 percent and annual insurance premiums by 13 percent. But the most important benefit from caps is better access to care. States with caps have 12 percent more physicians per capita than states without caps, according to a study published by the U.S. Department of Health and Human Services.
Non-economic-damage caps were an integral part of the malpractice reforms adopted in Missouri in 2005. Skyrocketing malpractice premiums had caused shortages of specialists, and patients had problems getting treatment. Thanks to the reforms, med-mal claims in Missouri are at a 30-year low. Average payouts are $50,000 lower than they were in 2005, before the caps went into effect.
Texas capped non-economic damages in 2003 as part of a broader tort-reform package, and since then, more than 16,500 doctors have flooded into Texas, many to previously underserved rural and minority communities. Texas has jumped six spots in the American Medical Association's ranking of doctors per capita. Nearly 430,000 Texans have health insurance today as a result of the medical liability reforms, says the Perryman Group.
Rising liability costs are causing hospitals to close; doctors to flee states; maternity centers, trauma centers, and clinics to shut down; and patients to travel long distances due to chronic shortages of providers in some communities. Congressional testimony relates the cases of Tony Dyess, who is brain-damaged, and Fred Andricks, who died, because lawyers drove neurologists out of their local areas, forcing long delays in treatment while being airlifted.
Despite these grim realities, Senate Majority Leader Harry Reid, a Nevada Democrat, claims: "The whole premise of a medical malpractice 'crisis' is unfounded." The senator is wrong, and so are those, including the CBO, who minimize the burdens.
Effective malpractice reforms would allow doctors to spend more time with patients, not attorneys, increase access to health insurance and local providers, and provide benefits of at least $242 billion a year. Less spending on wasteful litigation means better patient care and lower costs for all Americans.
Mr. McQuillan is director of business and economic studies at the Pacific Research Institute and coauthor of "The Facts about Medical Malpractice Liability Costs" and "Tort Law Tally."
Our images of bravery usually come wrapped in Army green or police-force blue.
But bravery comes in blond, too.
Jenna Quinn may look more like a beauty queen than an icon of bravery, but her courage is something to behold.
Jenna is a triumphant survivor of sexual abuse.
No, more than mere survivor, she has become a valiant warrior against sexual abuse of children and adolescents.
A new Texas law bears her name. And the 22-year-old Carrollton woman leaves today for Boston, where she will meet with legislators and others to encourage the fight against sexual molestation.
We first met Jenna here five years ago. She was 17 years old and already showing her courage.
Victims of sex crimes usually aren't named in news stories, but Jenna wanted her name used. She wanted to be a model of openness to other victims.
See, Jenna had previously tried to be brave in a very different way. For several years, starting at age 13, she worked very hard to keep a secret.
The secret: She was being sexually molested by her father's best friend.
His family and hers were practically one big family – always together, sharing meals, celebrating holidays, traveling as a group.
Because Jenna knew that telling her secret would devastate so many others, she decided to suffer the ordeal alone. And suffer she did, undergoing so much emotional torment that she came close to suicide.
Finally telling her secret brought such sweet relief that she has been on a campaign ever since to spare others her torment.
The first step in that campaign was telling her story in my column, just a few days after her molester was sentenced to 20 years in prison. "I'm not scared. Don't you be scared," she told other victims at the time.
She followed that by telling her story for a short documentary film, It's Not Just Jenna. Kellie Quinn, Jenna's mom, said the film is now used in schools all around the state to heighten awareness of sexual abuse – particularly that it's most often perpetrated by a close, trusted person.
Jenna said her proudest moment came in August when Gov. Rick Perry held a ceremony to sign "Jenna's Law." The legislation creates a state task force on sexual abuse and requires schools to implement more education and prevention measures.
The bill's sponsor, state Rep. Tan Parker, R-Flower Mound, praised Jenna for both proposing the idea and helping get it passed. "Her passionate testimony and strong dedication effectively moved this bill through the legislative process," he said.
Jenna said she hopes the warning signs of abuse will become better known, leading to earlier detection. "It takes pressure off the victim and puts more responsibility on parents and caretakers," Jenna said.
Along with all these accomplishments, Jenna managed to graduate in just three years with a bachelor's degree in psychology from the University of Texas at Dallas.
And she graduated with honors, no less.
As far as her molester, Jenna said she's disappointed that he still hasn't apologized. But she said she has forgiven him. "I just feel sorry for him," she said.
Their two families are no longer close. But Jenna was thrilled to get a note of congratulations on Jenna's Law from her molester's ex-wife.
"It meant everything to me," she said.
Jenna is excited about starting graduate school in January. She plans to become a counselor working with autistic children.
"I feel as though I've been restored fully," she said. "I couldn't be any better. I feel blessed."
We Texans value our property and private property rights are at the very core of a free society.
That explains why the controversial Kelo decision of 2005 rocked the nation as property rights activists rolled up their sleeves to get greater protections written into state constitutions, as the U.S. Supreme Court suggested.
The Texas legislature has passed a bill which, if passed on the November ballot, will improve private property rights in the State of Texas. By declaring that Prop.11 is "counterfeit eminent domain reform," some opponents are suggesting the legislation doesn't go far enough.
