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First Do No Harm?: Tort Reform and Birth Outcomes

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  • Janet Currie
  • W. Bentley MacLeod

Abstract

We examine the impact of tort reforms using U.S. birth records for 1989-2001. We make four contributions: First, we develop a model that analyzes the incentives created by specific tort reforms. Second, we assemble new data on tort reform. Third, we examine a range of outcomes. Finally, we allow for differential effects by demographic/risk group. We find that reforms of the "deep pockets rule" reduce complications of labor and C-sections, while caps on noneconomic damages increase them. Our results demonstrate there are important interactions between incentives created by tort law and other incentives facing physicians.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 12478.

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Date of creation: Aug 2006
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Publication status: published as Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, MIT Press, vol. 123(2), pages 795-830, 05.
Handle: RePEc:nbr:nberwo:12478

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References

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  1. Dranove, David, 1988. "Demand Inducement and the Physician/Patient Relationship," Economic Inquiry, Western Economic Association International, Western Economic Association International, vol. 26(2), pages 281-98, April.
  2. Daniel P. Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," NBER Working Papers 5466, National Bureau of Economic Research, Inc.
  3. Beomsoo Kim, 2007. "The Impact of Malpractice Risk on the Use of Obstetrics Procedures," The Journal of Legal Studies, University of Chicago Press, University of Chicago Press, vol. 36(S2), pages S79-S119, 06.
  4. Kessler, Daniel & McClellan, Mark, 1996. "Do Doctors Practice Defensive Medicine?," The Quarterly Journal of Economics, MIT Press, MIT Press, vol. 111(2), pages 353-90, May.
  5. Janet Currie & Jonathan Gruber & Michael Fischer, 1994. "Physician Payments and Infant Mortality: Evidence from Medicaid Fee Policy," NBER Working Papers 4930, National Bureau of Economic Research, Inc.
  6. Frank A. Sloan & Lindsey M. Chepke, 2008. "Medical Malpractice," MIT Press Books, The MIT Press, The MIT Press, edition 1, volume 1, number 0262195720, December.
  7. Janet Currie & Enrico Moretti, 2003. "Mother'S Education And The Intergenerational Transmission Of Human Capital: Evidence From College Openings," The Quarterly Journal of Economics, MIT Press, MIT Press, vol. 118(4), pages 1495-1532, November.
  8. Sloan, Frank & Entman, Stephen S. & Reilly, Bridget A. & Cheryl A. Glass & Gerald B. Hickson & Harold H. Zhang, 1995. "Tort Liability and Obstetricians' Care Levels," Working Papers, Duke University, Department of Economics 95-07, Duke University, Department of Economics.
  9. Douglas Almond & Kenneth Y. Chay & David S. Lee, 2004. "The Costs of Low Birth Weight," NBER Working Papers 10552, National Bureau of Economic Research, Inc.
  10. Pauly Danzon. Patricia M. & Kington Mark V. & Raynard S., 1990. "The Effects of Malpractice Litigation on Physicians' Fees and Incomes," University of Chicago - George G. Stigler Center for Study of Economy and State, Chicago - Center for Study of Economy and State 59, Chicago - Center for Study of Economy and State.
  11. Jon Gruber & John Kim & Dina Mayzlin, 1998. "Physician Fees and Procedure Intensity: The Case of Cesarean Delivery," NBER Working Papers 6744, National Bureau of Economic Research, Inc.
  12. Steven Shavell, 2003. "Economic Analysis of Accident Law," NBER Working Papers 9694, National Bureau of Economic Research, Inc.
  13. Browne, Mark J & Puelz, Robert, 1999. "The Effect of Legal Rules on the Value of Economic and Non-economic Damages and the Decision to File," Journal of Risk and Uncertainty, Springer, Springer, vol. 18(2), pages 189-213, August.
  14. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, Elsevier, vol. 18(4), pages 491-522, August.
  15. Patricia M. Danzon, 1991. "Liability for Medical Malpractice," Journal of Economic Perspectives, American Economic Association, American Economic Association, vol. 5(3), pages 51-69, Summer.
  16. Jennifer Arlen & W.Bentley Macleod, 2004. "Torts, Expertise, and Authority: Liability of Physicians and Managed Care Organizations," Working Papers, New York University, Leonard N. Stern School of Business, Department of Economics 04-26, New York University, Leonard N. Stern School of Business, Department of Economics.
  17. Currie, Janet & Gruber, Jonathan, 2001. "Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions," Journal of Public Economics, Elsevier, Elsevier, vol. 82(1), pages 63-89, October.
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Citations

