"The insurance underwriting cycle has become a touchstone in the debate over medical malpractice reform. On the one hand, trial lawyers and others who seek to preserve existing medical malpractice liability rules commonly report that the high-priced, "hard market" phase of the liability insurance underwriting cycle, and not real developments in malpractice litigation, fueled the medical malpractice insurance crises of the mid-1970s, mid-1980s, and early 2000s. ... On the other hand, medical associations and others who seek further restrictive tort reforms claim that those crises represented the long overdue consequence of escalating tort costs that the competiitve, "soft market" phase of the insurance underwriting cycle had allowed people to wish away."