Opinion ID: 1496754
Heading Depth: 1
Heading Rank: 1

Heading: History and Legislative Findings

Text: In 1975, the Texas Legislature enacted legislation creating the Texas Medical Professional Liability Study Commission. The function of the Commission was to study the reasons why physicians, hospitals, and other health care providers were experiencing tremendous increases in malpractice insurance premiums. The Commission held hearings, gathered evidence and submitted recommendations to the legislature that reconvened in 1977. The legislature considered a majority and several minority reports before it enacted The Medical Liability and Insurance Improvement Act, found in TEX.REV.CIV.STAT.ANN. art. 4590i (Vernon Supp.1988). See Keith, The Texas Medical Liability and Insurance Improvement ActA Survey and Analysis of its History, Construction and Constitutionality, 36 Baylor L.Rev. 265 (1984). The Act provides: The Legislature of the State of Texas finds that: (1) the number of health care liability claims (frequency) has increased since 1972 inordinately; (2) the filing of legitimate health care liability claims in Texas is a contributing factor affecting medical professional liability rates; (3) the amounts being paid out by insurers in judgments and settlements (severity) have likewise increased inordinately in the same short period of time; (4) the effect of the above has caused a serious public problem in availability of and affordability of adequate medical professional liability insurance; (5) the situation has created a medical malpractice insurance crisis in the State of Texas; (6) this crisis has had a material adverse effect on the delivery of medical and health care in Texas, including significant reductions of availability of medical and health care services to the people of Texas and a likelihood of further reductions in the future; (7) the crisis has had a substantial impact on the physicians and hospitals of Texas and the cost to physicians and hospitals for adequate medical malpractice insurance has dramatically risen in price, with cost impact on patients and the public; (8) the direct cost of medical care to the patient and public of Texas has materially increased due to rising cost of malpractice insurance protection for physicians and hospitals in Texas; (9) the crisis has increased the cost of medical care both directly through fees and indirectly through additional services provided for protection against future suits or claims; and defensive medicine has resulted in increasing cost to patients, private insurers, and the state and has contributed to the general inflation that has marked health care in recent years; (10) satisfactory insurance coverage for adequate amounts of insurance in this area is often not available at any price; (11) the combined effect of the defects in the medical, insurance, and legal systems has caused a serious public problem both with respect to the availability of coverage and to the high rates being charged by insurers for medical professional liability insurance to some physicians, health care providers, and hospitals; (12) the adoption of certain modifications in the medical, insurance, and legal systems, the total effect of which is currently undetermined, may or may not have an effect on the rates charged by insurers for medical professional liability insurance; (13) these facts have been verified by the Medical Professional Liability Study Commission, which was created by the 64th Legislature. For further amplification of these facts the legislature adopts the findings of the report of the commission. TEX.REV.CIV.STAT.ANN. art. 4590i, § 1.02(a) (Vernon Supp.1988) (emphasis added). The stated purposes of the Act are to: (1) reduce excessive frequency and severity of health care liability claims through reasonable improvements and modifications in the Texas insurance, tort, and medical practice systems; (2) decrease the cost of those claims and assure that awards are rationally related to actual damages; (3) do so in a manner that will not unduly restrict a claimant's rights any more than necessary to deal with the crisis; (4) make available to physicians, hospitals, and other health care providers protection against potential liability through the insurance mechanism at reasonably affordable rates; (5) make affordable medical and health care more accessible and available to the citizens of Texas; (6) make certain modifications in the medical, insurance, and legal systems in order to determine whether or not there will be an effect on rates charged by insurers for medical professional liability insurance; and (7) make certain modifications to the liability laws as they relate to health care liability claims only and with an intention of the legislature to not extend or apply such modifications of liability laws to any other area of the Texas legal system or tort law. TEX.REV.CIV.STAT.ANN. art. 4590i, § 1.02(b) (Vernon Supp.1988). [1] As a starting point in our constitutional review of article 4590i, it cannot be overemphasized that: [W]e begin with a presumption of validity. It is to be presumed that the Legislature has not acted unreasonably or arbitrarily; and a mere difference of opinion, where reasonable minds could differ, is not a sufficient basis for striking down legislation as arbitrary or unreasonable. The wisdom or expediency of the law is the Legislature's prerogative, not ours.... There is a strong presumption that a Legislature understands and correctly appreciates the needs of its own people, that its laws are directed to problems made manifest by experience, and that its discriminations are based upon adequate grounds. Smith v. Davis, 426 S.W.2d 827, 831 (Tex. 1968); see also Sax v. Votteler, 648 S.W.2d 661, 664 (Tex.1983). This presumption of constitutionality applies whether the basis of constitutional attack is grounded in due process or equal protection. Whitworth v. Bynum, 699 S.W.2d 194, 197 (Tex.1985). The burden of demonstrating constitutional invalidity rests on the party assailing the statute. Robinson v. Hill, 507 S.W.2d 521, 524 (Tex.1974); Smith v. Craddick, 471 S.W.2d 375, 378 (Tex.1971).