Rather than focusing on what is in the proposition, some naysayers are busy telling you what is not in the proposition. It is true that good faith negotiations, diminished access to property, relocation of displaced landowners, and voter approval of eminent domain are not covered in the proposal.
However, those are not issues which arose from the Kelo case that this legislation was designed to remedy. Those are issues that came up in property owners' opposition to the Trans Texas Corridor. Should the issues be addressed? Sure, but they can just as easily be addressed in statute as the constitution.
You may recall that the Kelo decision allowed local entities to take property - even homesteads - if the local government could get more in tax revenues were the property converted to another use - like a shopping center.
This isn't the legislature's first try to stop that opportunity. Legislation passed in the 2007 Legislative Session didn't make it to the ballot. With the support of the bill sponsor, Rep. Frank Corte, Gov. Rick Perry vetoed the bill.
Some would have you believe that Gov. Perry's 2007 veto of HB 2006 should result in the defeat of this measure because it does not propose that everything that was in that bill be added to the Texas Constitution. Even the Farm Bureau isn't buying that logic. That veto may have cost the governor the Farm Bureau's endorsement this campaign cycle, but the Farm Bureau is strongly in support of this constitutional measure. They recognize that this does not give them everything they would like, but it certainly moves us forward in the process of private property rights protection.
Here is how Proposition 11 would amend the Constitution in four primary ways:
1. It would define the term "public use," rather than leaving the definition of that term up to court interpretation;
2. It would specify that the taking of property for the purpose of economic development or enhancement of tax revenue purposes is not a public use;
3. It would provide that property taken to eliminate urban blight must be done on a parcel by parcel basis; and
4. It would require that any future power of eminent domain granted requires a 2/3 vote of the Texas Legislature.
So, why a constitutional amendment instead of statutory reform? The U.S. Supreme Court in rendering the Kelo case overturned years of precedent and changed the definition of public use that is found in both the Texas and U.S. Constitution. To prevent further erosion of property rights in Texas, there had to be a constitutional fix to the definition of "public use."
The definition used in Proposition 11 defines both what public use is, and reiterates what it is not. Public use does not include the taking of property for the primary purpose of economic development or enhancement of tax revenue purposes. That's protection we don't have if the proposal fails. But, Prop 11 goes even further to prevent the taking of property to eliminate urban blight except on a parcel by parcel basis. This will stop local governments from declaring a few pieces of property as blighted and then taking all the property in an area for a development project.
Passage of private property protection has been a long time coming in Texas. Passage of Prop. 11 will send a clear message to legislators that the issue is of utmost concern to the voters. Failure to pass the measure will let them know there is no need to continue to work on the issue because the people making the most noise will not even be content with a victory.
Peggy Venable is the State Director for Americans for Prosperity- Texas, www.afptx.org .
NEWS REPORTS that have flooded the media since the national health-care debate began have, for the most part, accurately reported the positive impact of medical-liability reforms passed in Texas in 2003. What has not been reported is the relentless and ongoing trial-lawyer attack against tort reform in Texas and nationwide.
Before the reforms, 24 Texas counties had no emergency-room physician. Now all do. Another 58 counties have added at least one more emergency-room physician to expand access to care. Twelve counties had no licensed obstetrician. Now they all do. And another 26 counties have at least one more obstetrician than they had before the reforms. Twelve Texas counties have added at least one orthopedic surgeon, including seven counties that previously had none.
Reforms passed in Texas dramatically increased the total number of doctors in our state — especially high-risk specialists — by lowering medical-liability insurance costs by as much as 50 percent and by reducing the threat that doctors will spend more days in court than treating patients. The reforms do not deny a citizen’s right to his or her day in court, but they do help to mitigate the threat of meritless lawsuits that drive up the cost of medicine without any demonstrable improvement in quality.
When nervous doctors are forced to practice expensive defensive medicine, common sense tells you it will increase medical costs. Ask your own doctor, and get ready for a serious conversation.
The economic benefits to Texas of systemic lawsuit reform go far beyond health care. Common-sense reforms like putting an end to judge-shopping, reforming joint and several liability, capping punitive damages, reining in abusive class-action lawsuits and curbing asbestos and silica lawsuit abuse had results that have helped Texas expand its economy.
It is no coincidence that last year our state created more jobs than the other 49 states combined, says the U.S. Bureau of Labor Statistics. But the positive impact of lawsuit reform has not moved trial lawyers to retire quietly into the night, even in Texas. Instead, they are fighting harder than ever. Trial lawyers spend far more in campaign contributions in Texas than any other business or industry, says a study of Texas Ethics Commission campaign-expenditure reports compiled by Texans for Lawsuit Reform.
Nationally, some analysts estimate that their campaign contributions total more than $1 billion a year. To assure there will be more money where that came from, a new study by the U.S. Chamber of Commerce recently found, trial lawyers have increased spending on medical-liability advertising from $3.8 million in 2004 to $62 million in 2008, a 1,400 percent increase. Those ads are running in Texas as well as states where no reforms have been enacted.
