The Missouri Senate is one vote away from approving a bill that would affect how damages are awarded in a trial involving medical care.
But it took 13 hours - from 5 p.m. Tuesday to 6 a.m. Wednesday - for state senators to give preliminary approval to the measure.
A final vote, which could come as early as today, is needed to send the bill to the House.
"All it did was say that "medical costs' should be medical costs," sponsor Ed Emery, R-Lamar, explained. "They shouldn't be some arbitrary, fictitious and phantom number that someone can just pick off of a page somewhere - that nobody's ever paid, has not resulted in the transfer of any cash, but somebody says that's what you should pay if you are found to blame in some kind of a civil lawsuit."
Emery's bill says that, in any lawsuit over medical care, the actual cost of the care or treatment shall not exceed the dollar amounts paid by, or on behalf of, a patient whose care is at issue - plus any remaining amount necessary to satisfy the financial obligation for medical care by a health care provider.
Projected future costs of care can't be included.
Sen. Scott Sifton, D-Affton, led the fight that turned into the marathon filibuster against a measure he and others thought was a bad bill from the beginning.
"You've got, unfortunately, many Missourians who are very seriously injured in accidents that are not their fault, every year," he explained. "Some of those folks have terrible injuries they're going to have to live with for decades.
"That requires expensive medical care - and to limit the ability of those individuals to get the medical care they need going forward is unconscionable."
Senate Floor Leader Mike Kehoe, R-Jefferson City, who has the authority to end the debate at any time, asked the parties to work out their differences without keeping everybody up all night.
But, he said Wednesday, the proposal was an important one to spend time debating.
"This "collateral source' is a common sense, fair step to try to protect people - and not only individuals, but companies - from onerous litigation that has payments that are unfair at the end of the day," Kehoe said.
"Sometimes it takes a little bit longer - and, unfortunately, through the night - for some people to start realizing that a compromise might be the best way to move a piece of legislation."
About 1 a.m. Wednesday, about eight hours into the debate, Sen. Bob Dixon, R-Springfield, got permission to introduce guests - then pointed to a section of empty chairs in the upstairs visitors' gallery and said, "I'd like you to welcome all my constituents who've contacted me about this issue."
Other lawmakers privately said the same thing - the filibuster involved an issue with little, or no, public concern about it.
"Sometimes, there are really important issues that we take up in this building, that impact people's lives in a way that they don't know," Sifton said, "and you're not going to have your inbox flooded with emails.
"I will tell you, I've gotten a lot of emails on this issue."
Kehoe added that he hears from constituents daily who are tired of rising insurance premiums, even if it's not their number one concern.
"They're tired of reading in the paper where people get these crazy settlements in lawsuits. They're disgusted with the way that our tort (civil lawsuit) system is working," Kehoe said.
"And, so, when you look at it from that vantage point, I do think it becomes a very important issue to get passed."
Emery said the issue is important to the business community, which really pays the price and passes it on to customers.
The main lobbying groups involved in the background of the debate were a coalition of business groups and medical-related associations backing the proposal and the trial attorneys opposing it.
Both Emery and Sifton were involved in negotiations trying to reach a compromise - although both acknowledged there was no movement on either side for more than half of the 13-hour talk fest.
"Everyone was dug in," Emery said, "and, it seemed like the longer we went on, the more the other side wanted in terms of concessions."
Finally, about 5:45 a.m., Emery said, his side approached Sifton with a compromise the opponents were willing to accept.
"When there's no negotiation, the only thing to do is continue the debate," Sifton said. "The people that I represent - we're talking about accident victims here - deserve no less."