Medical liability coverage has become increasingly expensive and scarce since 2001, especially for obstetrics and other high-risk specialties. Physicians, whose own fees are constrained, see this as a crisis needing tort reform to cap payouts. Plaintiffs' lawyers fight caps; they blame insurance trends and call for stronger regulation of insurers and physicians. Doctors' arguments are somewhat better than lawyers' about insurance developments, but the huge tort reform battle wholly ignores the biggest problems—the medical system has too many preventable medical injuries, and the legal system fails to prevent them. It is time to try out better approaches, three of which are discussed in this paper.