In the midst of ongoing debate over the scope and desirability of various health care reform proposals, an obvious and critical component of cost management is going unnoticed: malpractice litigation. By all accounts the soaring costs of health care have precipitated the national discussion on medicine, insurance, and the government’s role in provision and regulation. President Obama has pledged that any reform of the health care industry must be “revenue neutral” for a government already facing huge budgetary shortfalls. In a conference call to faith leaders from around the country on Aug. 19, the president noted, “By far the single biggest driver of our deficit and our debt is federal government spending on Medicare and Medicaid. And Medicare is about to go into the red in eight years.” At the same time he neglected to mention the need to address malpractice litigation as a contributing factor to health care insurance costs.