One of the results he points to is that, “Under Governor Bush, Texas enacted some of the most comprehensive patient protection laws in the nation.”

It is true that Texas enacted one of the toughest patient protection laws in the United States back in 1997 while Bush was governor. But did he pass a patient rights bill or did he merely stand by while the Texas legislature passed a bill he simply let become law? On patient rights, was he a “reformer with results”?

In May 1997, the Texas legislature passed a patient rights bill that, among other things, allowed Texans to sue managed care entities, including HMOs, for medical decisions that negatively affect a patient’s health.

In Texas, when the legislature passes a bill and sends it to the governor, the governor has three options. He can sign it into law, veto it, or do nothing and allow it to become law. Bush took the third course and simply let the patient rights bill become law.

In a one page statement on May 22, 1997, announcing his decision to simply let the bill become law, Bush said, “Given the choice between doing nothing and doing something to address a significant problem that impacts the health of thousands of Texans, I have concluded the potential for good outweighs the potential for harm.”

Today, Bush is taking credit for the law, including the right-to-sue provision, and saying the law “allowed patients who have been harmed the right to seek legal action because Texas law includes a strong, independent review process and lawsuit reforms designed to encourage quick, out-of-court resolutions instead of costly litigation.”

But when Bush signed the bill he was not so confident that the legislature had written the best possible legislation. At the time, Bush said he withheld his signature from the bill to signal “the need to carefully monitor its effects to make sure that the benefits do in fact outweigh any unintended consequences.”

In his letter, Bush was concerned that the bill had the potential to drive up healthcare costs and increase the number of lawsuits against physicians and other healthcare providers. “I hope my concerns are proven wrong,” he said.

In letting the bill become law, Bush raised policy concerns many other people have raised regarding the details of the patient rights debate. But, his role was clearly not one of taking the lead in reforming patient rights in Texas. It is clear from the record that he stood by while the legislature worked out the details. He expressed some reservations about parts of the bill, and then simply let it become law.

Real reformer? On patient rights, he was a real observer.

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