For nearly 10 years, Missouri hospitals have been in a legal wrestling match with the nation's largest tobacco companies, as they prepare for a jury trial in their case against the tobacco industry. While the pretrial arguments are complex, the hospitals' claim against Big Tobacco boils down to a simple notion: that the tobacco companies got people sick.

The hospitals contend that since they have had to pay for the care of uninsured smokers and smokers who didn't pay their bills, Big Tobacco should. The group of 30-odd hospitals are seeking payment for patients going back to 1993, which could result in damages of $1 billion or so. Big Tobacco, meanwhile, argues that they simply can't be sued by the hospitals, as they don't have standing. Since the hospitals themselves weren't directly damaged by cigarettes, the hospitals can't collect for the costs of cigarette-related illness.

The hospitals filed suit in 1998, just before 46 states signed an agreement with the five largest tobacco-makers to recover the costs of treating smokers' illnesses. In 2001, they won a major victory when a judge decided that the case could move forward to trial. Since then, the two sides have been stuck in "discovery," the phase where each side shares evidence with the other.

One hot issue between the two has been patient records. A skirmish came when the tobacco companies asked for records on each patient treated for a tobacco-related illness during the period. The hospitals balked and turned over millions of records that included the smokers as well as countless other patients. A judge then ordered the hospitals to give the tobacco firms what they wanted and fined seven of them a collected $418,000. And so it has gone, back and forth, for 10 years.

Now, the case may actually be heard in 2010. While it's far from a sure thing, experts note that the suit has already gotten further than 160 other similar cases, many of which were pitched out of court before the plaintiffs were given the opportunity to go to trial. If the hospitals prevail, you can be pretty sure that other hospitals and health organizations will follow suit, so to speak.

To learn more about this case:
- read this St. Louis Post-Dispatch piece [1]