Each of us has read about or maybe been directly involved with the issue of healthcare malpractice and its rising cost. Living in Illinois most of my life and being a nurse for more than 40 years has given me an inside perspective of the issues. Physicians are leaving the area where I practice in record numbers because they cannot obtain malpractice insurance. Chicago has had record settlements, including one in 2005 for more than $35 million. In my opinion, the fault lies squarely with trial attorneys.

Why can't physicians find affordable insurance, and what are the causes of these exorbitant run-away verdicts? According to Highline Data, a Massachusetts-based data service company, only one Illinois medical malpractice insurance company has been in continuous existence since 1990. In 2004, of the top five companies, all were founded after 2001. In his testimony before the IL House of Representatives on February 23, 2005, Kenneth Skertich, Trust Administrator with the Chicago Hospital Risk Pooling Program, stated that nonmeritorious lawsuits were responsible for nearly half of the $64 million paid for legal expenses in cases over the past 10 years (Skertich, 2005). According to William Brody, president of John Hopkins University, our system of medical justice is fair to no one but malpractice lawyers. Nationally, attorneys and the legal system collect about 60% of the costs involved with malpractice cases and awards. They are the true winners in this system, whereas patients, hospitals, and the general public are paying higher prices to subsidize the purchase of tickets for our medical lottery. A few new caps on liability costs are not going to solve the problem. It is time we begin a comprehensive reform of the medical justice system (Brody, 2004).

The shortcomings of the medical liability system have driven up health insurance premiums and reduced access to medical care, according to a new Joint Economic Committee (Saxton, 2003). Saxton contends that although the highest quality care is available in the United States, exploding malpractice insurance costs, with an average of $1 million in awards for a single malpractice case, are forcing physicians to leave medicine or severely curtail their practices. Access to care is threatened as health insurance becomes more unaffordable to low-income Americans and hospital emergency departments threaten to close because of high malpractice costs. The study found that the current lawsuit-based tort system for medical malpractice has failed. Malpractice awards are not correlated with negligent injury, for most patients who are truly injured never file a lawsuit, and negligent physicians are not punished consistently. According to Saxton (2003), "[horizontal ellipsis] the time has come to reform the medical malpractice system. The reforms reported in this new JEC study would reduce overall spending on healthcare, and save the federal government upwards of $67 billion over the next ten years. Medical malpractice reform will benefit patients by increasing their access to medical care and by making health insurance more affordable as costs go down. Moreover, many women will find it easier to get Ob/Gyn care."

The deep-pocketed trial lawyer lobby, however, is mounting major drives to block tort reform. Although 30 states have limits, the courts are reviewing the constitutionality of such limits. Wisconsin's tort reform was overturned in 2005; in Illinois, the plaintiff's attorney can suggest an amount for economic and noneconomic settlements to the jury, who seem greatly influenced by these suggestions. Until the system is fixed on a national level, healthcare and the patients we serve will suffer.

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