LawTort Reform

How Will Tort Reform Affect Health Care?

Tort reform can help increase the number of health care providers in a state, which leads to better choices for patients. Texas saw this happen after it enacted tort reform in 2003. Over the next ten years, the number of doctors in Texas nearly doubled, growing at twice the rate of the state’s population.

The huge increase in doctors that followed its enactment of tort reform is likely due, in part, to falling medical malpractice premiums. One study examined various states’ changes in malpractice premiums in the decade after tort reform. In that decade, malpractice premiums fell, on average, by over 60 percent in Texas. In contrast, however, malpractice premiums in New York rose by over 60 percent. One result of this was that nearly two thousand physicians moved their practice from New York to Texas.

More particularly, studies have shown that limiting non-economic damages under the law has lowered malpractice premiums. The majority of states have established such reforms — Arkansas is in the minority. One can imagine how physicians who practice medicine in a limitless-liability state like Arkansas would find it unpleasant to realize that, every time they make a medical decision, they’re in danger of an unlimited malpractice judgment that could bring an end to their career. Studies also show that tort reform reduces the use of “defensive medicine,” or medicine undertaken simply to avoid lawsuits. There is little to no evidence, however, that such reforms harm patient care or increase the risk of malpractice.

The bottom-line question: is tort reform good for patients? The answer is yes, because Arkansas needs more doctors and better health-care access. When measured by doctors per citizen, Arkansas is in the bottom 20 percent of states. Arkansas has the sixth highest rate of cancer deaths of all the states, largely because of poor access to cancer screening and treatment. These problems would presumably diminish if more health-care professionals practiced in Arkansas.

This is the second in a series of posts that will explore the issues surrounding tort reform.

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4 thoughts on “How Will Tort Reform Affect Health Care?

  • Matt Bishop

    Mr. Kilmer is, as usual, embodying Mark Twain’s “Lies, damn lies, and statistics” line.
    First, the Texas’ example. For some reason, the big government tort “reformers” want the public to believe Texas is the only state that has ever had their “reform”. Alas, it’s not true. California has had it for over 40 years.
    From a non-partisan source, the Association of American Medical Colleges, you can look up physicians per capita by state. Here’s from 2015:
    Page 15 has total active physicians per 100,000 residents by state. You will find Texas, WITH “tort reform”, is ranked 41st, Arkansas 46th. Behind Arkansas, at dead last, and also with tort reform like Mr. Kilmer advocates, is 50th. Nevada, also with Mr. Kilmer’s reform, is 47th. Idaho, with a cap on all tort cases like Mr. Kilmer advocates, is 49th.
    If one looks at the chart, the trend toward access to healthcare is clear, and it has nothing to do with limiting the rights of Arkansas voters that Mr. Kilmer favors. It’s the wealth of the state. Generally, the wealthier, the more physicians. Which is to be expected.
    Why Mr. Kilmer doesn’t share the full picture, well, only he and some lobbyists know.
    Next Mr. Kilmer makes an argument based on malpractice premiums. That they will be apparently lowered. This is a typical argument, but it skips over one salient point. There’s no promise from any insurer that it will in fact happen. Or that if it does, we’ll get more physicians. So we will be giving up our rights, for an insurance company, and their lobbyists like Mr. Kilmer, promise.
    Note that Mr. Kilmer doesn’t share that medical malpractice filings in Arkansas are steady or declining over the last decade on a year to year basis. Arkansans just don’t file that many of them. Maybe since he’s based in Maryland, he has a different experience, but the facts just don’t show a rash of litigation in Arkansas. That information is compiled by the State Supreme Court, and Mr. Kilmer could easily look up the number of lawsuits in Arkansas by type online. I hope he does.
    The last paragraph of his piece is just shameful. Claiming if Arkansans give up their rights they “presumably” will have fewer cancer deaths? I don’t even have words, other than to note that if we enact the legislation he favors, we DEFINITELY will be giving up rights we have as citizens, and for nothing more than empty promises from lobbyists for insurers and nursing homes.
    It continues to amaze me that a site dedicated to less government and the free market pushes this stuff.

  • Matt, I appreciate that you’re eager to accuse our author of making claims he didn’t make, but try to constrain the impulse. Of course it is not true that we’ve ever claimed that Texas is the only tort reform state.
    Comparing states has limited utility (different people, with different demographic mixes, live in different states), so it isn’t clear what point you’re trying to make when you reel various states off. Sometimes it makes sense to compare changes in one particular state over time. That is the point of the Texas example. If you want to argue that tort reform was harmful to the California economy or the provision of health-care services there (it wasn’t), feel free to make the case.
    And – there you go again – more mindless rhetoric about “giving up our rights.” I think at this point everyone knows that SJR 8 has nothing to do with giving up our rights. Which right is most important to you, Matt – the right to be undersupplied in health care services, or the right to be overcharged by a doctor? As far as I can tell, these are the two “rights” that you are defending.
    Finally, it is absurd for you to say that Arkansans just don’t file a lot of medical malpractice suits. On a per capita basis, we are near the top of the list. In 2015, Arkansas had the 6th highest filing rate in the nation. I think your comments would be more persuasive if they were less fictional.
    I wouldn’t be in favor of tort reform if I didn’t believe that it would make health care more available and make our state’s economy better.
    P.S. The utter disregard for facts that you keep on displaying is capped off by your accusation that our author is a “lobbyist.” Marc isn’t, and has never been, a lobbyist – for an insurance company or otherwise.

  • If comparing states has limited utility, why does this sites authors trot Texas out every time they extol the “benefits” of capping damages but no other state? Weird.
    As for “facts” I linked my sources. Why don’t you link yours?
    Show me the proof for your claim or the “fact” that tort reform will increase our doctor supply. So far all you’ve ever done is trot out Texas, which only has a few more docs per capita than us, and ignored that miss and Nevada disprove your claim. Do you think arkansas is more like Mississippi or Texas?
    I understand you believe these things. But beliefs aren’t evidence. The evidence isn’t there to support your beliefs. But if you can source any I am happy to review.

    • Matt, do you really not understand the difference between comparing two different states and comparing changes in one state over time? Weird.
      Texas is an excellent example because it is near us and because its “before and after” qualities are similar to our “before” qualities.
      Here are the “facts” I relied on. They are in sharp contrast to the “facts” you made up.
      Finally, if you think that “Mississippi and Nevada disprove my claim,” this suggests that you do not understand my claim.


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