Where I Stand — Mike O’Callaghan: Less medical patchwork

Friday, June 7, 2002 | 5:16 a.m.

THERE IS LITTLE DOUBT that Nevada has some of the most competent and skilled medical people in our country. Our family, that's three generations, has been fortunate to benefit from these skills. What is confusing is the lack of overall medical planning, both locally and nationally, which creates a negative impact on patients and the people delivering medical care.

Let's take a look at the shortage of nurses and its impact on patients. This shortage didn't just pop up last year. I can recall writing about the problem 14 years ago and giving some suggestions. Then in 1991 the late Gen. Harry Wald, a casino executive, saw the problem and did his best to provide some answers. Among Wald's ideas was the creation of Army Reserve Officers Training Corps at UNLV with concentration on providing nurses for the military. Both the Department of Defense and UNLV leaders turned their backs on Wald's ideas.

As we scramble to meet the shortage of nurses, a new study reveals what millions of patients have known for years. The New England Journal of Medicine has published a report that too few registered nurses caring for patients results in additional serious complications. This applies to the need of more registered nurses and not licensed practical nurses. As I have written before, doctors make it possible to live, but it's nurses who make you want to live.

All of us know about our local problems created by the soaring medical malpractice insurance costs. This is an emergency dumped on the government and patients with little advance notice. It didn't happen overnight, the medical leaders selling out their working insurance program in exchange for a pig in a poke started the slide into trouble several years ago. Now we are facing some problems that need almost immediate fixing. The American Medical Association has made it known for years that it doesn't want the government intruding into the field of medicine, at least not until its members scream for help.

Americans have watched the steep climb in cost for prescription drugs eat away at the meager savings of millions of patients. This has become so bad that thousands of them cross into Canada and Mexico to buy needed drugs. We have been told that even the best drugs must come down from their high prices after their patents expire. Last week USA Today and The Wall Street Journal told readers that this isn't always true. Drug makers have found ways to get around the patent restrictions and also have developed similar drugs at an even higher price.

A vital part of our medical picture is the government-promised care of military veterans. A red flag has been raised by the Department of Veteran Affairs and all of us should pay attention. Plans to restructure and close some VA hospitals, under the guise of improving and increasing outpatient services, reminds me of what California did more than 30 years ago. That's when our neighboring state closed some mental institutions because placing patients in the communities was more "humane." Oh, yes, it would also be cheaper, but it resulted in the first flood of homeless people with mental problems into our streets.

Today our veteran population from World War II and Korea is getting older and sicker, with the need of additional care, and Vietnam vets aren't far behind. Americans had better be alert to any hospital closures that can cause unnecessary suffering for people who have already had more than their share of it.

Medical care has improved immensely during recent decades and has the promise of even greater advancements. Our biggest problems in this field have been created by us or our lack of will to face up to them when first identified. Waiting for a medical crisis to occur causes leaders in the field to react in a rush with patchwork solutions. Patients, doctors, nurses and hospitals deserve clearer foresight and more immediate preventive action to head off predictable problems.

We all know the English proverb that an ounce of prevention is worth a pound of cure.