I meant the rush towards privatization in general, but you can pick almost any category and discover that Texas consistently underperforms given the size of its economy and population.

Health care specifically is like, bottom out of all states:

https://www.houstonchronicle.com/business/columnists/tomlinson/article/texas-health-care-ranking-bottom-18171519.php

Reasons vary, but the privatization meme applies to almost all of them.