At first glance, the numbers look good: In its 2006 survey, Medical Liability Monitor, a monthly publication that covers the malpractice insurance industry, reported on rate changes for three specialties-internal medicine, general surgery, and ob/gyn. Of the 837 rates that were quoted in states that don't have patient compensation funds-that is, where year-to-year comparisons can be made:

As in 2005, the lowest 2006 rates were reported in Idaho, Minnesota, Nebraska, South Dakota, and Wisconsin. And although rates began edging upward in Nebraska in 2005 when the state's patient compensation fund raised the level where it takes over from private insurers from $200,000/$600,000 to $500,000/$1 million, Nebraska physicians still shell out considerably less for malpractice insurance than their counterparts on much of the East Coast.

Medical Liability Monitor editor Michael Matray agrees that tort reform is an effective means of bringing liability rates down. But he notes that the effects take awhile to kick in because measures to limit liability and put caps on awards given in civil tort cases must first withstand court tests.