Correspondence

The New Medical Malpractice Crisis

N Engl J Med 2003; 349:912August 28, 2003

Article

To the Editor:

Mello et al. (June 5 issue)1 do an excellent job of summarizing the current medical malpractice crisis but overlook one of the simplest solutions. Physicians, unlike those in virtually any other business or industry, are unable to pass on costs. If, with every hike in malpractice premiums, we could increase our charges (and actually collect them), then the burden of malpractice premiums would fall on society as a whole. These increased charges would be no different from the increased prices we pay for most products when the industry producing them is hit with new taxes, wage hikes, increased costs of insurance, and so forth. At that point, society could decide how much it wished to spend on medical malpractice. I suspect the answer would be “not much,” and the crisis would be rapidly resolved.

Joseph P. Imperato, M.D.
Lake Forest Hospital, Lake Forest, IL 60045
xraylfh@attbi.com

1 References

1. 1

   Mello MM, Studdert DM, Brennan TA. The new medical malpractice crisis. N Engl J Med 2003;348:2281-2284
   Full Text | Web of Science | Medline

To the Editor:

Despite a more socialized health system, Australia has medical malpractice problems that are almost identical to those in the United States. The largest medical insurer collapsed, necessitating a government bailout, and there has been talk of tort reforms and capitation limits on blue-sky claims. This will serve only as a Band-Aid, and a few years down the track the same problems will surface.

Most writers on this issue and many legislators are lawyers, and as a result, the perceived right to sue has become a sacred cow. Until this notional right is overcome, there will be only marginal change. The pity of it is that excellent schemes such as the New Zealand accident-compensation scheme and other no-fault models in Scandinavia could serve as a template to address these issues. Most damage suits could not have been foreseen and rarely result from incompetence, malfeasance, or criminal behavior. If these circumstances exist, there are much more appropriate ways of dealing with them than hungry plaintiff lawyers' clamoring for a jury award. A no-fault scheme provides appropriate compensation, ongoing care, and professional protection.

Richard T.L. Couper, M.B., Ch.B.
University of Adelaide, Adelaide 5006, Australia
richard.couper@adelaide.edu.au