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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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  1. 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, vol. 118(4), pages 1495-1532, November.
  2. Douglas Almond & Kenneth Y. Chay & David S. Lee, 2005. "The Costs of Low Birth Weight," The Quarterly Journal of Economics, MIT Press, vol. 120(3), pages 1031-1083, August.
  3. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, vol. 18(4), pages 491-522, August.
  4. Steven Shavell, 2003. "Economic Analysis of Accident Law," NBER Working Papers 9694, National Bureau of Economic Research, Inc.
  5. 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 59, Chicago - Center for Study of Economy and State.
  6. Frank A. Sloan & Lindsey M. Chepke, 2008. "Medical Malpractice," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262195720, December.
  7. Kessler, Daniel & McClellan, Mark, 1996. "Do Doctors Practice Defensive Medicine?," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 353-90, May.
  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 95-07, Duke University, Department of Economics.
  9. Danzon, Patricia M., 2000. "Liability for medical malpractice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 26, pages 1339-1404 Elsevier.
  10. Jennifer Arlen & W. Bentley MacLeod, 2005. "Torts, Expertise, and Authority: Liability of Physicians and Managed Care Organizations," RAND Journal of Economics, The RAND Corporation, vol. 36(3), pages 494-519, Autumn.
  11. Currie, Janet & Gruber, Jonathan, 2001. "Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions," Journal of Public Economics, Elsevier, vol. 82(1), pages 63-89, October.
  12. 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, vol. 18(2), pages 189-213, August.
  13. Dranove, David, 1988. "Demand Inducement and the Physician/Patient Relationship," Economic Inquiry, Western Economic Association International, vol. 26(2), pages 281-98, April.
  14. 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.
  15. Daniel P. Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," NBER Working Papers 5466, National Bureau of Economic Research, Inc.
  16. 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.
  17. Beomsoo Kim, 2007. "The Impact of Malpractice Risk on the Use of Obstetrics Procedures," The Journal of Legal Studies, University of Chicago Press, vol. 36(S2), pages S79-S119, 06.
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Citations

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Cited by:
  1. Avraham, Ronen & Bustos, Álvaro, 2010. "The unexpected effects of caps on non-economic damages," International Review of Law and Economics, Elsevier, vol. 30(4), pages 291-305, December.
  2. Lakdawalla, Darius N. & Seabury, Seth A., 2012. "The welfare effects of medical malpractice liability," International Review of Law and Economics, Elsevier, vol. 32(4), pages 356-369.
  3. 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, vol. 3(3), pages 286-297, March.
  4. Daniel P. Kessler, 2011. "Evaluating the Medical Malpractice System and Options for Reform," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 93-110, Spring.
  5. Benjamin Ho & Elaine Liu, 2011. "Does sorry work? The impact of apology laws on medical malpractice," Journal of Risk and Uncertainty, Springer, vol. 43(2), pages 141-167, October.
  6. 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).
  7. Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 645-80, September.
  8. 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.
  9. Anca Cotet, 2009. "Tort Reform and the Demand for Medical Care: Evidence from State-by-State Variation in Non-Economic Damages Caps," Working Papers 200901, Ball State University, Department of Economics, revised Mar 2010.
  10. 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.
  11. Daniel Carvell & Janet Currie & W. Bentley MacLeod, 2012. "Accidental death and the rule of joint and several liability," RAND Journal of Economics, RAND Corporation, vol. 43(1), pages 51-77, 03.
  12. Shurtz, Ity, 2013. "The impact of medical errors on physician behavior: Evidence from malpractice litigation," Journal of Health Economics, Elsevier, vol. 32(2), pages 331-340.
  13. 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 456, Free University of Berlin, Humboldt University of Berlin, University of Bonn, University of Mannheim, University of Munich.
  14. Anca Cotet, 2009. "More Evidence on the Quality-Quantity Trade-off in Medical Care," Working Papers 200902, Ball State University, Department of Economics, revised Mar 2010.
  15. 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.
  16. Darius N. Lakdawalla & Seth A. Seabury, 2009. "The Welfare Effects of Medical Malpractice Liability," NBER Working Papers 15383, National Bureau of Economic Research, Inc.
  17. Sloan, Frank A. & Shadle, John H., 2009. "Is there empirical evidence for "Defensive Medicine"? A reassessment," Journal of Health Economics, Elsevier, vol. 28(2), pages 481-491, March.

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