Report Ranks States on Need for Medical Malpractice Reform

Published May 31, 2016

A new report by the Pacific Research Institute (PRI), a San Francisco-based think tank, ranks the states on their medical-malpractice and tort liability policies and indicates where each state has room to improve. The study ranks the fifty states based on numerous factors, which together illustrate the importance of medical malpractice reform in controlling health care costs, according to study author John Graham.

Using information from the 2010 edition of the U.S. Tort Liability Index by Lawrence J. McQuillan and Hovannes Abramyan, which analyzed some 42 variables, PRI ranked the states by calculating where they ought to stand on each type of measurement. John Graham, director of health care studies at PRI and author of the report, said the study illustrates which states are “getting it right” and which are not.

“This ranking shows every state where to focus its efforts to bring medical-tort costs under control,” Graham said.

Liability Laws Drive Costs

Graham’s report examines eight of the McQuillan and Abramyan variables, including the ratio of medical-malpractice insurance losses to projected personal health expenditures, the states’ caps on noneconomic and punitive damages, attorney-fee limits for medical-malpractice cases, and more.

“State liability laws that are too generous to trial lawyers increase medical costs through ‘defensive medicine,’ reduce the number of doctors, increase the prices of prescription drugs and medical devices, and result in meritless lawsuits clogging up the courts,” Graham said. “These high medical tort costs cause patients to suffer from reduced access to appropriate medical care.”

The PRI report names Mississippi, Nevada, Michigan, Colorado, and Louisiana as the most successful at medical tort reform.

“No state excels in all eight measurements. However, Mississippi tops the rankings because it reduces the number of unnecessary lawsuits through pretrial screening or arbitration and limits the product liability of medical-device manufacturers or drug makers who are in compliance with Food and Drug Administration or Federal Trade Commission regulations,” Graham said. “Unfortunately, Mississippi has no limits on how much trial lawyers can extract from victims of medical malpractice, thereby encouraging cost-increasing adventurism amongst lawyers.”

Some Remain Very Wrong

The report names Vermont, Rhode Island, Pennsylvania, Kentucky, and Iowa as the least successful in improving their malpractice laws.


“Vermont has no limits on noneconomic or punitive damages, no limits on how much of the damages the plaintiffs’ lawyers can seize, offers drug makers or medical-device makers no protection for being in compliance with FDA or FTC regulations, and does not qualify the credentials of expert witnesses at trials,” Graham said. “As a result, its medical-malpractice insurance losses are extremely high in relation to health spending.” 

Sarah McIntosh ([email protected]) is a constitutional scholar in Lawrence, Kansas. 

Internet Resources: 

“Medical Tort Reform: Ranking The 50 States”: