Tort reform may not affect all segments of society equally. Studies have shown that many tort reforms disproportionately reduce compensation to women, children, the elderly, disadvantaged minorities, and less affluent people. This study goes beyond tort reform's disproportionate effect on compensation, to explore whether tort reform also has a disproportionate effect on accidental death rates. We explain that, theoretically, tort reform's care-level effects and activity-level effects may disproportionately impact the accident rates of different groups. Using the most accurate, comprehensive data on medical malpractice tort reforms and state-level data from 1980-2000, we examine empirically whether tort reforms indeed have such a disproportionate effect. The results from our empirical analysis are consistent with our theoretical predictions. We find that the impact of tort reform varies substantially among demographic groups. When we consider the net effect of all the reforms in our study together, our results suggest that women, children, and the elderly do not enjoy tort reform's benefits as much as men and middle-aged people. In fact, they might even be harmed by reform.

This Special Report from The RAND Corporation's Institute for Civil Justice (ICJ) draws on seven years of ICJ research to consider three issues at the heart of the recent debate on trends in tort litigation: (1) how much litigation there is; (2) whether jury awards are stable or out of control; and (3) how much litigation costs and who gets the money. The research suggests that discrepancies among the statistics on tort litigation can be explained by the fact that there is no longer, if there ever was, a single tort system. Instead, there are at least three types of tort litigation, each with its own class of litigants, attorneys, and legal dynamics. The three types of torts are routine personal injury torts (e.g., auto suits), high-stakes personal injury torts (e.g., product liability, malpractice, and business suits), and mass latent injury cases (e.g., asbestos litigation). Each of these areas is characterized by a different litigation growth rate, jury verdict trend, and cost profile, and treating them together--as is done whenever overall statistics for tort litigation are reported--produces a distorted picture.

This study evaluates the impact of tort reform on private health insurance coverage using the Current Population Survey's March Demographic Files. Proponents of tort reform argue that reform will reduce medical malpractice insurance costs, damage awards, and costs associated with defensive medicine. If proponents are correct, these cost reductions should increase health insurance coverage. On the other hand, if the prior tort law was functioning well, reform may increase medical costs by reducing doctors' care-taking or increasing of the use of aggressive treatments. In this case, tort reform could actually decrease insurance coverage by raising healthcare costs. We evaluate the effect of eight common tort reforms on private health insurance coverage between 1981 and 2007. We find that damage caps, collateral source reform, and joint and several liability reform increased health insurance coverage for the most price-sensitive groups (the single-young and the self-employed) between one-half and one percentage point each. Accordingly, we conclude that tort reform may increase insurance coverage rates for price-sensitive groups, but its overall effect on coverage will be small.

The Measure of Injury is an intellectual tour de force of gender and race-based jurisprudence applied to critical issues in the law of torts. In this volume, Martha Chamallas and Jennifer B. Wriggins shed light on numerous issues related to law governing accidents and intentional injuries, while offering insights into the American tort system and the challenges it faces.Chamallas and Wriggins draw upon the feminist theory, critical race theory, and general critical theory in analyzing tort doctrines and evaluating potential reforms. The authors explore how racial perceptions can distort even seemingly neutral inquiries, such as those related to factual causation. In their review of tort precedent related to race and gender, the authors explore a number of important historical topics: the doctrine of coverture, the “nervous-shock” cases, wrongful-death cases, and wrongful-birth cases. Viewed in all of its complexity, the authors' argument seems to be that matters of race should be taken into account by tort law when cognizance will benefit persons who are members of classes that have historically suffered from discrimination, but not otherwise. To the extent that the author's arguments are found to be persuasive, The Measure of Inquiry may play a key role in revolutionizing the compensation of intentional injuries and accidents.

Tort reforms enacted in response to asserted crises date back to the 1970s and have emphasized the highly visible areas of punitive damages, medical malpractice, and products liability. Little evidence exists that reform of punitive damages affected the ratio between punitive and compensatory damages. This is consistent with the absence of evidence that punitive damages were ever out of control and in need of reform. Evidence of the effect of tort reform in the medical malpractice field is mixed. Caps on non-economic damages have reduced costs, thereby likely decreasing pressure on hospitals to improve care. Consistent evidence of effects on physician behavior and physician supply has not emerged. Tort reform has rarely sought to address the well-established problem of widespread harm caused by poor quality care. Products liability plaintiffs have had decreasing success over time. While one cannot rule out specific statutory reforms as achieving more favorable results for defendants, the national scope of plaintiffs' declining success supports an explanation based on the social construction of knowledge by well-funded industry groups.

"Drawing on an unusually rich trove of data, the authors have refuted more politically convenient myths in one book than most academics do in a lifetime." —Nicholas Bagley, professor of law, University of Michigan Law School "Synthesizing decades of their own and others’ research on medical liability, the authors unravel what we know and don’t know about our medical malpractice system, why neither patients nor doctors are being rightly served, and what economics can teach us about the path forward." —Anupam B. Jena, Harvard Medical School Over the past 50 years, the United States experienced three major medical malpractice crises, each marked by dramatic increases in the cost of malpractice liability insurance. These crises fostered a vigorous politicized debate about the causes of the premium spikes, and the impact on access to care and defensive medicine. State legislatures responded to the premium spikes by enacting damages caps on non-economic, punitive, or total damages and Congress has periodically debated the merits of a federal cap on damages. However, the intense political debate has been marked by a shortage of evidence, as well as misstatements and overclaiming. The public is confused about answers to some basic questions. What caused the premium spikes? What effect did tort reform actually have? Did tort reform reduce frivolous litigation? Did tort reform actually improve access to health care or reduce defensive medicine? Both sides in the debate have strong opinions about these matters, but their positions are mostly talking points or are based on anecdotes. Medical Malpractice Litigation provides factual answers to these and other questions about the performance of the med mal system. The authors, all experts in the field and from across the political spectrum, provide an accessible, fact-based response to the questions ordinary Americans and policymakers have about the performance of the med mal litigation system.

Focusing on issues of vital importance to those seeking to understand and reform the tort system, this volume takes a multi-disciplinary approach, including theoretical economic analysis, empirical analysis, socio-economic analysis, and behavioral anal