Reform of medical malpractice insurance in Nevada clearly still has a long way to go, and just as clearly a cap on awards in lawsuits wasn't the answer the insurance industry claimed it would be.
In a special session during the summer of 2002, the Nevada Legislature did its best to rein in runaway medical malpractice premiums by imposing a cap of $350,000 on jury awards for non-economic damages.
They took out a list of exemptions that would have allowed people who lost limbs or eyesight or incurred brain damage, for example, because of a doctor's mistake to sue for more on claims of pain and suffering.
The cap - pushed at the federal level by Sen. John Ensign, R-Nev. - is controversial in itself. Is it really fair to put a limit on how much pain such a catastrophic event can cause a person?
But the insurance industry won out, and the 2002 special session was adjourned with lawmakers thinking they'd made significant progress.
In the 2003 session, although the medical profession pointed out that much work needed to be done, little changed. Doctors who are hit with malpractice judgments must be identified, which is an important way to weed out misfits who create most of the liability for insurers.
But the doctors wanted some strict regulations on the insurance industry, such as a law that wouldn't allow premiums to be increased to make up for losses incurred by a company in other investments. In other words, the doctors don't want to pay for the insurance company's mistakes.
Those reforms never made it out of the Legislature. And now, with Farmers Insurance Co. dropping its coverage, the medical malpractice crisis is back in Nevada - just as severely as when the St. Paul Co. pulled out 18 months ago.
Doctors are attempting to take matters into their own hands by asking patients to sign waivers. The long-term answers, however, lie within the insurance industry by allowing small companies to pool their resources and offer affordable policies.
Driving more companies out of the business only hurts. Creating competition through innovative insurance packages - giving doctors some options - is the way out of the woods.
