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How It Work’s – Why Tort Reform Hasn’t Helped

This newly released book contains over 20 years of research that confronts many assumptions about our medical malpractice liability system and legal tort reform. One of many conclusions in this book is that tort reform is not the “cookie-cutter” solution that many believe. This book covers the limitations of the medical malpractice liability system, the effects of legal (tort) reforms, and whether these reforms are “worse than the disease” (page 2). The book is a must-read for everyone in our legal, legislative, and healthcare industry. There are a couple of links at the bottom of this article to a 30-second video and a link to preview this book.

The book challenges those who disagree with its conclusions to bring any relative data to the debate. This is best described by a quote in the Praise given by Senator Bill Cassidy, MD (R-LA), ‘In God we trust, everyone else bring data’, by Edward Deming.

An excerpt of a few interesting conclusions that this book makes are as follows:

Did you know…?

  • “Recent studies have put the annual death toll from preventable medical errors in the United States at 250,000 or even 440,000.” (Foreward by US Senate minority leader, Tom Daschle) (this death toll is equivalent to 2 Boeing 787 airplane crashes every single day!)
  • It is estimated that every $1 delivered to negligently injured plaintiffs (patients) costs $1.33 in legal and overhead expenses. (book page 9)
  • Patients injured by medical error rarely recover more than the policy liability limits which may not cover the economic damages. (page 9 – 10)
  • The dominant approach to solving healthcare litigation in the US has been “damage caps or bust.” (page 14) While caps have proven to lower malpractice premiums over time, is this reasonable or the only solution?
  • Malpractice insurance “premiums can rise steeply even when claim frequency or payout per claim holds steady or declines.” (page 14)
  • “The medical malpractice system accounts directly for perhaps 0.3 percent of health care spending, and that figure has been declining since 2001. (page 251)
  • “A page of data is worth a volume of logic.” (Oliver Wendell Holmes – (page 14)

The book is authored by 5 university scholars, 4 law professors, and 1 economic professor. The research is based on peer-reviewed articles that were published in leading journals over a decade – between 2005 and 2017 (page 15 – 16).

The Table of Contents best displays the research, conclusions, and potential reforms that are found within this book.


Opening “Praises” (testimonies for the book by 26 prominent scholars), Terms and Abbreviations, and Foreward by US Senate minority leader, Tom Daschle

Chapter 1:  Why This Book Matters
Chapter 2:  Our Data Sources and Limitations

PART ONE – Misdiagnosing the Problem:  Texas’s Medical Malpractice System…

Chapter 3:  The Texas Medical Malpractice Insurance Crises
Smoke without Much Fire
Chapter 4:  Haircuts  Jury Verdicts and Post-verdict Payouts
Chapter 5:  Impact of Policy Limits in Cases against Physicians
Chapter 6:  Defense Costs

PART TWO – Mistreating the Problem  The Impact of Tort Reform in Texas

Chapter 7:  The Impact of Capping Damages
Chapter 8:  Medical Malpractice Claiming by Elderly Patients
Chapter 9:  Defensive Medicine? Impact on Health Care Spending
Chapter 10:  Impact on Physician Supply in Texas

PART THREE – Mistreating the Problem:  A National Perspective…

Chapter 11:  The Receding Tide of Medical Malpractice Litigation
Chapter 12:  Defensive Medicine in the New-Cap States
Chapter 13:  Does Tort Reform Attract Physicians to the New-Cap States?

PART FOUR – If Damage Caps Aren’t the Answer, What Is?

Chapter 14:  Synthesis  Lessons and Pathologies
Chapter 15:  Reform Strategies  Toward a Better Medical Malpractice System
Chapter 16:  Three Concluding Points (1. medical malpractice litigation is slow, expensive, and noisy 2. medical malpractice crises are big news but account for only perhaps 0.3% of healthcare spending. If we want reforms, then we should select those that will fix the problems with the system.)


Link to a 30-second video about this book: https://www.youtube.com/watch?v=vS9E3s15L-Q

Link to a preview of the book:  https://www.google.com/books/edition/Medical_Malpractice_Litigation/yaUkEAAAQBAJ?hl=en&gbpv=1&pg=PP1&printsec=frontcover


Aviso Insurance is an independent agency that works for YOU, the medical expert. We can access nearly all medical malpractice insurance markets for you.

“At Aviso Insurance, we are proud to serve the many heroic professionals in our healthcare community.”

Dan Reale, Agent/Owner – Office: (407) 808-6149
E-Mail:  [email protected]