Question of the day

A reader, a doctor, sends it in:

My question to you, and maybe you could lead me to a resource where I can learn more about this, is what is the effect of litigation on the economics of health care on the macro level. I feel like there has been no dialogue on this matter during any of these presidential debates even though this is an important issue from the health care provider standpoint (physicians, nurses, hospitals etc).

I don't have good data on the macro effects of tort reform; the trial lawyers push one set of studies, the tort reformers another, but I've never sat down and tried to pull it all apart. I do know that no one, except trial lawyers, thinks that our current system is very good. Whether you get sued has distressingly little to do with whether you were negligent (and yes, I mean that negligent doctors escape lawsuit, as well as the reverse). There are certain kinds of injuries, most notably birth defects, but also cognitive deficits, that garner sympathy awards from the jury--which is why, in states with bad tort systems, there are actual shortages of these sorts of doctors developing.

The problem mostly obsesses doctors, who are a large, but not the only, source of costs in the medical system. If there is a macro effect, it is almost certainly because of defensive medicine--unnecessary tests ordered because of lawsuits. Nor is that probably limited to states with tort problems. We've developed a medical culture that prizes exploring every remote possibility over common sense (except for primary care physicians, who get reimbursed for rushing patients through as quickly as possible). That probably wouldn't go away even if we had a better malpractice system.

Overlawyered is a very good place to start with these issues. Readers are encouraged to suggest other research or resources in the comments, or indeed just to vent about our legal and medical systems.