The Medical Malpractice Myth

This book is a must read for anyone who thinks that tort reform is a good idea. We've tried it in California. The effect has been to effectively immunize health care providers from liability by closing the courthouse door to claims of medical negligence. There is no incentive to improve the health care system or to address the systemic problems that cause most injuries and deaths. Medical negligence is a fact. Our government estimates that as many as 98,000 people per year die from preventable medical errors. The cost of these errors is enormous and, when our civil justice system is crippled by tort reform, those costs are often shouldered by the public through increased taxes and fees. Tort law is designed to do two things: to provide just and reasonable compensation to people injured by the negligence or carelessness of another and to discourage behavior likely to result in injury. When we "dis-incentivize" good medical practices by immunizing health care providers, we make it more, not less, likely that people will be injured as a result of medical errors. There is no evidence of which I am aware that these reforms have benefitted anyone other than big insurance companies. In California, it is increasingly difficult or impossible for patients who are injured by medical errors to receive "just and reasonable" compensation for the harm caused. The cost of litigating such cases is prohibitive in light of the 32-year-old MICRA cap which limits damages to $250,000 in most cases - even those involving gross negligence or the death of a child.

As a current medical student and son of a malpractice lawyer, I found this book intriguing and insightful. His cocnlusions are sound and based on reputable studies conducted by MEDICAL SCHOOLS and PEER-REVIEWED JOURNALS with strong ties to healthcare (such as the New England Journal of Medicine). He in no way attacks physicians as a whole. In fact, he devotes a good portion of the book entirely to reform that would PROTECT physicians. His book represents an easy-to-read, fair treatment of malpractice in healthcare. For the open-minded and honest physician/medical student, this book will help you rise above the malpractice myth that is almost universally held by physicians/medical students and completely contested by malpractice attorneys. Very objective and data centered.

This is a copy of my review from the Insurance Scrawl blog, http://www.insurancescrawl.com : Nearly 100,000 killed last year, the same rate as in the ongoing, repellent genocide in Darfur. But this figure is the estimate of the number of Americans who die annually due to medical-malpractice errors. That's one of the key points emphasized in the trenchant new book by Professor Tom Baker, The Medical Malpractice Myth (2005). Baker's slim, accessible, engaging, and well-written volume argues that the prevailing myths concerning medical malpractice and doctors' liability-insurance premiums are the stuff of urban legend. One of the key contributions of the book is to assemble in one handy place the current literature about the amount of medical malpractice, the number of med-mal claims, the settlement/judgment costs and transaction costs of these cases, insurance premiums, and ups and downs in insurance markets. Baker argues convincingly that there is an epidemic of medical practice in the United States, nearly 100,000 preventable deaths annually, with only a fraction of claims being pursued (and most nonmeritorious claims are resolved before trial and often are dropped). The number of deaths annually exceeds automobile-related and workplace-related deaths combined, yet the medical-liability insurance premiums in toto are a small fraction of the premiums collected for auto and worker's comp. Baker approaches his study with an open mind and transparently - he shows the reader the evidence, the bases for his interpretation of the evidence, and honestly identifies where the data are uncertain, limited or unclear. The book is quite refreshing in this regard, given the jeremiads one usually sees in these discussions. Baker assembles the evidence that the pricing spikes we see in med-mal insurance are straightforward reflections of the insurance cycle and are not driven (much) by the tort-litigation side. As he writes, "the two most recent medical liability insurance crises did not result from sudden or dramatic increases in medical malpractice settlements or jury verdicts." (p. 53-54) Baker's analysis of the mechanisms of insurance markets and the insurance cycles is consistent with the analyses of Warren Buffett and Richard Stewart, even though most people seem to uncritically adopt the myth of actuarial pricing of insurance. The Medical Malpractice Myth discusses the evidence of the impact on the supply of doctors and the costs of defensive medicine, arguing ultimately that med-mal claims have little effect. Baker takes the normative position that medical-malpractice claims are good for the system and that the legal system adequately sifts out nonmeritorious claims. Further, Baker tries to gauge the overall costs of the tort system, arguing ultimately that med-mal victims are undercompensated (especially bearing in mind the large majority of potential plaintiffs that do not seek recompense). Baker further offers his suggestions for reforming th

This book is a model for what social science can do, in four ways. First, it takes on an important topic--one that has generated incredible heat in the popular press and in political circles. Second, it takes an entirely fair perspective. Old fashioned as it may seem, the author is actually interested in finding out the truth about the med mal problem. Third, it surveys the available literature in the social sciences, reads and cogently digests every significant study, and assess the merits of each. The author is not an economist, but his understanding of economics and his sober and astute assessment of the quantitative AND qualitative evidence is terrific. Finally, the book does all this with a clarity and cogency of writing that make it eminently readable. This is not a dull slog through endless tables and figures. While the empirical evidence is discussed, and there is even some attention paid to issues of methodological reliability and so on, the prose is lucid and no one interested in the topic will find it tough going in the least. In fact, no one interested in the topic--from doctor to lawyer to politico--can afford not to read this book. If only more social science were this good, the world would be a better place.

I just bought three copies of this book to send to friends who are doctors. Unlike a lot of the literature and journalism surrouding medical malpractice, which is full of hyperbole and inaccuracies, this book gives concrete information and a coherent argument about why doctor's malpractice premiums are so high and what can be done about it. Baker looks at all the players - insurance companies, doctors, hospitals, patients and legislators - in his analysis of the situation. The book is also extremely well written, with lots of interesting and shocking anecdotes, and makes a complex topic easy to understand. I highly recommend this book to anyone interested in this topic. It should be mandatory reading for any legislator contemplating tort reform.