Medical malpractice suits may not be doing as much to drive up U.S. health care system costs as some system observers believe.[@@]

Gerald Anderson, a researcher at Johns Hopkins University, and colleagues have published a paper discussing that proposition in the latest issue of Health Affairs, a health care finance and delivery academic journal.

“The 2 most important reasons for higher U.S. spending appear to be higher incomes and higher medical care prices,” Anderson and his colleagues write in the paper.

The researchers looked at records for malpractice settlements and judgments in Australia, Canada and the United Kingdom as well as in the United States.

U.S. health care costs averaged $5,267 per person in 2002, and that average was 53% higher than the average for any other country included in the study, the researchers write.

U.S. providers faced 18 malpractice claims for each 100,000 U.S. residents. That was much higher than the Canadian malpractice claims rate of 4 claims per 100,000 residents, but comparable to the claims rate of 12 claims per 100,000 residents in Australia and Canada.

The average payment per settlement or judgment was about $265,000 in the United States. That was much higher than the average of $97,000 in Australia, but it was lower than the average of $309,000 in Canada and the average of $411,000 in the United Kingdom, according to Anderson and his colleagues.

Malpractice awards cost an average of about $16 per resident of the United States, $4 per resident of Canada, $10 per resident of Australia, and $12 per resident of the United Kingdom.

“I all 4 countries, costs for claims against physians are small compared with total health spending,” Anderson and his colleagues write.

“Defensive medicine” – a tendency for doctors to conduct more procedures than necessary out of fear of lawsuits == probably contributes more to health care costs, but, “unfortunately, it is difficult to establish how much care is attributable to defensive medicine, in either the U.S. or other countries,” the researchers write.

Defensive medicine probably accounts for less than 9% of current U.S. health system expenses, the researchers estimate.