The estimate of defensive medical costs in the study was $46 billion not $46 million. You wrote "million" twice so I wasn't sure that was a typo.

In this debate, we all keep discussing the numerator (the $46 billion) without considering the denominator (total medical costs per year in the U.S.). That denominator is an incredible amount of money and it is constantly growing. By arguing that defensive medicine costs are only 2.4% of total medical costs (whether it is $46 billion or some amount more), I am simply making the point that it is a small percentage of total medical costs and reforming medical malpractice in the form of capping awards will not do anything meaningful to lower total medical costs and help consumers.

My larger point though is that the drive to cap awards is not about lowering medical costs for consumers, it is a drive by insurance companies to limit their exposure and grow their bottom lines all at the expenses of real victims who are entitled to real compensation and awards that are set by a jury of their peers. It is wrong for a legislative body to step in and provide a one-size-fits-all framework for all Med Mal cases. By far, the best system is the jury system.

Also, the majority of Med Mal cases are definitely not unnecessary and/or vindictive money grabs. As I explained earlier, these cases are very, very difficult and very expensive. Lawyers do not pursue them unless the case has merit and that includes the lawyers having a worthy client. Of course, there are outliers but they are rare. Lawyers who pursue Med Mal cases are putting a lot of their own money at risk from the very beginning.

Also Med Mal cases aren't always about making meaningful change to improve patient outcomes. Most of the time, the case is brought to simply give redress to the injured person or his/her family. And of course, all of this has to be proved to a jury ... most of the time (as this thread indicates) a very skeptical jury.

You also equate "redress for victims" to punitive damages. These are two completely different things. Redress to victims is compensation in the form of economic damages (additionally incurred medical expenses, lost wages, other out-of-pocket expenses) and hedonic or general damages. Punitive or exemplary damages are much different and legally permissible only when there s a showing of willful or malicious misconduct by the tortfeasor (i.e., a doctor knowingly performing a surgery while under the influence of drugs). Punitive damages are extremely rare.

What Med Mal is really about is representing a person who has been harmed by someone else's negligence (again, negligence that must be proved with the help of a standard of care expert who also happens to be a doctor).

Just as it was laughable for you, as a med student, to hear lawyers talk about medicine, it is not laughable, but disconcerting for me to hear lay people talk about the law and be so disparaging about seeking justice for injured often destitute people.