Malpractice problems are threefold: (1) Physicians and other medical providers periodically face great difficulty in finding and financing liability insurance protection. (2) Preventable patient injuries continue to occur much too frequently, few of them addressed by lawsuits. (3) Tort litigation fails to prevent these preventable injuries and creates liability risk that is hard to insure. Malpractice reforms have always been single-minded: help doctors get liability insurance by cutting back on legal remedies. Affected physicians and attorneys dominate debate and either attack or defend traditional legal process. Policy should instead combine liability reform with thoroughgoing promotion of patient safety. (Indiana Health Law Review 3(1): 3-26, 2006)