Kevin writes,

Most trial lawyers point to the statistic that malpractice comprises of less that 1 percent of health care costs.

However, they are missing the fact that the threat of malpractice litigation raises costs by encouraging defensive medicine, as well discounting the significant amount of cases that are settled prior to trial.

The link points to this story: “Malpractice curbs hailed, faulted.” In my opinion, the article raises some strong possibilities that the Texas form of tort reform could be improved. But it doesn’t at all convince me that tort reform is unnecessary or inconsequential. And it most certainly that John Edwards is being accurate when he fends off calls for it by pointing to a completely irrelevant comparison:

But Democratic hopeful John Edwards, a former trial lawyer, has said that the changes hurt the victims of medical errors while doing little to reduce the cost of healthcare. Edwards recently said that “insurance company-driven hysteria” has created the false impression that malpractice insurance rates are significantly driving up healthcare costs.

“I think the reality is that the cost associated with legal cases is well under 1 percent of our [medical] system,” said Edwards, a former senator from North Carolina.

If this low single digit figure has any basis in reality, Kevin is right to point out that it is certainly overlooking the cost of defensive medicine.

But what about the doctors? Is there any doctor who only pays one percent of his income to medical malpractice insurance? Sure, if you add up every single aspect of the medical “system”–the pharmaceutical companies, the hospitals, the office personnel, etc.–perhaps medmal costs seem relatively low.

But the costs of medical malpractic are not distributed evenly throughout the system. They are paid by doctors. In fact, there are whole areas of medicine that are disappearing due to medmal rates. And this means that one very important part of “the medical system”–namely, the doctor–bears a huge burden. For one thing, he is constantly tempted to find a way to shift from the part of the healthcare system that is constantly getting sued and has to pay for insurance that reflects that fact, to a relatively less risky place in administration.

So in addition to the expense that can be counted monetarily, there is also the problem of scarcity–shortages caused by economic and other kinds of stress related to the medmal lottery. An essential part of the system is bearing the weight. Comparing the cost to the whole system completely misses the point.