Columnist Erin Neff: Victorious doctors may have little to celebrate

Erin Neff

Friday, Aug. 2, 2002 | 4:06 a.m.

EVERYONE INVOLVED in the medical malpractice insurance crisis talked about the need to bring "predictability" to the Southern Nevada market.

But the only thing predictable for political observers about last week's special session was the compromise -- a solution common enough for lawmakers, but one that doctors still can't seem to fathom.

On Wednesday night, just hours before the Legislature signed off on a deal for a $350,000 cap on pain and suffering awards, the doctors were out in force with continued cries for the $250,000 cap that no one -- not even the Republican governor -- thought was realistic.

Here's what doctors still don't understand -- the surgery that is lawmaking has a lot less to do with saving lives than saving face.

It is like making sausage. And the doctors were squeezed out of the casing months ago.

Late last December, doctors had the upper hand and the governor's ear. Their insurance company, St. Paul Cos. of Minnesota, was leaving and the rates they were quoted were astronomical.

Help us, they cried.

Gov. Kenny Guinn obliged, establishing a state underwriting association and urging doctors and lawyers to get together to solve the long-term crisis.

But it was the politically adept trial lawyers who ruled those negotiations, often correcting the doctors' "understanding" of current laws and regulations.

Doctors mistakenly hopped behind Southern Nevada Republicans, begging -- no, demanding -- that lawmakers re-create California's Medical Injury Compensation Reform Act here in Nevada.

The problem with that move is that the Assembly Republicans have no real power in Carson City and the few Senate Republicans the docs leaned on ultimately sided with their party's leader, Guinn.

Initially doctors worked just to get Guinn to call a special session, thinking erroneously that a session would mean the end to their troubles.

When the University Medical Center had to close its trauma center for 10 days in early July, any support the doctors had left with lawmakers -- especially the Democrats -- began to wane.

Yet they plodded on, behind the arrogance of a few figureheads sent to the negotiations, thinking MICRA and its $250,000 cap was not only the answer, but what they could realistically get.

Nobody, save the gaming industry, gets everything it wants out of Carson City, and even the casinos at times are dealt minor setbacks so the legislators can continue to believe their own spin that they actually write most of the laws.

And with Assembly Democrats and Guinn veering into the trial attorneys' camp, the doctors stood no chance of getting everything they wanted.

The $350,000 cap is actually the fourth-lowest in the nation, even with a judge's ability to waive the cap in cases of gross malpractice or where there is clear and convincing reason it should not apply.

The task now is for the doctors' lobbyists to convince them that the law will actually work for them -- a message competing with the national insurance companies' claims that it does nothing now. And that won't be easy, because nothing Guinn signs this week is going to immediately change anything.

Insurance companies said as much going in, yet doctors -- backed by the "Help Me Keep My Doctor" mountain of mail sent to lawmakers -- actually believed the stroke of the pen would get them the cap.

Late Thursday afternoon, the doctors' PR firm issued a press release calling the settlement a "victory for Nevada doctors," not just to spin the press but to convince the doctors.

Doctors can view the past seven months as Nevada Poli Sci 101 -- a starter course in how politics usually works.

Perhaps that's why a few candidates worked the room at the doctors' information session Wednesday night.

For the first time in anyone's memory, there are four MDs running for the state Assembly.

And while that might not have been predictable last year, doctors have got to start somewhere.