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Cited by:
  1. Darius N. Lakdawalla & Seth A. Seabury, 2009. "The Welfare Effects of Medical Malpractice Liability," NBER Working Papers 15383, National Bureau of Economic Research, Inc.
  2. Avraham, Ronen & Bustos, Álvaro, 2010. "The unexpected effects of caps on non-economic damages," International Review of Law and Economics, Elsevier, Elsevier, vol. 30(4), pages 291-305, December.
  3. Anca Cotet, 2009. "Tort Reform and the Demand for Medical Care: Evidence from State-by-State Variation in Non-Economic Damages Caps," Working Papers, Ball State University, Department of Economics 200901, Ball State University, Department of Economics, revised Mar 2010.
  4. Janet Currie & W. Bentley MacLeod, 2013. "Diagnosis and Unnecessary Procedure Use: Evidence from C-Section," NBER Working Papers 18977, National Bureau of Economic Research, Inc.
  5. Anca Cotet, 2009. "More Evidence on the Quality-Quantity Trade-off in Medical Care," Working Papers, Ball State University, Department of Economics 200902, Ball State University, Department of Economics, revised Mar 2010.
  6. Kesternich, Iris & Schumacher, Heiner & Winter, Joachim, 2014. "Professional norms and physician behavior: homo oeconomicus or homo hippocraticus?," Discussion Paper Series of SFB/TR 15 Governance and the Efficiency of Economic Systems, Free University of Berlin, Humboldt University of Berlin, University of Bonn, University of Mannheim, University 456, Free University of Berlin, Humboldt University of Berlin, University of Bonn, University of Mannheim, University of Munich.
  7. Benjamin Ho & Elaine Liu, 2011. "Does sorry work? The impact of apology laws on medical malpractice," Journal of Risk and Uncertainty, Springer, Springer, vol. 43(2), pages 141-167, October.
  8. Shurtz, Ity, 2013. "The impact of medical errors on physician behavior: Evidence from malpractice litigation," Journal of Health Economics, Elsevier, Elsevier, vol. 32(2), pages 331-340.
  9. Lakdawalla, Darius N. & Seabury, Seth A., 2012. "The welfare effects of medical malpractice liability," International Review of Law and Economics, Elsevier, Elsevier, vol. 32(4), pages 356-369.
  10. Daysal, N. Meltem & Trandafir, Mircea & van Ewijk, Reyn, 2013. "Returns to Childbirth Technologies: Evidence from Preterm Births," IZA Discussion Papers 7834, Institute for the Study of Labor (IZA).
  11. Sloan, Frank A. & Shadle, John H., 2009. "Is there empirical evidence for "Defensive Medicine"? A reassessment," Journal of Health Economics, Elsevier, Elsevier, vol. 28(2), pages 481-491, March.
  12. Daniel Carvell & Janet Currie & W. Bentley MacLeod, 2009. "Accidental Death and the Rule of Joint and Several Liability," NBER Working Papers 15412, National Bureau of Economic Research, Inc.
  13. Daniel P. Kessler, 2011. "Evaluating the Medical Malpractice System and Options for Reform," Journal of Economic Perspectives, American Economic Association, American Economic Association, vol. 25(2), pages 93-110, Spring.
  14. Erin M. Johnson & M. Marit Rehavi, 2013. "Physicians Treating Physicians: Information and Incentives in Childbirth," NBER Working Papers 19242, National Bureau of Economic Research, Inc.
  15. Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, American Economic Association, vol. 50(3), pages 645-80, September.
  16. Arab Naz & Umar Daraz & Waseem Khan & Qaisar Khan & Tariq Khan & Anwar Alam & Irum Mughal, 2013. "Human’s Complexity and Man’s Atrocity: Causes Of Medical Malpractices among Pakhtuns of Pakistan," Asian Journal of Empirical Research, Asian Economic and Social Society, Asian Economic and Social Society, vol. 3(3), pages 286-297, March.
  17. Eric Helland & Darius N. Lakdawalla & Anup Malani & Seth A. Seabury, 2014. "Unintended Consequences of Products Liability: Evidence from the Pharmaceutical Market," NBER Working Papers 20005, National Bureau of Economic Research, Inc.

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