How many people are harmed by preventable medical errors? That number is in hot dispute. About 25 years ago the Institute of Medicine estimated that 98,000 people died unnecessarily in hospitals. More recently a study in the British Medical Journal put that figure at 250,000—making medical errors the third leading cause of death. Yet the critics charge that many hospital fatalities occur among patients who are old and sick and probably would have died anyway.

Whatever the real number, almost everyone thinks it is too high. Further, our system of dealing with it is woefully inadequate.

Currently, patients who are harmed by medical errors have little choice but to seek compensation through the tort system. Yet according to a Harvard study, fewer than 2 percent of patients who are harmed by malpractice (or their families) ever file a lawsuit. An even smaller number ever receives compensation. At the same time, roughly one-third of all malpractice lawsuits filed involve no malpractice at all. At the end of the day, malpractice victims receive only forty-six cents of every dollar that is spent on settlements and jury verdicts. The rest goes to attorney fees, court costs, and other litigation expenses.