Editorial: UMC is at a critical crossroad

Monday, Dec. 9, 2002 | 9:09 a.m.

Clark County Manager Thom Reilly and the County Commission have made an important observation about University Medical Center, the public hospital operated by the county. About every 10 years, the hospital experiences a crisis largely brought on by financial pressure. The 1992-93 crisis consumed months of the County Commission's time as it sought ways to fulfill the hospital's primary mission without excessive losses. This is difficult, of course, as the primary mission is to ensure quality care -- particularly for those who cannot afford to pay for it. The crisis 10 years ago was stemmed by hiring new management. The crisis today -- the hospital is losing about $2.5 million a month -- is being handled through cost-cutting measures and emergency appropriations. What's strikingly different this time, however, is Reilly's determination to "go beyond fixing the hospital every eight to 10 years."

Public and private auditors are studying every aspect of UMC's operation -- its Medicaid reimbursements, its contracts, its hiring practices, everything. The reason is to prepare for a major question: What should be the role of UMC? In past crises, this question may have been asked but with nowhere near the implications it now carries. Reilly and the County Commission are planning to put everything on the table and re-create the public hospital. The only constant, they promise, will be the quality of care and the commitment to the area's indigent population.

We support this aggressive approach. There is no point conducting studies that will conclude with the obvious -- that the financial problems are related to the "payor mix," the term for the ratio of patients who can pay versus the patients who cannot pay. Reilly's point is to go way beyond this fact and ask, when the numbers are all in, a more fundamental question: Can UMC really afford its burn unit, its trauma center, its Quick Care satellites, its AIDS wing, its cancer center, its women's center, its role as a training ground for state medical school students? In other words, should UMC dish many of those responsibilities off to private hospitals and concentrate on a more manageable mission?

When the discussion is over, the role of UMC could change forever. That's why when it begins, everyone should participate. The county will hear feedback from two committees but that won't be enough. Opinions should flow from all people who either directly or indirectly need UMC -- and that pretty much accounts for everyone in Southern Nevada.