CONGRESSIONAL BUDGET OFFICE CALLS MALPRACTICE EVIDENCE SCANT.

Restrictions on medical malpractice awards don't appear to have much effect on health care spending, the nonpartisan Congressional Budget

Office reported Jan. 8.

"Evidence from the states indicates that premiums for malpractice insurance are lower when tort liability is restricted than they would be otherwise," the CBO says in its report, Limiting Tort Liability for Medical Malpractice.

"But even large savings in premiums can have only a small direct impact on health care spending - private or governmental - because malpractice costs account for less than 2 percent of that spending," it says.

"Advocates or opponents cited other possible effects of limiting tort liability, such as reducing the extent to which physicians practice 'defensive medicine' by conducting excessive procedures; preventing widespread problems of access to health care; or conversely, increasing medical injuries. However, evidence for those other effects is weak or inconclusive."

Doctors in have been pushing, successfully in several states, for limits on malpractice liability, most commonly by capping noneconomic damages at $250,000.

President Bush and members of Congress have proposed similar limits at the national level.

The CBO notes premiums for medical malpractice insurance have risen sharply in recent years, by an average of 15 percent between 2000 and 2002. Increases for certain specialties were even more dramatic: 22 percent for obstetricians/gynecologists and 33 percent for internists and general surgeons.

It says there are two apparent reasons.

"The available evidence suggests that premiums have risen both because insurance companies have faced increased costs to pay claims (from growth in malpractice awards) and because of reduced income from their investments and short-term factors in the insurance market," the report says.