Here's a nice email from a lawyer who's seen this type of work from both sides:

I am a lawyer in Atlanta (native of Tennessee-UT undergrad, Vandy law). I have been practicing 14 years, the first half at a large defense firm (King & Spalding) and now as a plaintiffs' lawyer. I feel I have a good sense of the realities of the tort world.

One thing I know is that the public perception of the tort system as defined by the "reformers" is completely unrelated to the reality in the trenches. Specifically with regard to medical malpractice, there is no harder case for a plaintiffs' lawyer to pursue. In Georgia, as in most places, doctors win the vast majority of the trials (statistically over 70%) even though no case can even be filed here without a qualified doctors swearing under oath that the defendant doctor was negligent. This is the result, in part, of a "Marcus Welby" view of doctors as benevolent caregivers and the propaganda jurors hear about the evils of the civil justice system. Every plaintiffs' lawyer knows that when he or she goes to strike a jury there will be a significant number who will vote for the defense no matter the merits--this is just the real world we face.

These cases are very expensive to pursue (experts are the prime expense) and hard to settle much less win at trial. Because the insurers know they have the upper hand at trial regardless of the merits, they have significant leverage in settlement and they often refuse to settle. Because this risk versus benefit is so treacherous, any lawyer who wants to remain in business has to screen these cases very carefully and only take those that are clearly meritorious. Taking an iffy case has the very real possibility of ending 3 years later with no recovery and hundreds of hours and much money spent. Thus, the reality is that in this country where there are tens of thousands of documented cases of neglect each year many, in fact most, of these situations end with the victim being without recourse.

No one wants health care to suffer because doctors quit practicing due to insurance premiums. If it were shown that insurance rates were increased by jury awards and not the effects of the economy on insurers' bottom line (through investment losses), then a change in the system would be worth considering. However, whether the message gets through the propaganda or not, the truth is that large jury verdicts are exceptionally rare and that t most victims are left uncompensated.

Yep.