title: National costs of the medical liability system.
abstract: Concerns about reducing the rate of growth of health expenditures have reignited interest in medical liability reforms and their potential to save money by reducing the practice of defensive medicine. It is not easy to estimate the costs of the medical liability system, however. This article identifies the various components of liability system costs, generates national estimates for each component, and discusses the level of evidence available to support the estimates. Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending.
authors.affiliation: Harvard School of Public Health, Department of Health Policy and Management, and Brigham and Women's Hospital, Boston, MA, USA. mmello@hsph.harvard.edu
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Mello
authors.forename: Amitabh
authors.initials: A
authors.lastname: Chandra
authors.forename: Atul A
authors.initials: AA
authors.lastname: Gawande
authors.forename: David M
authors.initials: DM
authors.lastname: Studdert
mesh_terms: D003675:Defensive Medicine / Q000191:economics* / Q000331:legislation & jurisprudence; D018166:Health Care Reform / Q000191:economics*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D016365:Liability, Legal / Q000191:economics*; D014481:United States
references.citation: Am Econ Rev. 1990 May;80(2):122-7
references.pmid: 10104316
references.citation: J Health Econ. 2002 Nov;21(6):931-55
references.pmid: 12475119
references.citation: J Health Econ. 1999 Aug;18(4):491-522
references.pmid: 10539619
references.citation: Inquiry. 2003 Fall;40(3):283-94
references.pmid: 14680260
references.citation: J Health Econ. 2009 Mar;28(2):481-91
references.pmid: 19201500
references.citation: Health Aff (Millwood). 2004 Jul-Aug;23(4):54-67
references.pmid: 15318567
references.citation: J Gen Intern Med. 2010 May;25(5):380-1
references.pmid: 20349156
references.citation: JAMA. 1995 Nov 22-29;274(20):1606-10
references.pmid: 7474245
references.citation: Health Aff (Millwood). 2007 May-Jun;26(3):841-52
references.pmid: 17485765
references.citation: Health Aff (Millwood). 1984 Fall;3(3):128-33
references.pmid: 6519633
references.citation: JAMA. 1993 Jan 20;269(3):366-73
references.pmid: 8418343
references.citation: N Engl J Med. 2009 Jul 2;361(1):1-3
references.pmid: 19528190
references.citation: J Health Polit Policy Law. 1992 Fall;17(3):463-82
references.pmid: 1464708
references.citation: N Engl J Med. 2006 May 11;354(19):2024-33
references.pmid: 16687715