The current lawsuit culture is creating a crisis in US health care. The broad perception that anyone can sue for almost anything has fundamentally altered the practice of medicine, eroding the quality and availability of health care. Current reform proposals to "cap" one category of damages are not nearly ambitious enough. Providing relief to doctors squeezed by insurance premiums is important but will not. heal the deep distrust that skews daily de cisions, nor will it provide incentives to overhaul outdated practices. The United States needs an entirely new system of medical justice. Its first goal is to be reliable: reliable in protecting patients against bad practices, reliable in protecting physicians who act reasonably, and reliable in interpreting standards of care. (C) 2003 by The American College of Obstetricians and Gynecologists.