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What Pennsylvania’s Budget Battle Told Us About Tort Reform

Lawmakers’ long, heavy-going struggle to enact Pennsylvania’s budget didn’t give
state residents much to delight in, but it did help settle a timely debate: How much
does the public pay for medical liability costs?

Tort-reform opponents insist that litigation against medical professionals bears
minimally on the cost of medicine. We’re apparently to believe that patients end up
covering no significant portion of the high malpractice insurance premiums that
doctors have to pay. We’re expected to think that lawsuits aren’t driving physicians
out of Pennsylvania, reducing the supply of practitioners and inflating health-care

And still, the same Harrisburg that didn’t consider excessive litigation a big
enough problem to approve tort reform instead created the Medical Care Availability
and Reduction of Error Fund (Mcare) in 2002. When a jury orders a medical
practitioner to pay damages to a plaintiff, Mcare helps pay those damages. (If the
state thinks most plaintiffs deserve these awards, you have to wonder why it takes
on a financial burden to help the defendants pay them.)

This year, though, lawmakers decided they needed to use $808 million from the Mcare
fund to close a massive budget hole. That figure represents roughly 1/34 of the
$27.799-billion spending plan that Gov. Ed Rendell signed. For a state that cannot
legally run a deficit, that fraction is enormous. In other words, Mcare’s very
existence threatened to throw Pennsylvanians’ state budget severely off-balance. (It
still does, if some doctors successfully sue the commonwealth to restore Mcare’s

Remember, many politicians actually favor this costly program over letting doctors
shoulder malpractice insurance costs on their own. That is, they expect
Pennsylvanians would suffer even more without Mcare than with it. The upshot:
Pennsylvanians pay dearly for the state’s medical-liability crisis, whether as
patients or as taxpayers. Only real tort reform can eliminate these crushing
expenses.  (Source:

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