>>>Yes but the problem with our bottomless tort system, as I'm sure you know, is that there is no incentive to not litigate any negative medical outcome and we are churning out more lawyers than we are doctors. The insurance reforms are not going do to anything to correct this.
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>But who will you sue? Just as insurers must match coverage and exclusions to size of premium, facilities will need to declare the level of care they can provide for the sorts of payment available from Medicare. Obviously facilities will go broke if they try to provide today's level of care without reimbursement so if Courts or legislators try to enforce it, the result will be exactly as predicted by Ayn Rand. Meanwhile if society really does decide to make physicians de-facto executioners and then sues them for it, many physicians will quit with regret and will gravitate to other pursuits that society obviously regards as more useful, such as currency trading or derivatives.

I think that is exactly the outcome that we were headed for - Obamacare or no - and our big "reform" does nothing to address it. It is not a question of if I would sue but if enough lawyers find aggrieved parties they can represent by promising them riches from the "deep pockets" of insurance companies. And an increasingly complex health care allocation system and "the government" - the deepest pocket of all - as a potential responsible party and shoulderer of liablity - will just make it all more tempting.

So just as it is now the insurance companies will pass on the cost of settling out of court millions of nuisance suits to the policy holders - doctors and hospitals - and that will continue to be the cost of doing business. And yes, just as it does now, it will discourage many from practicing medicine and will drive many dedicated doctors into retirement or just exodus. There is no protection against unlimited civil suits and no penalty for frivolous suit and the burden of proof in the civil arena will be on the health care provider.

One thing we have mastered as a society is identity through victimhood and aggrievement. We teach people to find how they have been wronged, insulted or sinned against, and where they are not receiving what they are entitled to and we have a whole industry - academic, legal and political - that depends on making our society a collection of groups of injured parties who demand the world be put right by giving them their due.