Q&A: Are medical malpractice lawsuits a pressing concern?

Q: Are we in the middle of another medical malpractice crisis?

A: Top Republicans say frivolous lawsuits are driving up malpractice insurance premiums and forcing physicians out of business. That’s why House Speaker Paul Ryan, R-Wis., and Rep. Tom Price, R-Ga., tapped to be the nation's top health official by President-elect Donald Trump, are vowing to make tort reform a key part of their replacement plan for the Affordable Care Act.

But researchers and industry experts say the nation’s medical malpractice insurance industry is running smoothly and has not been in crisis for more than a decade.

“It’s a wonderful time for doctors looking for coverage, and it’s never been better for insurers,” said Michael Matray, editor of Medical Liability Monitor, a trade publication.

Doctors are paying less for malpractice insurance than in 2001 — even without adjusting for inflation, according to the Doctors Company, a national malpractice insurer. And the rate of claims has dropped by half since 2003.

“It’s a time of relative calm, and this hasn’t been a front-burner issue or crisis,” said Nicholas Pace, a researcher who studies the civil justice system at the Rand Corp., a nonprofit policy think tank. “But now Republicans see an opportunity to make changes they have wanted for a long time as they replace Obamacare.”

Their proposals would make it easier for doctors to defend themselves in malpractice cases and raise the burden of proof on patients. Many Republicans also back sharp limits on damage awards.

Medical errors claim more than 250,000 lives annually, researchers estimated this year. That would make errors, which include cases of malpractice and negligence, the nation’s third-leading cause of death behind heart disease and cancer.

Although the costs are tough to quantify, studies suggest that about 3 percent of the nation’s $3.2 trillion in health-care spending, nearly $100 billion, is related to malpractice cases and “defensive medicine” — ordering unnecessary tests and treatments to protect against litigation. That’s a considerable sum, but researchers have found that stronger protections against lawsuits don’t necessarily change physician behavior or produce less expensive care.

Meanwhile, plaintiffs’ lawyers say damage caps make them reluctant to take on cases, given the money often required for trial preparation and expert witnesses qualified to discuss medical practice.

“You need solid empirical evidence before you move forward on national malpractice reform, not anecdotes or horror stories from a particular county in western New Hampshire,” Pace said. “That is not how you decide to overhaul the entire system.”

- Chad Terhune, Kaiser Health News