Ruling out

People who, for ideological reasons,  don't actually want to do what is necessary to solve the problem of excessive spending  on health care often claim that the real problem is the cost of malpractice insurance. So they propose "tort reform" as the solution. The argument is that it isn't just the direct cost of insurance that's to blame, but also that physicians practice "defensive medicine," ordering unnecessary tests and procedures, to avoid possible liability.

First, let's just get the extent of the problem, if any, out of the way. The best estimate is that liability costs -- including both components, insurance premiums and any defensive medicine that may be happening -- account for 2.4% of health care spending in the U.S. Even if it were eliminated entirely, it wouldn't make a dent in the difference between spending in the U.S. and the rest of the world, but of course medical liability exists in every other country as well and people who are harmed by negligence, incompetence or malice should be compensated. 

So no, if this is a problem at all it is not a big problem, at least not compared to our other problems. That is not to say, however, that the status quo is ideal. Medical procedures sometimes go awry and people are harmed, but they can't get compensation unless they can convince a jury that a physician's negligence caused the bad outcome. (And no, "frivolous" cases don't make it to a jury. A judge will throw them out first and for that reason lawyers won't normally take them.) That means a lot of people who are seriously injured, even permanently disabled, can't get a dime. 

A better way is to create a pool of money to compensate people who suffer iatrogenic harm (i.e. harm caused by medicine) and to set up a separate procedure to decide whether a physician bears responsibility and some action should be taken. That could range from retraining, to restricting scope of practice, to delicensure. Of course, if wee had universal health care people's medical expenses would be taken care of anyway so we'd only be talking about compensation for other losses, such as lost income or the need for supportive services. Again, this wouldn't save much money, if any, but it would take money away from lawyers and give it to people who need it, and it would be more fair and constructive.

But you know, socialism.