Article

Do Noneconomic Damages Caps and Attorney Fee Limits Reduce Access to Justice for Victims of Medical Negligence?

Journal of Empirical Legal Studies (Impact Factor: 1.4). 12/2009; 6(4):637 - 686. DOI: 10.1111/j.1740-1461.2009.01156.x

ABSTRACT We analyze effects of noneconomic damages caps and attorney fee limits (AFLs) on the ability of people injured by negligent physicians to retain qualified lawyers to represent them. We employ survey data from 965 plaintiffs' attorneys who reported likelihoods of accepting hypothetical meritorious cases described by scenarios. We estimate how willingness to accept such cases increases with the expected hourly fees associated with them, and the estimates suggest substantial effects and plausible tradeoffs. We conclude that caps and AFLs make it harder to retain counsel in various circumstances, and we present policy simulations elucidating how several factors combine to determine these effects.

0 Followers
 · 
69 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The impact of medical malpractice reforms on the average size of malpractice payments in specific physician specialties is unknown and subject to debate. We analyzed a national sample of malpractice claims for the period 1985-2010, merged with information on state liability reforms, to estimate the impact of state noneconomic damages caps on average malpractice payment size for physicians overall and for ten different specialty categories. We then compared how the effects differed according to the restrictiveness of the cap ($250,000 versus $500,000). We found that, overall, noneconomic damages caps reduced average payments by $42,980 (15 percent), compared to having no cap at all. A more restrictive $250,000 cap reduced average payments by $59,331 (20 percent), and a less restrictive $500,000 cap had no significant effect, compared to no cap at all. The effect of the caps overall varied according to specialty, with the largest impact being on claims involving pediatricians and the smallest on claims involving surgical subspecialties and ophthalmologists.
    Health Affairs 10/2014; 33(11). DOI:10.1377/hlthaff.2014.0492 · 4.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Despite claims of a judicial funding crisis, there exists little direct evidence linking judicial budgets to court utilization. Using data on thousands of auto injuries covering a 15-year period, we measure the relationship between state-level court expenditures and the propensity of injured parties to pursue litigation. Controlling for state and plaintiff characteristics and accounting for the potential endogeneity of expenditures, we show that expenditures increase litigation access, with our preferred estimates indicating that a 10 percent budget increase increases litigation rates by 3 percent. Consistent with litigation models in which high litigation costs undermine the threat posture of plaintiffs, increases in court resources also augment payments to injured parties. We present suggestive evidence that these effects are driven by general expenditures rather than judicial salaries.
    The Journal of Legal Studies 06/2011; 40(2):295-332. DOI:10.1086/658863 · 1.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: New rules and methods for medical injury dispute resolution have been launched in New Hampshire and New York, and demonstration projects are underway elsewhere. This article describes major medical malpractice reforms undertaken and proposed in recent years. Reforms are classified as (1) liability-limiting initiatives favoring health-care providers; (2) procedural innovations promoted as improving dispute resolution processes, such as patient compensation funds, "sorry" laws, disclosure and early offer laws, health courts, and safe harbor laws; and (3) major conceptual reforms to move liability away from physicians to hospitals or administrative no-fault compensation systems. Empirical evidence about the practical effects of already-implemented reforms, such as damage caps, is reviewed. In light of declining malpractice claim rates, heavier adverse impacts of damage caps on vulnerable groups (people who have severe injuries, who are elderly, and who are unemployed) and repeated findings of state law unconstitutionality, the rationale for nationwide damage caps is questioned. Attention to innovative reform proposals such as patient compensation funds, disclosure and early offer laws, safe harbor laws, enterprise insurance and no-fault compensation systems, is encouraged.
    Chest 07/2013; 144(1):306-18. DOI:10.1378/chest.12-2861 · 7.13 Impact Factor