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An interesting editorial on possible solutions for the "medical malpractice crisis" was featured on the Web site of the New York Times Union. The short article mentions several experiments to be tried in New York City:

The search for a solution to the high cost of medical malpractice has long been like a murder mystery -- we could solve it, if only we could figure out who the villain is.

The problem, of course, is that who you think the bad guy is depends on your agenda, your politics or your view of the world. It's the ambulance-chasing lawyers and the greedy trial attorneys. It's the profit-hungry insurance industry. It's the bad doctors. It's the sloppy, secretive hospitals. It's the opportunistic plaintiffs. It's the insane juries. It's the Democrats, in the back pocket of the trial lawyers. It's the Republicans, in the back pocket of the insurance companies.

The fact is, every one of those culprits plays a role in the high cost of medical malpractice, which in turn translates into the high cost of malpractice insurance, which plays a significant role in the high cost of health care. The complexity of the problem defies simplistic solutions.

So it's encouraging to see the state Health Department and Unified Court system join with five New York City hospitals in a pilot program to try to address malpractice issues in a more comprehensive way.

The three-year program, underwritten by a $2.9 million grant from the federal Agency for Healthcare Research and Quality, has four basic components.

The hospitals will develop "a culture of patient safety." Four of them will focus on safety in obstetrics, one on general surgery. If a mistake is made, they will notify the patient or their family early on, and, if appropriate, offer compensation before a lawsuit begins.

For cases that result in a lawsuit, a court will be established in which trained judges will direct negotiations and try to help the parties reach a quick settlement.

The program will be monitored and Harvard's School of Public Health will evaluate the results. Proponents hope it will lead to the creation of a national model.

This is, clearly, a more thoughtful and challenging approach than, say, passing a law to cap malpractice awards. Its success will depend on the willingness of a lot of players to view medical errors and mishaps differently -- not as a liability or a lottery, but as an injury for which a person deserves to be made as whole as possible, and as a mistake that must be reviewed to see if it can be prevented from happening again.

But in that challenge there is, it seems, more promise to address the full range of complexities surrounding medical malpractice than simplistic legislation. If the medical and legal fields can find a way to promote greater safety, admit and correct mistakes, and come to reasonable settlements, it would lay the foundation for, we would hope, better care, less practice of costly defensive medicine, lower malpractice insurance rates and reduced health care costs, including lower premiums on health care insurance.

If everyone just keeps seeing dollar signs and lawsuits, though, this will be an opportunity lost.

The issue:

The state and five hospitals look to reduce medical accidents and malpractice costs.

The Stakes:

The payoff could be lower health care costs for the rest of us.

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