In addition, personal-injury trial lawyers have leveled the most aggressive and sustained attack on lawsuit reform that we have seen in over a decade. They pushed more than 900 bills this year to try to get the Texas Legislature to roll back lawsuit reforms or create new opportunities to sue. Trial lawyers mask the size and source of their millions in political contributions by funneling them through innocuous-sounding front groups like the Texas Values in Action Coalition and Vote Texas.
Trial lawyers know that at least 70 percent of Americans believe the country suffers from too many lawsuits. They understand the public would not respond positively if they knew how much money trial lawyers put into campaigns. President Obama did not include aggressive lawsuit reform in his health-care plan priorities, and former Democratic National Committee Chairman Howard Dean, a physician, has made it clear why: “The reason why tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers.”
Congress should not be intimidated. Lawsuit reform must be a key part of any effort to improve the quality and access of health care in America.
Richard Weekley, of Houston, co-founded Texans for Lawsuit Reform in 1994 and is currently volunteer chairman and chief executive.
Given recent comments about our state's budget, I feel it is time to separate fact from political fiction. The fact is, in stark contrast to the U. S. Congress, the Texas Constitution requires the Legislature to balance the state budget every two years, and that would have happened with or without any federal stimulus dollars.
In 2007, I led the effort to save $7 billion to balance the revenue shortfall we anticipated this year.
So it's simply political fiction that stimulus dollars were necessary to balance our budget.
Although we tried to use the federal stimulus dollars on one-time expenditures, in some cases the federal government made us use the money on recurring costs that actually add to the cost of state government.
While other states struggle with overwhelming deficits, Texas has created a model for the rest of the nation to follow that is based on living within its available revenue. The state cut taxes a net $4 billion per year in 2007 while fostering a predictable regulatory environment that allows business to thrive and continue to make Texas the No. 1 job creator in the U.S. over the past two years.
Although this year's session took place in the context of significant turmoil in the global marketplace and economic upheaval in Texas and across our country, the Legislature successfully shaped a balanced state budget that meets the needs of Texans and sufficiently funds essential programs and agencies through the next two years.
Working together, we crafted and Gov. Rick Perry signed a balanced budget that has left our state prepared to tackle the challenges that lie ahead. Not only did we balance our budget without raising taxes, we cut taxes for more than 40,000 small businesses and left our Rainy Day Fund untouched so we can once again balance our budget in 2011.
The fact remains that Texas is one of only six states whose budget isn't in the red, even though our state is among the fastest growing in the nation. The state has an unemployment rate well below the national average, it continues to attract jobs from companies that have relocated or expanded in Texas, it has one of the healthiest housing markets in the nation, and Texas cities are consistently recognized for their healthy job markets, high quality of living and resistance to the recession. Here in Texas, we live within our means and create a climate that gives individuals and businesses the opportunity to succeed.
Texas has faced and overcome tough financial situations in the past by tightening our belt, just like Texas families are doing today. In 2003, Texas encountered a $10 billion budget shortfall. Instead of raising taxes, we cut discretionary spending and implemented sound fiscal policies that helped us generate a multi-billion dollar surplus over the next six years, before the national recession hit Texas.
Unlike Washington, we balance our budget every session, control spending, keep taxes low and ensure our children and grandchildren aren't saddled with the kind of crippling debt that our federal government has irresponsibly created.
T-Stem is a program aimed at getting more students interested in technology, science, engineering and math. And since we often discuss the importance of those subjects here, I won't go into great detail about why that matters. Rather, here's why the governor is right:
Berkner High School in Richardson has a T-Stem academy, and, among other things, the school touts one of its students as having won a prestigious statewide math contest. At least part of that success is due to the project focus that Berkner uses in getting students to have a hands-on feel for science, math, technology and engineering. And the teaching at Berkner is drawing notice. Texas Instruments recently inducted a Berkner T-Stem teacher into its academy for recognized math and science teachers.
R.L. Turner High School also has a T-Stem academy. Like Berkner, the METSA program there uses project-based learning. And it draws heavily from first-year teachers, who come to these subjects fresh.
That's probably one reason Gov. Perry also is proposing more money be invested in recruiting young science and math teachers, including through the U-Teach program. UT started that as a way to get college students into math and science teaching.
Conrad High School in Dallas has an academy, too. What caught my eye with it is the fact that 97 percent of Conrad's students are Latino or African-American. And the academy is showing impressive results, including having 95 percent of its 9th graders pass Algebra I.
Williams Prep in northwest Dallas serves a similar population. And the charter school's T-Stem academy is working with nearby UT-Southwestern to engage its students in these subjects.
To me, Williams' collaboration is a perfect example of how T-Stem academies are trying to open students to the possibilities of these fields. And, as the governor noted in his proposal for putting $160 million into them in the next Legislature, they are succeeding. The state has given about 90 percent of T-Stem schools either an exemplary or recognized rating, which are the top two ratings the state awards.
Score one for the governor for introducing a serious idea into the campaign. And score an even bigger one for T-Stem academies. They deserve this boost.