Medical Malpractice: Experience with Efforts to Address Problems

GAO discussed the effects of medical malpractice problems on health care and malpractice insurance costs and quality and the reform of the health care system. GAO noted that: (1) insurance premiums have increased due to the increase in the number and cost of malpractice claims, which in turn has affected the availability of malpractice insurance and medical services; (2) state licensing boards have taken few disciplinary actions against negligent or impaired physicians despite the large number of fatalities and serious injuries; (3) federal legislation has provided for a database to keep track of disciplinary actions by states, hospitals or other institutions, and medical malpractice claims against licensed physicians; (4) the tort system has not effectively deterred negligent behavior because most injured patients do not file claims, which take years to settle and are paid by insurers; (5) providers may be practicing more defensive medicine in the face of high malpractice insurance costs and litigation threats, but how that affects costs and quality of care is unknown; (6) quality assurance programs may reduce malpractice in hospitals; (7) states have primarily used tort reform to address medical malpractice problems and have somewhat reduced the number of claims and the size of awards and settlements; and (8) other efforts to reduce malpractice and its attendant costs include risk management programs, practice guidelines, arbitration, and no-fault programs for obstetrical services.