Tort Reform at the Tea Party Presidential Debate

Denunciation of (plaintiffs) trial lawyers is standard red meat for the lions at Republican Party gatherings. Tonight tort reform in medical malpractice cases was declared by Gov. Perry to be  powerful job creation engine.

Just for the record, the Congressional Budget Office (CBO), in a 2009 letter to Senator Orrin Hatch (R-UT) doesn't think there is much gain there:

CBO estimates that the direct costs that providers will incur in 2009 for medical malpractice liability—which consist of malpractice insurance premiums together with settlements, awards, and administrative costs not covered by insurance—will total approximately $35 billion, or about 2 percent of total health care expenditures. Therefore, lowering premiums for medical liability insurance by 10 percent would reduce total national health care expenditures by about 0.2 percent.

The savings would be achieved by a package of reforms:
 A cap of $250,000 on awards for noneconomic damages;
 A cap on awards for punitive damages of $500,000 or two times the award for economic damages, whichever is greater;
 Modification of the “collateral source” rule to allow evidence of income from such sources as health and life insurance, workers’ compensation, and automobile insurance to be introduced at trials or to require that such income be subtracted from awards decided by juries;
 A statute of limitations—one year for adults and three years for children—from the date of discovery of an injury; and
 Replacement of joint-and-several liability with a fair-share rule, under which a defendant in a lawsuit would be liable only for the percentage of the final award that was equal to his or her share of responsibility for the injury.

Hospital injuries: little or no improvement over 10 years - — NEJM

Ten years ago, in the landmark report To Err is Human the Institute of Medicine reported the high rates of medical injuries - and low rates of malpractice actions.  Reform was promised.  A survey of 10 North Carolina hospitals shows that 1 in four hospital patients is harmed due to medical error.  
Temporal Trends in Rates of Patient Harm Resulting from Medical Care — NEJM:

 "In December 1999, the Institute of Medicine (IOM) reported that medical errors cause up to 98,000 deaths and more than 1 million injuries each year in the United States.  In response, accreditation bodies, payers, nonprofit organizations, governments, and hospitals launched major initiatives and invested considerable resources to improve patient safety.  Some interventions have been shown to reduce errors, such as implementing computerized provider order-entry systems, limiting residents' work shifts to 16 consecutive hours,and implementing evidence-based care bundles. However, many of these interventions have not been evaluated rigorously or implemented reliably on a large scale. Unfortunately, it remains unclear whether, in the aggregate, efforts to reduce errors at national, regional, and local levels have translated into significant improvements in the overall safety of patients."