The lowest medical malpractice insurance rates are found in Minnesota, Wisconsin, Iowa and the Dakotas. Why is that? Probably not because doctors there have managed to achieve anything resembling error-free practice; and probably not because the five states, taken as a whole, are distinguished by any unusually pro-defendant set of tort laws. MedInnovationBlog takes up the question here and here, and speaks with a mutual insurer executive in search of explanations, which may include (among others) a “culture of collegiality among doctors and society as a whole”, a hard line against doubtful claims, and a paucity of giant verdicts of the John Edwards variety. (cross-posted from Point of Law).
Med-mal in the Upper Midwest
The lowest medical malpractice insurance rates are found in Minnesota, Wisconsin, Iowa and the Dakotas. Why is that? Probably not because doctors there have managed to achieve anything resembling error-free practice; and probably not because the five states, taken as a whole, are distinguished by any unusually pro-defendant set of tort laws. MedInnovationBlog takes up […]
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The Midwest has an Eden like culture of trust. Had a huge restaurant bill in Iowa. Restaurant did not take credit cards. I did not have the cash. No problem. Mail us a check. Funny thing was, I did, with a big tip.
Trust is efficient, and diverts effort from defensiveness to productivity. Their medical care is topnotch and cheaper as a reward for their restraint of rapaciousness. The Swedes of MN have better health stats than the Swedes of Sweden.
Indiana must have some comparatively low rates for malpractice insurance. My dad practices there very close to the borders of two other states and he says there is no way he could afford the insurance to extend his practice into those states.
Anyway, Indiana had a doctor governor back in the 70s who passed some of the strictest medmal limits in the country. There is a cap on the damages any single doctor can pay of $250,000 with a total cap of $1.25 million for patient recovery. The difference can be paid by a state insurance fund but attorney fees from fund-paid damages are limited to 15%. To even get to a trial the plaintiff must get the ok from a 3 doctor panel (P chooses 1, D chooses 1, those 2 choose the 3rd).
Without disagreeing with the main point of the article, some of it doesn’t make sense. Michigan has strict tort reform, Ohio and Wisconsin don’t. Doesn’t this make a difference?
Ned:
Michigan has some of the worst judicial “hellholes” in Wayne, Oakland and McComb counties. It is trying to pull itself out with reforms but it has a long, long way to go to overcome the damage these courts have created.
As Prof. Robt. Putnam of Harvard has shown, higher levels of ethnic homogeneity lead to higher levels of trust.
http://www.amnation.com/vfr/archives/008152.html
The upper Midwest, typically derided on the coasts for the dreaded characteristic of being “too white,” turns out to have an advantage in some respects. My own personal take on this is that plaintiffs in more “diverse” areas don’t see their lawsuit as draining community resources, but rather, the resource of “the other,” and so the moral hazard is increased.
As a former longtime Minnesota resident, I believe this reflects the frugality of Upper Midwesterners, perhaps a lingering effect of Scandinavian culture. I doubt that the modest jury awards are limited to med-mail. Minnesotans don’t like paying more for a product than it’s worth, and I doubt they’d like paying a plaintiff more than his claim is worth.