Larry: Nice post. I've written extensively about Texas caps on the Des Moines blog. Here is my take on caps. The effect of caps on damages is to shift costs from treating serious medical mistakes to the patient or consumer. When patients become aware they will not be allowed to collect all their damages from those who’ve made the medical mistake they are naturally outraged. Up to that point they vote for those who push for caps because they mistakenly believe it will save them premium dollars. Time has shown that is not the case. All caps and so called tort reform do is shift costs back to the patient. Medical service providers that aren't required to take responsibility for bad mistakes have no disincentive to do otherwise. What caps do is to make the situation worse, because it removes responsibility. It’s interesting to me that tort reformers talk about patient responsibility, but that’s exactly what caps avoid for the medical professions making mistakes, they walk away from responsibility and spend the savings on better lifestyles or larger retirement contributions. Meanwhile those patients who the effects of these mistakes live a new life with a partially dead brain, an inability to walk more than a few hundred feet, amputated limbs, incorrectly removed healthy organs or some other dreadful disability. It’s only the most seriously affected that suffer from caps. Patients get screwed and those making the most serious medical mistakes get a better lifestyle, maybe a new house, some get a new car and vacations at the best resorts. Fair or foul? You be the judge. As lawyers all we can do tell voters to consider getting surgery in states without caps. That way if a serious medical mistake affects them, then they can be fairly compensated. Nice post.