Nelson Leonard J, Morrisey Michael A, Kilgore Meredith L
Samford University, Birmingham, Alabama, USA.
Milbank Q. 2007 Jun;85(2):259-86. doi: 10.1111/j.1468-0009.2007.00486.x.
This article reviews the empirical literature on the effects of damages caps and concludes that the better-designed studies show that damages caps reduce liability insurance premiums. The effects of damages caps on defensive medicine, physicians' location decisions, and the cost of health care to consumers are less clear. The only study of whether consumers benefit from lower health insurance premiums as a result of damages caps found no impact. Some state courts have based decisions declaring damages caps legislation unconstitutional on the lack of evidence of their effectiveness, thereby ignoring the findings of conflicting research studies or discounting their relevance. Although courts should be cautious in rejecting empirical evidence that caps are effective, legislators should consider whether they benefit consumers enough to justify limiting tort recoveries for those most seriously injured by malpractice.
本文回顾了关于损害赔偿上限影响的实证文献，并得出结论：设计更优的研究表明，损害赔偿上限降低了责任保险保费。损害赔偿上限对防御性医疗、医生选址决策以及消费者医疗保健成本的影响则不太明确。关于消费者是否因损害赔偿上限而从更低的医疗保险保费中受益的唯一一项研究未发现有影响。一些州法院基于缺乏损害赔偿上限立法有效性的证据，做出了宣布此类立法违宪的裁决，从而忽视了相互矛盾的研究结果或低估了其相关性。尽管法院在驳回损害赔偿上限有效的实证证据时应谨慎行事，但立法者应考虑这些上限是否能让消费者受益到足以证明限制对医疗事故中受重伤者的侵权赔偿是合理的。
