Rick Perry: Sure, 21% of TX residents can't get treatment, but we've added more doctors for everyone else!!

I think the headline accurately depicts former Texas Governor and current Presidential Candidate Rick "Do The Glasses Make Me Look Smarter?" Perry's defense of the appallingly high uninsured rate in Texas during his 14-year tenure as chief executive of the state.

Perry appeared on FOX News Sunday with Chris Wallace this morning, and for the 2nd week in a row, Wallace actually acted like a Real Journalist® instead of a GOP/FOX hack and pressed Perry with some solid questions regarding the sorry state of healthcare coverage in his state.

WALLACE: One more question about Main Street or looking out for the little guy. When you were governor of Texas, your state had the highest uninsured rate in the country. One in five, more than one in five Texans didn't have health coverage, and yet you refused to set up a state exchange under Obamacare. You refused to expand Medicaid. Is that looking out for the little guy when 21 percent of Texans didn't have health insurance?

PERRY: If how you keep score is how many people you force to buy insurance, then I would say that that's how you keep score. That's not how we --

WALLACE: But the flip side of it, how many people don't have health insurance.

PERRY: Let me explain what we do in Texas. This is a state by state decision. We make access to healthcare the real issue. We passed the most sweeping tort reform in the nation. We got 35,000 more physicians licensed to practice medicine in 2013 than we did a decade before that. This is an issue for me, it's about access to healthcare. And it's not about whether you force somebody to buy insurance. It's whether Texans have access to good healthcare.

We have got the Texas Medical Center, and physicians are showing up in places that literally we didn't have physicians to do those subspecialties ten years ago that we do today.

WALLACE: I understand that, sir, but don't you, as the governor for 14 years, don't you feel some responsibility when 21 percent of the people in your state didn't have health insurance?

PERRY: That's not how we keep score. I think it's a fallacy to say access to healthcare is all about insurance. What we happen to say in the state of Texas is we're going to try to make as assessable as we can good, quality healthcare. And that's what we've done in the state of Texas.

Do you think all those people moved to the state of Texas because somehow know they couldn't get healthcare? 5.6 million people added to the population rolls, oh and by the way, 1.5 million jobs created between 2007 and 2014. That's what people care about. They know they can come to the state of Texas and have access to really good healthcare, and government was not going to force them to buy insurance.

So...lemme see if I have Perry's argument here straight:

  • According to the Kaiser Family Foundation, as of March 2015, Texas had exactly 57,616 professionally active physicians state-wide.
  • Supposedly, as of 2013, Texas had "35,000 more physicians licensed to practice medicine" than they did in 2003.
  • Assuming Perry's 35K figure is accurate, that suggests that Texas has increased the number of physicians in the state by more than 2.5x over the past decade, which would indeed be impressive if true.
  • Texas' population is currently about 27 million, vs. 22 million in 2003 (only a 5 million increase, not 5.6 million, but whatever), so that means (again, assuming the numbers cited are accurate) that they've gone from around 970 residents per doctor to 470 residents per doctor today, which, again, is indeed impressive.

Unfortunately, Perry's "35,000 more doctors!" claim appears to be a big ol' pile of bull puckey anyway. According to this PolitiFact analysis from a few years back, he used to claim that Texas had added 21,000 doctors "due to tort reform" from 2003 - 2009, and that turned out to be significantly exaggerated:

The Texas Medical Board issues licenses and tracks whether those doctors actually work in the state.  According to their numbers, between 2003 and 2011, the accurate increase is 12,788.  That’s about 8,000 doctors fewer than the governor’s claim.

Still, thousands of additional physicians is nothing to sneeze at, and the next question is, can credit be put at the feet of tort reform?

Not much. By far, the biggest driver is population growth.  From 2002 to 2010, the population of Texas grew by 20 percent.  At the same time, the number of doctors went up 24 percent.  

Hmmm...according to the links to the Texas Medical Board (I had to use a cached version from the Internet Wayback Machine), in 2003 there were 37,188 actively practicing in-state physicians in Texas. In 2013 this number was 53,235, or just 16,047 more (both numbers only count both in-state doctors, although the difference is still around 16K even when you include out-of-state as well). That's better than the PolitiFact numbers from 2010: A 43% increase.

When you compare the 2015 numbers, you get a 55% increase in practicing physicians (from 37,188 to 57,616...an increase of 20,428, not 35,000), vs. a 23% population increase. Normal population growth would have accounted for about 42% of the physician increase (around 8,600), leaving an increase of only around 11,800 doctors which could even remotely be considered "due to" actions/policies of Gov. Perry.

In other words, under Perry's watch, Texas went from around 590 residents per doctor to 470 apiece...a ratio reduction of only 20%, not the 50% cut Perry is claiming.

Assuming all of this is accurate (and that the quality of physicians in Texas has remained relatively consistent throughout the process, as opposed to slashing training standards), then a 20% physician-per-capita increase is a reasonable thing to brag about, I suppose...and he's certainly correct that "access to healthcare" is about more than just having insurance; as many recent stories have noted, it can still be difficult to access actual healthcare treatment when you're facing massive deductibles.

HOWEVER, having health insurance coverage is certainly the first and one of the most important steps towards "accessing" healthcare...and on that front, Perry's record is an embarrassment.

In other words, Perry is bragging about supposedly shortening the wait time for 79% of the population when the actual question asked was about the other 21% who can't even get into the waiting room.