We thank David Dranove, Craig Garthwaite, Kate Litvak, Anup Malani, Y. Tony Yang, an anonymous referee, and participants in the 2010 ASLME Health Law Professors conference, 2010 Midwest Law and Economics Association, 2010 Canadian Law and Economics Association, 2011 Midwest Health Economics, and 2011 American Law and Economics Association annual meetings, and 2011 Conference on Empirical Legal Studies for helpful comments. We also thank Elliot Fisher for providing the Dartmouth Atlas data on Medicare spending at the HSA level and the Searle Center on Law, Regulation and Economic Growth at Northwestern Law School for financial support.
Will Tort Reform Bend the Cost Curve? Evidence from Texas
Article first published online: 7 MAY 2012
Copyright © 2012 Cornell Law School and Wiley Subscription Services, Inc.
Journal of Empirical Legal Studies
Volume 9, Issue 2, pages 173–216, June 2012
How to Cite
Paik, M., Black, B. S., Hyman, D. A. and Silver, C. (2012), Will Tort Reform Bend the Cost Curve? Evidence from Texas. Journal of Empirical Legal Studies, 9: 173–216. doi: 10.1111/j.1740-1461.2012.01251.x
- Issue published online: 7 MAY 2012
- Article first published online: 7 MAY 2012
Will tort reform “bend the cost curve?” Health-care providers and tort reform advocates insist the answer is “yes.” They claim that defensive medicine is responsible for hundreds of billions of dollars in health-care spending every year. If providers and reform advocates are right, once damages are capped and lawsuits are otherwise restricted, defensive medicine, and thus overall health-care spending, will fall substantially. We study how Medicare spending changed after Texas adopted comprehensive tort reform in 2003, including a strict damages cap. We compare Medicare spending in Texas counties with high claim rates (high risk) to spending in Texas counties with low claim rates (low risk), since tort reform should have a greater impact on physician incentives in high-risk counties. Pre-reform, Medicare spending levels and trends were similar in high- and low-risk counties. Post-reform, we find no evidence that spending levels or trends in high-risk counties declined relative to low-risk counties and some evidence of increased physician spending in high-risk counties. We also compare spending trends in Texas to national trends, and find no evidence of reduced spending in Texas post-reform, and some evidence that physician spending rose in Texas relative to control states. In sum, we find no evidence that Texas's tort reforms bent the cost curve downward.