BairdWebel
Specialist in Financial Economics
Vivian S. Chu
Legislative Attorney
Amanda K. Sarata
Specialist in Health Policyb
Asa policy area, medical malpractice involves issues related to its prevalence inthe health care system; the market for provider liability insurance; andthe resolution of malpractice complaints through the tort system.
Medical malpractice has attracted congressional attention numerous times overthe past decades, particularly in the midst of three “crisis” periods forthe liability insurance market in the mid- 1970s, the mid-1980s, and theearly 2000s. These periods were marked by sharp increases in medicalliability insurance premiums, difficulties in finding any medical liabilityinsurance in some areas as insurers withdrew from providing coverage,reports of providers leaving areas or retiring following insurancedifficulties, and a variety of public policy measures at both the state andfederal levels. The effectiveness of various public policy measures inaddressing the issues in the medical malpractice liability market has beena matter of debate, in part because these difficulties have arisen at theintersection of the health care, tort, and insurance systems.
The overall medical liability insurance market is not currently exhibiting acomparable level of disruption to that in the “crisis” periods.Nonetheless, concerns persist regarding the affordability and availabilityof malpractice insurance in particular regions and for certain physicianspecialties (e.g., obstetricians). In addition, concern about medicalmalpractice claims may affect individual provider decisions and the costof health care.
In terms of direct costs, medical malpractice insurance adds relativelylittle to the overall cost of health care. Medical malpractice premiums in2010 totaled approximately $10.2 billion, whereas overall healthexpenditures were $2.6 trillion in 2010 according, respectively, to data from insurancerating firm AM Best and the National Health Expenditure Accounts. Indirect costs, particularlyincreased use of services by providers to protect against future lawsuits (“defensive medicine”),have been estimated to be higher than direct costs. CBO estimated that enacting federaltort reforms would reduce health care spending by approximately 0.4%-0.5%(roughly $9 billion-$11 billion) and the federal budget deficit by between$40 billion and $57 billion over a 10-year period.
The malpractice system also faces issues of equity and access. For example,some observers have criticized the current system’s performance withrespect to (1) compensating patients who have been harmed by malpractice,(2) deterring substandard medical care, and (3) promoting patient safety.There are differing opinions as to the extent that each of these areas has beenaffected by the current malpractice system.
In the 112th Congress, the primary vehicle addressing medical malpractice hasbeen H.R. 5, which focused on medical liability tort reform whenintroduced but was amended to include language similar to other legislation,specifically H.R. 157, H.R. 1150, H.R. 1943, and H.R. 3586. The amendedversion of H.R. 5 passed the House in March 2012. Language similar to theintroduced version of H.R. 5 was included in H.R. 5652, the House budgetreconciliation bill for FY2013, which passed the House in May 2012. TheSenate has yet to consider H.R. 5 or S. 218 and S. 1099, companion billsto H.R. 5 as introduced. The President’s budgets for FY2012 and FY2013 bothrequested $250 million for grants to test a variety of reform proposals, butthis funding has not been appropriated by Congress.
Date of Report: June 18, 2012
Number of Pages: 20
Order Number: R41693
Price: $29.95
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