Med-mal payments have never driven healthcare costs. It's like the Big Lie about jews causing the masses to go without. Insurance companies won't allow the public to see their books in Illinois, while they make out like bandits on high premia. The public's also told defensive medicine is why the doc's order way too many tests. It's really because most MD's are doing and ordering what their bosses are telling them to order. Because most MD's are not self employed any longer, but merely willing dupes.
We're also entering into a two-tiered medical system. The hottest (and most profitable) medical practices are now "boutique" medicine. All cash payments, doctors on call 24-hours a day, seven days a week. House calls (sic!!!) included.
There's some truth in that, clearly, the kindly old doctor in the Norman Rockwell paintings is pretty much gone, but a comprehensive solution to the coming health care crisis will require changes in practically every aspect of the way medical care is delivered. Certainly, society is not better off by a bunch of lawyers making megabucks while their clients get screwed a second time. Insurance companies that spend incredible sums on trying to exclude people and procedures are not delivering health care to by these practices.
I hate to admit it, but this situation might just have evolved into a natural monopoly situation, and that means government steps in. I see it as inevitable, and I'd rather have Republicans drawing up the plans, as opposed to President Rodham.