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Does Malpractice Liability Keep the Doctor Away? Evidence from Tort Reform Damage Caps

  • David A. Matsa
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    Many U.S. states limit awards for noneconomic damages in malpractice cases. Proponents often argue that such tort reform increases physician supply and access to care. However, the degree to which marginal changes in malpractice liability affect physician supply is theoretically ambiguous. If patients bear the full incidence of cost changes and market demand is inelastic, then tort reform will not affect physicians' net income or location decisions. I use county-level, specialty-specific annual counts of physicians from 1970-2000 to estimate the effect of damage caps on physician supply. The results suggest that caps do not affect physician supply for the average resident of states adopting reforms. On the other hand, caps appear to increase the supply of frontier rural specialist physicians by 10-12 percent. This is likely because rural doctors face greater uninsured litigation costs and a more elastic demand for medical services. (c) 2007 by The University of Chicago. All rights reserved.

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    File URL: http://dx.doi.org/10.1086/519466
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    Article provided by University of Chicago Press in its journal The Journal of Legal Studies.

    Volume (Year): 36 (2007)
    Issue (Month): S2 (06)
    Pages: S143-S182

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    Handle: RePEc:ucp:jlstud:v:36:y:2007:i:s2:p:s143-s182
    Contact details of provider: Web page: http://www.journals.uchicago.edu/JLS/

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    1. Daniel P. Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," NBER Working Papers 5466, National Bureau of Economic Research, Inc.
    2. Bresnahan, Timothy F & Reiss, Peter C, 1991. "Entry and Competition in Concentrated Markets," Journal of Political Economy, University of Chicago Press, vol. 99(5), pages 977-1009, October.
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    5. W. Kip Viscusi & Patricia H. Born, 2005. "Damages Caps, Insurability, and the Performance of Medical Malpractice Insurance," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 72(1), pages 23-43.
    6. Daniel Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 353-390.
    7. Danzon, Patricia, 1984. "The Frequency and Severity of Medical Malpractice Claims," Journal of Law and Economics, University of Chicago Press, vol. 27(1), pages 115-48, April.
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