I misspoke. $46 billion, not million. My mistake. Listen. I agree with the majority of what you say. I do think that there needs to be recourse and I respect your opinion on that. I don't think that recourse should be unlimited, no matter the degree of negligence (maybe we just have to agree to disagree on this, though I think many agree that major settlements tend to be too high and society in general, too sue-happy).

One point: I don't see how capitated payments eliminate a victim's recourse. And sure, capitated payments won't necessarily decrease overall healthcare expenditure (though it might, I'm not convinced by the literature either way at this point). But that isn't the only consideration. How about areas of the country where malpractice insurance is so high, that OB's have to close their practice? Settlements drive up malpractice insurance rates. And while I don't consider malpractice insurance providers to be completely innocent, many providers go out of business every year. Here in VA, several of the largest providers have gone out of business over the past decade. So doctors are losing. Insurance companies are losing (arguably). Who is winning?

Another point: I don't trust a jury of lay people listening to an expert witness who makes $1500/hour to understand the nuanced differences that comprise "standard of care." The water is simply too muddy.

The whole system needs to be revamped. Not because healthcare costs will magically plummet. Not because victims don't need recourse. Not because doctors aren't sometimes negligent. It needs to be revamped because it is unreasonable in it's current iteration.