"And because lawsuits are driving many good doctors out of practice -- leaving women in nearly 1,500 American counties without a single OB/GYN -- I ask the Congress to pass medical liability reform this year."
–George Bush, State of the Union, January 31, 2006
"Another aspect of making sure that medicine is affordable and available is -- listen, there's too many lawsuits. I said a startling statistic the other night: Do you realize there are 1,500 counties in America without an OB/GYN?"
–George Bush, 3M Headquarters, February 2, 2006
"The House passed a bill. Of course, it's stuck in the Senate. It needs to get out of the Senate. In order to make health care more affordable and more available we need comprehensive medical liability reform immediately. You know what's an amazing statistic, is there are 1,700 counties in our country that have no OB/GYN. They got run out of business. And that's not right and it's not fair, and it's necessary for Congress to act."
–George Bush, Bridgeport, CT, April 5, 2006
"You know, I met an OB/GYN coming through the line here. First of all, I can't think of a more noble profession than being an OB/GYN. But there's a problem in the United States of America. We got these junk lawsuits running good doctors out of practice. You know, there's over 1,500 counties in America that don't have an OB/GYN because of all these junk lawsuits."
–George Bush, Chicago, July 7, 06
"I will start off by telling you a startling statistic: there are 1,600 counties in the United States without an OB/GYN."
– George Bush, Minnetonka, MN, August 22, 2006
I'm going to start by telling you a startling statistic, too. There are between 3,077 and 3,143 counties in the U.S., depending on who's counting and what they count. So depending on the day and the President's mood, half the counties in the U.S. don't have an OB/GYN.
I'd bet they don't have a Wal-Mart or a Taco Bell, either.
I tried to find the source of the President's startling but wandering statistic. All I found were other searchers.
I called the American College of Obstetricians and Gynecologists. I figure, hell, they should know, right? I was transferred to their resource department where I was told that they don't have the data to back up that claim. Well, okay.
So, I called the White House and talked to someone. The woman who helped me was very nice and found the list of counties and the source for the list. Only, I still don't know what either of those are because, as this very nice young lady very politely explained, she was told not to tell me. Huh?
And those trying to parse what the secret list might tell us.
We've all heard about the high premiums OB/GYNs pay for malpractice insurance. So Bush's statement makes perfect sense – it's the evil trial lawyers' fault that the 774 residents of Logan County, Nebraska probably don't have their own obstetrician. Same goes for their 729 neighbors just to the north in Thomas County. It couldn't possibly be the case that most of those 1,500 counties Bush cited don't have OB/GYNs because they're in lightly populated rural areas. Why, what with Nebraska's birth rate - which is slightly higher than the national average, mind you - there are around 11 babies born each year in Thomas County. Almost one a month! Plenty of business, if only we could get those darn malpractice awards under control.
I looked myself into census data, physician shortage lists and studies of supply and demand. The national average is 28 OB-GYNs per 100,000 females. Texas has 26 per, about the same as other top-ten populations in Ohio (26), California (27) and Florida (25). Of the 254 counties in Texas, 218 have population of less than 100,000; 195 less than 50,000; about 150 less than 23,000; and 100 less than 12,000.
Minnesota, with 87 counties, has 77 with populations under 100,000.
North Carolina has 100 counties, of which 76 have less than 100,000 people. That state publishes a list of health professional shortage counties; 77 counties are on the OB-GYN shortage list. All 100 counties are on the Podiatry shortage list, and we all know how Podiatrists' malpractice premiums have been going through the roof.
Of course, there are reasons those counties have low populations. Do you think those reasons could have anything to do with how many physicians practice there? How many software companies are headquartered there? Or how many good restaurants are in those counties?
You and I may think numbers are a tool for discovery and understanding. But for some, numbers are costume jewelry designed to distract from the truth.
I'll have more on this one later.
