Toward a Workable Model of No-Fault Compensation for Medical Injuries in the United States

Despite the lack of any widespread dissatisfaction with the malpractice system today, concerns persist about the system's ability to promote high quality health care and to distribute compensation fairly to patients who suffer injury cause by negligence. The Institute of Medicine's 2000 report, To Err is Human, focused attention on the issue. Now, for the first time in more than a decade, serious discussion about experimentation with alternative approaches to patient compensation has begun. No-fault approaches present the most intriguing possibility and have been shown to be affordable. In this article, the authors discuss the many legal and logistical difficulties that need to be resolved before a no-fault program for medical injury could be tested. They also suggest a number of solutions that may be suitable for incorporation through legislation that enables experimentation with no-fault regimes in health care.