Tom Baker and Mark Geistfeld\u27s contributions to this Symposium offer detailed and persuasive analyses of medical malpractice insurance. Their principal contribution to the malpractice reform debate, however, is simple: confirming that liability insurers should not be left to their own devices between malpractice crises or appeased during crisis periods. Instead, liability insurance must be consciously designed to help the health care system work toward its core goals of high quality, broad access, and affordable cost.
In 2000, the IOM issued a follow-up report to its earlier indictment of medical error, calling upon the health care system to become safe, effective, patient-centered, timely, efficient, and equitable. The medical malpractice system possesses none of these qualities, in large part because of the incentives created by third-party liability insurance. The inadequacy of the current insurance system should be readily apparent to both market participants and malpractice reformers. History and politics, however, have blinded them to the obvious. In the topsy-turvy world of medical malpractice policy, grassroots constituencies seem to have their heads in the clouds, while scholars peering out of the ivory tower somehow manage to see the lay of the land
