There is perhaps no better indicator of the general perception of "crisis" in the American medical system than the lavish attention given President Clinton's health care reform initiatives in the media.2 In the 1970s, the frequency of medical malpractice claims and the cost of malpractice insurance, two sources of this perceived crisis, came into sharp focus.3 Experiencing a decline in profits as a result of increased malpractice litigation, many insurers began refusing to provide coverage or demanding high premium increases.4 This created a problem in malpractice insurance availability to health care providers.5 Health care providers, insurers, and state legislatures responded with a variety of reforms,6 some of which aimed to curb the frequency and cost of malpractice controversies through the use of alternative dispute resolution mechanisms such as arbitration.7



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