Where I Stand — Mike O’Callaghan: A health care crisis

Friday, Feb. 1, 2002 | 4:12 a.m.

HOW MANY MORE health care bumps are the patients, doctors and nurses of Southern Nevada willing to tolerate? Among the bumps are shortages of nurses, a loss of malpractice coverage at a reasonable cost to doctors, rising hospital costs and managed health care businesses reducing pay rates to physicians, forcing many good doctors to withdraw from treating the people covered by them.

So who is the loser? Those involved are pointing fingers, but when all is said and done there are few winners and thousands of losers. The lady keeping an appointment for medical care arrives at the office of the doctor to learn he no longer accepts her health care coverage. Without giving notice, her health care insurance company had reduced pay rates 21 percent below the Medicare reimbursement rate. Just one more Nevada working family cheated from the health care they need and are denied. This is no longer a rare occurrence.

For more than seven years Nevada nurses have been telling decision makers that the shortage in their profession was going to affect health care. The 2001 Legislature finally took a weak swipe at the problem, but 20 or 30 scholarships won't do the job. At that time nurses told me how they worried about carrying an overload of patients as some hospital staffs were downsized.

Next door in California, Gov. Gray Davis proposed regulations that will limit hospital nurses to caring for only five patients. In addition he is pledging $60 million to train 5,100 nurses during the next three years. Of this amount, $24 million is for training in hospitals, community colleges and universities.

How many more Nevada nurses will cross the border to enjoy better working conditions when caring for patients?

The shortage of nurses is not a new problem and neither is the loss of reasonable malpractice insurance for doctors. This problem for physicians popped up more than 25 years ago and was "solved." I have confidence that the problem will again be "solved" and won't become a serious problem for another two or three decades. What we must hope is that the solution will come before we lose some of our better doctors to retirement or to other states.

Attorney Bill Bradley, past president of Nevada Trial Lawyers Association, best described the present problem as doctors being "caught in the middle of a greedy insurance company and the recession." He went on to tell Sun reporter Cy Ryan that the St. Paul insurance company had also made several bad business and legal decisions in the field of medical malpractice.

A health care professional told me that the withdrawal of St. Paul could result in insurance costs forcing situations that are detrimental to all Southern Nevadans. If good doctors don't retire or move out of state they "may have to charge an additional malpractice fee on top of the co-pay to cover their insurance costs. This would be out-of-pocket for the consumer."

The hassle between the Health Services Purchasing Coalition and local hospitals is one more sign of the times. The price hasn't been right and the way the health system problems shape up, they aren't going to be right during the coming months and years.

Let's face reality and acknowledge that all of these health care problems are related. So why do we continue to meet them as separate issues? Legislators want to cap hospital costs and still have quality care. Doctors and insurance companies would eagerly have caps put on the amount of money a jury can award in a medical malpractice lawsuit. Consumers are tired of being pushed around by the people running their health care programs, while watching their favorite doctors taken off provider lists.

Hospitals want to continue making profits and nurses want better working conditions and a reasonable number of patients to attend.

We are heading for a serious health care crisis here in our valley unless coordinated steps are taken to answer today's problems and action is taken to meet challenges of the future. This can't be accomplished by political speeches, threats, or legal action. Nor can we allow the system to further deteriorate at the expense of the people needing care.

The time has arrived for a conference on these issues with all health care regulatory agencies and providers in attendance, along with the professionals providing the care. Yes, the conference must also include consumer representatives as well as employers. The conference should be structured so that at the end of two or three days there are medical, legal, business and political plans for bringing our health care system back from the brink of disaster. If done with the goal of providing better health care for people is reached, we will have solved some problems ignored too long. So why do we continue to meet them as separate issues?