My wife is a nurse who has worked in several practices. Many people just see the amount of money they're paying (or more likely, their insurance company is paying) and think their doctor has to be rich. Most people don't consider the overhead costs of a medical practice. Next time you're in a doctor's (or dentist's) office, look around and see how many people are working there. As an example, when my wife worked for two oral surgeons, she was just one of 14 employees on their staff. Their combined salaries and other expenses (boss's SSN contribution, unemployment insurance premiums, etc) add up to a lot of money each year. Throw in other business expenses like office rent, utilities, etc. and you'll get a better picture of what it costs to run even an ordinary practice.

Consider the case of that obstetrician mentioned in the article whose malpractice insurance premiums shot up to $223,000 a year. How much money do you think he'll have to gross in a year to pay those premiums, his business expenses, taxes, etc. and still have anything left over. Do keep in mind that doctors can't just charge whatever they want for their services. Most doctors are at the mercy of the insurance companies, HMOs, and the government when it comes to reimbursement for their services.

Capping malpractice liability is a reasonable idea but it has little chance of getting enacted. It didn't surprise me last night when they showed a map of the states with the biggest increases in premiums. One of them was Alabama, home of what is called "Jackpot Justice." Juries there tend to see lawsuits as a good substitue for a lottery and have the reputation for awarding outrageous settlements all out of proportion to the damages. One notorious case was so absurd it went all the way to the US Supreme Court. In another case, two plaintiffs were awarded $581 million when the actual damages were $1200.

Lawyers also love Jackpot Justice because they make big bucks, and since the majority of state legisators are lawyers and all of the State Supreme Court are lawyers, I wouldn't hold my breath waiting for sensible tort reform.