Debunking the Bad Apple

Our medical malpractice system works against us. We cannot just tweak it. We must reject it and create a whole new one.
What do we want to happen when we are injured during medical care? At present, it appears that our primary goal is vengeance. As Lucian Leape wrote, "We name, blame and shame" the guilty person. In our minds, doctors have swung from near-God status, through fiduciary ["hold responsibility for the benefit of another"] to perp [perpetrator]. Subconsciously, we still give them God-like status by assuming they can fix anything. Therefore, if we have a bad outcome, the "bad apple" God was either malevolent or asleep at the switch. Either way, let's punish him or her. The Bad Apple theory also assumes that by penalizing the perp (doctor, nurse, or hospital) we will get good care.
Wrong, wrong and wrong.
1) Some bad outcomes are avoidable by systems that protect us in advance: checklists; feedback loops; information sharing; and celebrating rather than hiding the adverse impact. However, most bad outcomes are not avoidable for one basic reason: medical science is primitive and cannot predict what will happen in an individual patient. If the doctor gives you a guarantee, get another doctor because she cannot do that.
2) Getting rid of the presumed "bad apples" does not solve the primary reason why bad things happen to us: doctors do not know the future. They only know that 90% of patients respond well to drug X or to procedure Y. They cannot tell whether you are in the 90% or the 10% group.
3) The Bad Apple theory and the whole medical malpractice tort system is not structured to get us what we really want. So, what do we really want?
I think (I hope) we can agree that what we really want are two things: 1) Help, and if appropriate compensation, whenever we are injured (regardless of whether a provider is proven negligent); and 2) Learning, so that the bad outcome may be avoided in the future. Our current system cannot do either. We need a new system.