 Tort reformers maintain that the present tort system is an expensive and inefficient way to compensate those injured.According to a 2004 study of medical malpractice costs, "program administration—defense and underwriting costs—accounts for approximately 60 percent of total malpractice costs, and only 50 percent of total malpractice costs are returned to patients.These costs are high even when compared with other tort-based systems, such as automobile litigation or airplane crashes, that determine fault and compensate victims.