Malpractice Reform: Beyond the Current Debate

September 29, 2003

Medical errors and claims of malpractice are a fact of daily life, according to the Institute of Medicine and other researchers. For doctors, hospitals and other providers, so are rising malpractice premiums, which recent reports suggest may be hurting providers’ ability to administer care in some regions of the country and in some specialties, such as obstetrics.

Given this state of affairs, a consensus is growing across the political spectrum that the way we deal with medical errors and malpractice insurance needs fixing. President Bush and members of Congress have introduced a variety of proposals.

Regardless of what happens to current legislation, policy analysts are considering new strategies for addressing the issue, such as: Should we develop speciality courts to hear these cases? Is there merit in such approaches as enterprise liability (in which an “enterprise” such as a hospital or health plan assumes liability for acts committed by its employees), an “early offer” model or “no-fault” system? What can we learn from liability models used in other settings, such as the system used by the V.A.? Can state demonstrations, such as those recommended by the Institute of Medicine, provide guidance about possible, national remedies? Are there other options to address the problem of steep increases in malpractice insurance?

To help examine these questions, this September 29, 2003 briefing presented a highly qualified panel of speakers: Randy Bovbjerg, principal research associate at the Urban Institute; Robert Berenson, senior consultant, AcademyHealth; and Michelle Mello, assistant professor at the Harvard University School of Public Health. Ed Howard of the Alliance moderated the discussion.

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