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States' medical malpractice liability systems are in various stages of disarray throughout the country. But the most common diagnosis and cure -- caps on noneconomic damages to curb "junk lawsuits" -- misses the underlying disease. Health courts offer a true cure: fair and reliable compensation for patients injured by medical mistakes and clear legal signals for doctors and hospitals to help them prevent mistakes.

In today's system, most patients receive no compensation for injuries from medical negligence. Studies in several states show that only 2 percent of patients injured by negligent care in a hospital file malpractice claims. Elderly and low-income patients, in particular, are even less likely to sue. Only about one-third of malpractice claims produce a payment through a settlement or a trial.

Injured patients usually do not know if they are victims of bad care or simply bad luck. Filing a malpractice claim can be an emotional, time-consuming ordeal. It entails confronting your doctor and spending countless hours in acrimonious legal proceedings. Only people with serious injuries and the potential for large awards are likely to find a lawyer to take their case, given the high legal costs. Even for those with a serious injury (a disability lasting six months or more), the malpractice system compensates only one-in-14 people. The legal system is notoriously anti-patient according to studies that show patients win only 27 percent of court cases, the lowest rate of all areas of tort litigation examined by researchers.

Health courts would make it much easier and less costly for patients to seek compensation. States would establish them as specialized, administrative courts similar to the system that handles workers' compensation claims. According to a national survey conducted by Harris Interactive and commissioned by Common Good, nearly 2 out of every 3 Americans favor having medical malpractice cases decided by special health courts.

Under workers' compensation systems, employees injured on the job simply submit a claim form through their employer to an administrative law judge or board. If the judge or board determines that the injury occurred on the job, workers receive compensation according to a schedule of benefits that takes into account the severity of the injury, the degree of disability, and the worker's age and pay. Injured workers cannot sue employers in a traditional court because workers' compensation provides an alternative system of justice, which the Supreme Court has upheld as constitutional.

A health court system would be similar to the workers' compensation system in two ways. First, there would be a schedule of benefits to compensate patients for medical injuries. Second, a health court system would be designed to provide quick, consistently fair damage awards. In a health court system, injured patients would submit a simple claim form, available through their health care providers, to local health court review boards. These boards would investigate claims and determine if they are clear, uncontestable cases of malpractice. In such cases, they would simply order injured patients' health care providers to pay damages according to a schedule of benefits.

Some states, such as Indiana, have established review boards, but they are not responsible for investigating claims of malpractice or ruling on cases. Although Indiana's review boards give juries an independent assessment of a case and their findings can lead to settlements, they can also prolong the process, since they have no real authority.

"Our comprehensive approach to the medical malpractice crisis is the alternative to the two dueling initiatives that pit doctors and lawyers opposite each other without offering real answers to the patients whose interests should be front and center." -- State Rep. Patricia Lantz, Washington

After health court review boards rule whether or not cases are cut and dried, appeals of those decisions -- and cases where additional review is necessary -- would go before health court judges. In health court trials, as in civil trials, both parties would be represented by lawyers. But unlike malpractice cases in civil trials, health courts would render decisions that would help shape clear legal standards for medical practice. In addition, health court judges, not the plaintiffs or defendants, would hire expert witnesses to settle questions about medical standards. When health court judges find malpractice, they would determine awards using the same schedule of benefits used by review boards.

Health courts would be less expensive than the current system. Today, more than 50 percent of court awards go to court costs and lawyer fees, nearly twice the overhead of a typical workers' compensation system. Over time, medical malpractice premiums should fall as compensation for injured patients becomes more predictable and the new system helps clarify standards of practice to reduce injuries. Initially, however, premiums would be about the same as they are now. Malpractice insurers would no longer pay any of the sizable awards that make headlines in the current system, but they would more frequently pay limited compensation awards for injuries that receive nothing today.

To get started, states can take steps toward health courts in the following ways: