I think getting rid of the large settlements (replaced with criminal charges) is the way other countries have it. Again, I'd be interested to see if work can be done towards this.
Not necessarily. Some "loser pays" systems allow the plaintiff's lawyers (or an insurance company) to take the risk of paying the defendant's costs if the lawsuit is unsuccessful. (The key is that those systems allow such folks to get paid for taking that risk.)
In the US, when a contingency lawyer loses a case, s\he is typically out his time and occasionally expenses as well. Loser-pays "just" doubles the hit from a loss.
I'm not saying that loser-pays is a good idea, I'm just saying that it doesn't necessarily exclude poor folks.