The uncertainty of future medical expenses makes them controversial. Projecting future medical costs requires a long-term prognosis for both the plaintiff and the economy. Given the recent inflation rate for medical care, any projection of the cost of care 30 years in the future will result in an astronomical number. The plaintiff’s most certain evidence of future medical needs is the current cost of the needed medical care. If the plaintiff requires constant care, the jury’s starting point is the current cost of these services. To attack the plaintiff’s projections successfully, the defendant must convince the jury that the plaintiff’s condition will improve. Conversely, the defendant’s position is strongest when the plaintiff is not currently in need of medical care.

Awards for future medical expenses underlie many large jury verdicts. The largest awards are for persons who will require long-term skilled nursing care, augmented with acute medical services. Central nervous system injuries are perhaps the most expensive, especially given the legal assumption that the patient will have the same life span as an uninjured person of the same age. Although respiratory and other complications greatly decrease the average survival of severely brain- injured patients or those with high spinal cord injuries, the law is concerned with the theoretical possibility of a long life, not its statistical probability. It is the cost of future medical rehabilitative services that makes birth injury cases so expensive.