Columnist Jon Ralston: Prospects of failure are traumatic

Friday, July 26, 2002 | 3:46 a.m.

Will that happen at the medical malpractice crossroads in Carson City next week at The Doctors' Session? I'd be optimistic except for a few minor concerns:

This is one of those legislative conflicts where the victor has been declared before it begins. The physicians have won because the Legislature has been called back for the emergency purpose of passing tort reform. All that's left is to determine whether their victory is marginal or massive.

Meanwhile, standing in the middle of the aforementioned intersection and miraculously escaping without a scratch is the insurance industry. The doctors and lawyers don't like the insurance companies, but the carriers can point to federal regulations and their ability to simply vacate the premises if they can't make a profit. Maybe I missed it, but I didn't see one piece of insurance reform in Guinn's Friday session proclamation for The Doctors' Session.

As perhaps it should be. This is not a manufactured crisis and it is national in scope -- look at President Bush's speech last week and Sen. John Ensign's involvement (even to the point of creating a litmus test to get political contributions from his PAC).

Doctors are leaving, women can't find OB/GYNs and an insurance company pullout has created stratospheric rates for specialists. This is an issue that could have a deleterious impact on the quality of life in Southern Nevada and renders moot any talk of an academic medical center or a cancer research institute here until it is resolved.

Ah, but resolution is in the eye of the beholder. And behold this political and policy mess:

Beyond a few lawmakers -- Assembly Majority Leader Barbara Buckley especially -- most of the Gang of 63 don't care a whit about this issue, except how it affects their political viability -- the primary is almost here and the general looms two months afterward. They worry about newspaper editorials, constituents ginned up by ad campaigns and especially the angry doctor unloading resources to beat them if they don't do what they want -- so they probably will realize, too, that this is The Doctors' Session.

The only politician who has absolutely nothing to lose here, and who must be counted upon to lead with his vertebrae, is Guinn. If the session degenerates into partisan bickering or serial posturing, he must step in. He must inform the public that lawmakers are dithering and he must clearly delineate what he will and will not accept -- that is, he must threaten to veto.

It's not like we need the debate anymore -- the session should have been called two months ago. The issues have played out, either superficially or substantively, in TV ads, in legislative hearings and, of course, on "Face to Face."

Both partisan sides already have agreed to the doctors' holy grail of a cap; the question is how big is too big, whether it should be indexed for inflation, whether it should apply in catastrophic cases.

The rest of the stuff is minor in comparison, although going beyond tweaking the civil justice system to totally favor defendants might make a few famous guys turn over in their graves. Again, that's where Guinn comes in -- the governor must let lawmakers know how far is too far.

Negotiations were expected to occur this weekend to try to get closer to a deal before the session starts. That's almost preferable as the process already, as usual, has been perverted by special interests who can't control themselves and politicians who bent the law that prohibits fund raising once a session is called.

The consequences of failure this week -- either doing too much or too little -- are monumental. UMC's trauma center may be open again, even if just ephemerally. But there is no trauma center for the carnage that could be caused if the coming collision of politics and policy known as The Doctors' Session results in yet another legislative train wreck.