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Defensive Medicine: Evidence from Military Immunity

Author

Listed:
  • Michael Frakes
  • Jonathan Gruber

Abstract

We estimate the extent of defensive medicine by physicians, embracing the no-liability counterfactual made possible by the structure of liability rules in the Military Health System. Active-duty patients seeking treatment from military facilities cannot sue for harms resulting from negligent care, while protections are provided to dependents treated at military facilities and to all patients—active duty or not—who receive care from civilian facilities. Drawing on this variation and exploiting exogenous shocks to care location choices stemming from base-hospital closures, we find suggestive evidence that liability immunity reduces inpatient spending by 5 percent with no measurable negative effect on patient outcomes.

Suggested Citation

  • Michael Frakes & Jonathan Gruber, 2019. "Defensive Medicine: Evidence from Military Immunity," American Economic Journal: Economic Policy, American Economic Association, vol. 11(3), pages 197-231, August.
    • Handle: RePEc:aea:aejpol:v:11:y:2019:i:3:p:197-231
    Note: DOI: 10.1257/pol.20180167
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    Citations

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    Cited by:

    1. Hao Yu & Olesya Baker, 2022. "Do noneconomic damage caps reduce medical malpractice insurance premiums? Evidence from North Carolina," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 25(2), pages 201-218, June.
    2. Howard, David H. & McCarthy, Ian, 2021. "Deterrence effects of antifraud and abuse enforcement in health care," Journal of Health Economics, Elsevier, vol. 75(C).
    3. Liu, Gordon & Yi, Junjian & Yuan, Ye & Zhao, Shaoyang, 2023. "The short- and long-run effects of medical malpractice lawsuits on medical spending and hospital operations in China," Journal of Comparative Economics, Elsevier, vol. 51(4), pages 1142-1161.
    4. Sebastian Panthöfer, 2022. "Do doctors prescribe antibiotics out of fear of malpractice?," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 19(2), pages 340-381, June.
    5. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    6. Michael R. Richards & Coady Wing, 2019. "Recruiting and retaining dental labor in federal facilities: Harder than pulling teeth?," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1356-1369, November.
    7. Frakes, Michael & Gruber, Jonathan & Jena, Anupam, 2021. "Is great information good enough? Evidence from physicians as patients," Journal of Health Economics, Elsevier, vol. 75(C).
    8. Engy Ziedan & Kosali I. Simon & Coady Wing, 2020. "Effects of State COVID-19 Closure Policy on NON-COVID-19 Health Care Utilization," NBER Working Papers 27621, National Bureau of Economic Research, Inc.
    9. Michael Frakes & Jonathan Gruber, 2020. "Defensive Medicine and Obstetric Practices: Evidence from the Military Health System," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 17(1), pages 4-37, March.

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H56 - Public Economics - - National Government Expenditures and Related Policies - - - National Security and War
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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