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Damage caps and defensive medicine, revisited

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  • Paik, Myungho
  • Black, Bernard
  • Hyman, David A.

Abstract

Does tort reform reduce defensive medicine and thus healthcare spending? Several (though not all) prior studies, using a difference-in-differences (DiD) approach, find lower Medicare spending for hospital care after states adopt caps on non-economic or total damages (“damage caps”), during the “second” reform wave of the mid-1980s. We re-examine this issue in several ways. We study the nine states that adopted caps during the “third reform wave,” from 2002 to 2005. We find that damage caps have no significant impact on Medicare Part A spending, but predict roughly 4% higher Medicare Part B spending. We then revisit the 1980s caps, and find no evidence of a post-adoption drop (or rise) in spending for these caps.

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  • Paik, Myungho & Black, Bernard & Hyman, David A., 2017. "Damage caps and defensive medicine, revisited," Journal of Health Economics, Elsevier, vol. 51(C), pages 84-97.
    • Handle: RePEc:eee:jhecon:v:51:y:2017:i:c:p:84-97
    DOI: 10.1016/j.jhealeco.2016.11.001
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    Cited by:

    1. Xin Zhao & Xiaoxue Li & Benno Torgler & Uwe Dulleck, 2021. "Patient violence, physicians treatment decisions, and patient welfare: Evidence from China," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1461-1479, June.
    2. Zabinski, Zenon & Black, Bernard S., 2022. "The deterrent effect of tort law: Evidence from medical malpractice reform," Journal of Health Economics, Elsevier, vol. 84(C).
    3. Mohammad Rahmati & David A. Hyman & Bernard Black & Charles Silver, 2016. "Insurance Crisis or Liability Crisis? Medical Malpractice Claiming in Illinois, 1980–2010," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 13(2), pages 183-204, June.
    4. Victoria Perez & Coady Wing, 2019. "Should We Do More to Police Medicaid Fraud? Evidence on the Intended and Unintended Consequences of Expanded Enforcement," American Journal of Health Economics, University of Chicago Press, vol. 5(4), pages 481-508, Fall.
    5. Michael Frakes & Jonathan Gruber, 2020. "Defensive Medicine and Obstetric Practices: Evidence from the Military Health System," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 17(1), pages 4-37, March.
    6. Bernard S. Black & Amy R. Wagner & Zenon Zabinski, 2017. "The Association between Patient Safety Indicators and Medical Malpractice Risk: Evidence from Florida and Texas," American Journal of Health Economics, MIT Press, vol. 3(2), pages 109-139, Spring.
    7. Michael D. Frakes & Jonathan Gruber, 2018. "Defensive Medicine: Evidence from Military Immunity," NBER Working Papers 24846, National Bureau of Economic Research, Inc.
    8. Andrew I. Friedson, 2017. "Medical Malpractice Damage Caps and Provider Reimbursement," Health Economics, John Wiley & Sons, Ltd., vol. 26(1), pages 118-135, January.
    9. Xiaoqian Fan & Qian Cao & Lin Yang, 2021. "Do professional norms in the medical industry favor outcome bias?," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 42(5), pages 1275-1283, July.

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    More about this item

    Keywords

    Medical malpractice; Tort reform; Defensive medicine; MEDICARE; Healthcare spending;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K23 - Law and Economics - - Regulation and Business Law - - - Regulated Industries and Administrative Law
    • K32 - Law and Economics - - Other Substantive Areas of Law - - - Energy, Environmental, Health, and Safety Law

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