[dzink]

Huge chunk of the costs come from the fact that Doctors pay astronomical malpractice insurance rates in some states with no tort reform. Some have to spend more than 100k on insurance - 1/3 of their total pay. Since some states allows multi-million dollar judgments from juries that raises insurance everywhere, which raises not only prices for everyone but also dramatically contributes to more procedures and tests being done at even higher costs to avoid liability. The risks of having your entire livelihood wiped out chases out doctors from those states and reduces availability of care for patients as well. If you want objective cost comparison, compare Veterinary care which has similar consumables and training, but no insurance and liability impact on prices.

[sethammons]

The doctor that delivered my middle child said he had to deliver three babies a week just to cover insurance, and he had never had a case against him in his decades of practice.

[LorenPechtel]

Yup, obstetrics is a really nasty one. The problem is in many cases it's impossible for the doctor to prove he didn't harm the baby, the jury sees a baby that needs a lot of care and they see deep pockets.

And then you get stuff like the local case the lawyers were using as a poster boy for supposedly blaming the insurance companies. Baby had serious problems. Trial #1, 90% fault to the mother, IIRC 10% to the birthing center (which was no longer in existence.) By state law she couldn't collect because she was more than 50% at fault. Trial #2, same case, refiled in the name of the baby. 90%/5%/5% to one doctor who saw her once several hours before delivery. The whole $6 million judgment landed on him and last I heard that was being litigated over sticking him with the whole bill.

Hey, both juries agreed she was the problem. But there's no way to prove the others were blameless.

I've also seen this more directly: mock jury. Their screening questions weren't adequate--I knew how things would actually play out. Claim for IIRC ~150k, defense presents a smoking gun, but I don't think they went far enough on arguing the implications of it. We "settled" (didn't have to be unanimous) on ~30k, giving her a fifth of what she was asking for--except that doesn't make the medical bills for running up the tab go away. Lawyer is going to get his percent, docs will get the rest, she will see nothing. I kept quiet about this part as I knew it was information their screening questions missed.

[deltoidmaximus]

Maybe if we didn't have enormously expensive healthcare that is tried to our employers the payouts would need to be so huge. If I'm injured by medical malpractice and can't work I'm going to need a lot of money to make me whole in the US, even more so if I need additional medical treatment.

[dzink]

The money that goes to the injured is dramatically smaller than the money that everyone in the system pays to cover the insurance liability calculated insurance rates when the payouts can be arbitrarily set by juries. So if one jury says 600 million for one egregious case, all insurance for all doctors and all care for all patients skyrockets to trillions based on the risk assessment of insurers at that point. It is better to manage the risk with better measures (some states have a damage pool)