Lecture 7- Tort Reforms and Birth Outcomes (Currie and MacLeod,2008) Flashcards
Who wrote Tort Reforms and Birth Outcomes and when?
Currie and MacLeod in 2008
What was the goal of Currie and MacLeod of the paper
To see if the Tort reforms in the 1980s and 90s led to a change in procedures performed and as a result, health outcomes of mothers and babies
What were the differing types of tort reforms?
Caps on (amount you can sue for _non-economic damages (NE) e.g pain Caps on punitive damage (PD)- this payment is to charge defendants for willful misconduct
Modifications on the joint and several liability rule (JSL)- if there are several defendants ( ones being blamed for causing the damage) the richest defendant can be asked to pay all the compensation - even if they are only partially responsible
Were these tort refrms specifically aimed at medical malpractices?
No, it was an overall law change to all areas. Not at physicians in particular, if it was this change would be endogenous and suggest the change in law came about because an increase in physicians malpractice.
This would mean our results would most likely show reverse causality and be biased.
How do we write out the formula for the physicians expected liability given they have made a mistake
H(s,p,law)
s= condition of the patient
p=procedure choice
law=the law at the time
The higher s is the worse the patients condition, if s=0, this is the least complicated case.
There is either p=P which means a procedure is done
or p=NP, no procedure is done
The procedure Currie and Macleod observe are Cesareans and the induction of Labour
What is the expected utility?
U(s,a,p,law)= B(s,a,p) - H (s,p,law)a
a= probability that the physician will make a mistake that results in potential tort liability
s= condition of patient
p=whether procedure was done
law = law at the time
What are the assumptions of the expected utility model?
That procedures are needed for more complicated patient he physicians utility rises faster when a procedure is done compared to when it isn’t done as s rises
Describe the dataset?
The data came from the Vitality Statistics Natality Data, shows the birth date, state of birth and other factors that influence infant health and could influence amount of procedures
Can a change in one type of tort reform be linked with a change in another?
Yes
What regression was used?
Outcome it= a0+b1Tortst +b2 XVarit +b3 County
b1 shows how health outcome e.g child mortality, was affected by the introduction of several tort reforms
Tort st is a vector of several tort reforms (Cap on non-economic damages (NE), Punitive damage cap (PD) , joint and several liability (JSL) in a given state,s at time t
Does a tort reform being switched off 12 months after the time a doctor makes a decision affect his decision, (does a change in law at t1 affect you at t0?
Yes, if a law is being passed that says that e.g. caps on sues for Non-economic damages iaws unconstitutional (so tort is switched off) this will cause doctors to reduce cesareans (tort laws punish most harshly for neglect i.e not performing ) so now they put in less effort if they know the law won’t be in effect.
