assessed on a case-by case basis by citizens in a court of law?
FYI CBO study on tort reform and health care cost.
Congressional Budget Office(December 2008) estimated that imposing limits on torts for medical malpractice cases would lower malpractice premiums nationwide by about 6 percent, on average from the levels likely to occur under current law. (The savings in each state would depend in part on the restrictions already in effect.) Savings of that magnitude would have only a modest impact on total health care expenditures, however reducing total health care spending by less than 0.2 percent.
http://www.cbo.gov/ftpdocs/99xx/doc9924/12-18-KeyIssues.pdf

