Medical Malpractice Reform in Three Southern States

Louisiana, Alabama, and Mississippi have adopted medical malpractice reform legislation in response to the three crises in medical liability insurance. In 1975, Louisiana adopted damages caps, created a patient compensation fund, and mandated the submission of claims to screening panels. In 1987, Alabama adopted damages caps and modified the collateral source rule, but these reforms were declared unconstitutional in the 1990s. In 2002, Mississippi adopted a damages cap. In this article we review the effect of these reforms on the malpractice environment in each state. We find that based on the total value of paid claims and paid claims per 1,000 physicians, Alabama has the most difficult environment for malpractice plaintiffs while Louisiana has the most plaintiff-friendly environment. Alabama's medical liability insurance premium rates are also substantially lower than the rates in either Mississippi or Louisiana. We conclude that despite its higher costs, Louisiana has established a stable malpractice system that is supported by providers and insurers, provides compensation for more victims of malpractice than the other states, and provides a more useful model for medical malpractice reform.