As my reader knows, my views on medical malpractice and the solution to the "crisis" are somewhat diferent from mainstream thinking in the medical community. The current approach to reining in malpractice premiums is a cap on "non-economic" damages (such as pain and suffering, loss of consortium, etc.).

As discussed here on Bloviator, while this may have some effect, it will be relatively minor. The introduction of caps was associated with only a ~10% decrease in premiums (from cited studies by the Urban Institute’s Randall R. Bovbjerg including Zuckerman S, Bovbjerg RR, Sloan F. Effects of Tort Reforms and Other Factors on Medical Malpractice Insurance Premiums, Inquiry 27(2):167-82, 1990). This may be because 60% of the money goes to the system (lawyers, experts, etc.), and only 40% to the patient. According to a study by the Office of Technology Assessment, about 25% of the awards were attributable to medical costs, leaving 15% or less attributable to other costs including non-economic damages.

Restricting loses to estimated future medical costs and lost wages may be unfair unless fully accurate predictions of future medical costs are available. For example, see the argument advanced by Dr. Chris Rangel. For other views, see the medical blogs by Dr. Sydney Smith, Med Rants, Lagniappe, and Tales of Hoffman. Nevertheless, such caps, along with structured settlements, disclosure of collateral sources, and elimination of "joint and several" liability, would at least introduce some measure of sanity into the system.

These measures are more likely to be introduced than a total replacement of the current tort system with a system based on non-adversarial indemnification and risk-management. Here is part of a comment to the first post cited above from an anonymous pathologist in response to the assertion that caps will reduce malpractice premiums:

"True, but the size of the premiums isn't the main problem. The primary problem is too many physicians practicing substandard medicine on a daily basis. The second problem is that the medical profession refuses to police itself effectively. The third problem is that our medical malpractice legal system is ridiculous. We need expert panels that review potential malpractice cases, choose the ones with merit, and rapidly arbitrate them using a second expert panel that includes physicians, nurses, and knowledgeable laypersons. That panel would decide the case, the award, and how to handle incompetent physicians. We also need specialty boards and state medical review boards that place patient care above physicians' interests. I won't hold my breath."

Concise and to the point.