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This has been conclusive disproven by comparing what happened in different states that enacted tort reform for medical malpractice. The cost of insurance droppe

This has been conclusive disproven by comparing what happened in different states that enacted tort reform for medical malpractice. The cost of insurance dropped a bit, but there has been no effect the cost of healthcare provisioning.

briandear 8y ago
I would argue that it hasn't been "conclusively" disproven. One key study "disproved" it in the aggregate across all insurance, but not on a specific specialty-by-specialty basis[1]. The malpractice costs of OB-GYN's for example are reflective of the potentially catastrophic tort liability exposure despite an overall low level of influence of tort reform on insurance costs generally. However, this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3536953/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3536953/ demonstrated that tort reform resulted in a larger percentage of growth in the number of physicians which would indicate that tort reform does have an important effect on medical care provisioning simply because tort reform, according to that study, resulted in a larger number of practitioners, which would, necessarily increase access to care. So while tort reform may not have reduced costs across all of insurance, it does have an effect on medical care supply and it could have an effect on costs on a specialty-by-specialty basis. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701901/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701901/ "An important consideration when interpreting our results is that our analysis provides evidence that the Texas reform had little influence on levels of health insurance losses, in the aggregate, across a variety of patient groups and provider specialties... As a result, if tort reform’s effects on provider behavior differ by the provider’s specialty type or the type of patient, then different analyses presented in the literature, utilizing different but relatively homogenous samples of provider or insured types, may yield conflicting results regarding the influence of malpractice exposure on healthcare cost and health insurance markets. Further research may consider how specific provider specialties and patient groups are influenced by changes in medical malpractice liability exposure."
- karmajunkie 8y ago
  That doesn't demonstrate any conclusions whatsoever about costs. What it demonstrates, however tenuously [1], should surprise no one: physicians have a preference to practice in areas where the costs of their malpractice are minimized. The notion that it brings costs down by increasing supply is a central tenet of the tort reform movement. However, this hypothesis has not been borne out by the evidence [2]. Moreover, as someone who worked in public health in Texas during the post-tort-reform era, particularly with hospitals in rural Texas, I can tell you anecdotally that the supply of physicians available outside major metropolitan areas declined when tort reform activists predicted an increase in supply. [1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2047433 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2047433 [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701901/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701901/

briandear 8y ago

I would argue that it hasn't been "conclusively" disproven. One key study "disproved" it in the aggregate across all insurance, but not on a specific specialty-by-specialty basis[1]. The malpractice costs of OB-GYN's for example are reflective of the potentially catastrophic tort liability exposure despite an overall low level of influence of tort reform on insurance costs generally. However, this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3536953/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3536953/ demonstrated that tort reform resulted in a larger percentage of growth in the number of physicians which would indicate that tort reform does have an important effect on medical care provisioning simply because tort reform, according to that study, resulted in a larger number of practitioners, which would, necessarily increase access to care. So while tort reform may not have reduced costs across all of insurance, it does have an effect on medical care supply and it could have an effect on costs on a specialty-by-specialty basis. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701901/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701901/ "An important consideration when interpreting our results is that our analysis provides evidence that the Texas reform had little influence on levels of health insurance losses, in the aggregate, across a variety of patient groups and provider specialties... As a result, if tort reform’s effects on provider behavior differ by the provider’s specialty type or the type of patient, then different analyses presented in the literature, utilizing different but relatively homogenous samples of provider or insured types, may yield conflicting results regarding the influence of malpractice exposure on healthcare cost and health insurance markets. Further research may consider how specific provider specialties and patient groups are influenced by changes in medical malpractice liability exposure."

karmajunkie 8y ago
That doesn't demonstrate any conclusions whatsoever about costs. What it demonstrates, however tenuously [1], should surprise no one: physicians have a preference to practice in areas where the costs of their malpractice are minimized. The notion that it brings costs down by increasing supply is a central tenet of the tort reform movement. However, this hypothesis has not been borne out by the evidence [2]. Moreover, as someone who worked in public health in Texas during the post-tort-reform era, particularly with hospitals in rural Texas, I can tell you anecdotally that the supply of physicians available outside major metropolitan areas declined when tort reform activists predicted an increase in supply. [1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2047433 https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2047433 [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701901/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701901/