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A silver lining in the current malpractice crisis is the opportunity to pursue shared, rather than individual, liability insurance.
PROLOGUE: Just when it appears that the persistent issue of medical error has been bumped from the national spotlight, a particularly egregious incident will surface to catapult the topic back to the front pages, reignite public outcry, and galvanize demands for change. Media coverage and public perception aside, however, the scope and pervasiveness of this problem are undeniable. More than one-fourth of U.S. adults have experienced a medical error within the past two years, despite the fact that the United States spends much more on health care than any other country.
As Bill Sage notes in this paper, the gathering movement seeking increased patient safety may be the catalyst for breaking the impasse over medical malpractice reform. The positions of both sides of the medical malpractice debate are well known and virtually calcified. Providers and hospitals insist that caps on damage awards in medical malpractice suits are necessary to stem rising malpractice insurance rates. Trial lawyers counter that spiking rates are more attributable to trends in liability insurance markets. Both camps seem to believe that patient safety matters, however, and Sage hopes that this slender thread of agreement can be woven into a new liability system that "will reduce the need for litigation by linking patient safety to risk management within health care organizations." Perspectives by Martin Hatlie and Susan Sheridan, and George Huber follow.
Sage is a professor of law at Columbia University, where he teaches courses in health law, regulatory theory, and the professions. He serves as principal investigator for the Pew Charitable Trusts' Project on Medical Liability in Pennsylvania and is a member of the Health Affairs editorial board. Sage holds a law degree, and also a medical degree, from Stanford University.
ANOTHER "MALPRACTICE INSURANCE CRISIS" has arrived.1 Premiums are skyrocketing, insurers are exiting markets, and physicians and hospitals are warning that patients may find medical care unavailable unless "something" is done-meaning the enactment or strengthening of tort reform legislation. A new wrinkle in this long-standing debate is that both sides have embraced the rhetoric of patient safety.2 Trial lawyers point to the statistics on medical error as evidence that physicians require...