While the nature and prevalence of defensive medical practices have been widely debated, most agree that the costs are exorbitant. In fact, some estimates report that the practice of defensive medicine costs the American health care system in excess of $100 billion dollars annually, which would account for up to 12% of all health care expenditures. 5 In a study published last year by the Pacific Research Institute, the total impact of the current tort system on medical expenditures was estimated to be $124 billion annually, with an additional $38 billion in reduced access to health care. 6 A.