Smith John J, Brenner R James
Med-Tel International, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
J Am Coll Radiol. 2004 Apr;1(4):249-54. doi: 10.1016/j.jacr.2003.12.019.
As described in the previous article in this series, the United States is in the midst of a medical liability insurance crisis. Research conducted in the wake of similar previous insurance environments has shown that only a fraction of patient injury as a result of negligent medical care is addressed by today's tort malpractice system. This large reservoir of potential malpractice cases, coupled with the inevitable cycles of the economy and insurance markets, means that current action is mandatory to prevent another, even more serious crisis in the future. A variety of potential solutions have been proposed, including reform of the existing tort malpractice system, a no-fault compensation system, and so-called hybrid systems that combine tort and no-fault. These mechanisms should be evaluated in terms of three key factors: (1) the adequacy of compensation to injured patients, (2) the prevention of future medical injury, and (3) their overall cost and administrative feasibility. Whatever reform mechanism or combination of mechanisms is pursued should represent an improvement on today's existing tort malpractice system.
正如本系列上一篇文章所述，美国正处于医疗责任保险危机之中。在之前类似保险环境之后进行的研究表明，当今的侵权医疗事故制度仅处理了因医疗疏忽导致的患者伤害的一小部分。大量潜在的医疗事故案件，再加上经济和保险市场不可避免的周期，意味着必须采取当前行动以防止未来出现另一场甚至更严重的危机。已经提出了各种潜在的解决方案，包括改革现有的侵权医疗事故制度、无过错赔偿制度以及将侵权和无过错相结合的所谓混合制度。这些机制应根据三个关键因素进行评估：（1）对受伤患者的赔偿充足性；（2）预防未来的医疗伤害；（3）它们的总体成本和行政可行性。无论采用何种改革机制或机制组合，都应是对当今现有侵权医疗事故制度的改进。
