It extends to communities that lose their local doctors, and to patients who bear the stress and risk of traveling long distances for health care. Sometimes they never reach it, when their condition prevents completing the trip. For example, a mother in Arizona trying to drive 40 miles to an obstetrical facility did not reach it, and a nurse delivered her baby on the side of the road. Her local hospital had closed its maternity ward.

The Insurance Information Institute reports that medical malpractice insurers return on net worth was a negative 7.4% in 2002, down from negative 4.7% in 2001. Three years before it was positive 7.6%. An early 2004 report shows the value of claims rising 9.7% per year since 2000, and the number of claims growing 3% a year. Hospital claims for for 2004 are expected to be $150,000 per claim, and physicians $178,000 per claim.

How does this work out for individual doctors? While state, region and specialty make large differences, the Congressional Budget Office reported in January 2004 that premiums for all physicians nationwide rose 15% from 200-2002, and for OB/GYN 22%, for internists and general surgeons 33%. They report average claim payment to be $320,000 in 2002, growing 8% annually. 15 claims were filed per 100 doctors, with 30% producing insurance payouts.

An article by Kurt Kooyer calls for solutions to a problem for which liability tort reform in Congress is only the beginning. He laments "desperate Americans suffering the ill effects of a diseased tort system that the medical community is powerless to cure".