Brian King emails:

The comic strip Rex Morgan M.D., which I never read [Ed.: here's some background on the venerable strip], is launching onto a tort reform comment regarding med. mal. I don't know if your paper carries it but in the first frame one character asks another what is wrong and the second replies that the office's med mal insurance premium just went up $40K. The first character asks if the doc has been sued by someone and the second character says "never . . . in all our years of practice we've never had a claim." End of today's strip. I'll be interested in tomorrows and the next days'.

The strip is poised to make a great point against med mal tort reform. Why is it that premiums skyrocket (assuming they are) for docs who have a clean claim history? Is this a lawyer/plaintiff problem that needs remedying? It certainly seems that the doc is an innocent victim but if no one has sued him it seems to me the problem is not with frivolous claims either. Seems to me its an insurance industry in need of reform.

I am not qualified to address the ins and outs of actuarial practice or how med mal insurers can or should be setting premiums. But it is my understanding that many (most? all?) med mal insurers do not take a doc's claims experience into account in setting that docs premiums. If that is true, it is a travesty. Especially when you read the stats from various states (Florida comes to mind although I don't know where I read this) that a huge percentage of the money paid out over time (my recollection is approaching or exceeding 50%) to plaintiffs come from malpractice committed by less than 5% of the docs. Why don't insurers do a better job of adjusting the premium based on a docs own claims history? I, with an accident free driving record over the past 5 years, would certainly not be pleased to pay the same auto insurance premium as someone who has had three DUI convictions over the past 5 years. Med mal insurers are not doing a very good job of weeding out the bad docs by making a direct correlation between premiums charged in the future for a given doc and that doc's claims experience. If they did so, we'd have fewer bad docs practicing medicine, fewer injured plaintiffs and lower premiums for competent docs. Why is this not being discussed more often?

Tort reform in the funny papers? Why, that's, uh, appropriate! By the way, you can see the strip in real time here.