Hopwood v. Texas (1996) case. Thirty-six (36) separate and distinct public universities exist in Texas, of which 32 belong to one of the six state university systems. Discovery of minerals on Permanent University Fund land, particularly oil, has helped fund the rapid growth of the state's two largest university systems: the University of Texas System and the Texas A&M System. The four other university systems: the University of Houston System, the University of North Texas System, the Texas State System, and the Texas Tech System are not funded by the Permanent University Fund. The Carnegie Foundation classifies four of Texas's universities as Tier One research institutions: The University of Texas at Austin, the Texas A&M University, the University of Houston and Texas Tech University. The University of Texas at Austin and Texas A&M University are the flagship universities of the University of Texas System and Texas A&M University System, respectively. Both were established by the Texas Constitution and hold stakes in the Permanent University Fund. The state has sought to expand the number of flagship universities by elevating some of its seven institutions designated as "emerging research universities". The two expected to emerge first are the University of Houston and Texas Tech University, likely in that order according to discussions on the House floor of the 82nd Texas Legislature. The state is home to various private institutions of higher learning—ranging from liberal arts colleges to a nationally recognized top-tier research university. in Houston is one of the leading teaching and research universities of the United States and is ranked the nation's 17th-best overall university by U.S. News & World Report. Trinity University, a private, primarily undergraduate liberal arts university in San Antonio, has ranked first among universities granting primarily bachelor's and select master's degrees in the Western United States for 20 consecutive years by U.S. News. Private universities include Abilene Christian University, , , , and . Universities in Texas host three presidential libraries: George Bush Presidential Library at Texas A&M University, the Lyndon Baines Johnson Library and Museum at The University of Texas at Austin, and the George W. Bush Presidential Library at Southern Methodist University. Healthcare Notwithstanding the concentration of elite medical centers in the state, The Commonwealth Fund ranks the Texas healthcare system the third worst in the nation. Texas ranks close to last in access to healthcare, quality of care, avoidable hospital spending, and equity among