Legislators seek solutions to health care affordability

Michelle Swafford

Friday, Feb. 11, 2005 | 10:46 a.m.

State Democratic legislators want more transparency and cost controls for Nevada's hospitals after contentious contract negotiations in Las Vegas nearly left 320,000 workers without "affordable" hospital rates.

Assemblywoman Sheila Leslie, D-Reno, called an emergency meeting of the Assembly Health and Human Services Committee Thursday night to discuss solutions to make health care more affordable and accessible.

The meeting was in response to heated negotiations among HCA Inc., Universal Health Services Inc. and the Health Services Coalition, which represents unions and employers of firefighters, police officers, teachers, construction workers and hotel and casino employees. The coalition reached agreements Tuesday with HCA, owner of Sunrise, MountainView and Southern Hills hospitals, and Universal, owner of Desert Springs, Valley, Summerlin and Spring Valley hospitals.

"We're glad the immediate crisis was averted, but we all want to avoid getting in this crisis again," Leslie said. "We need to stop responding to crises and start planning for averting the crisis."

About 200 Health Services Coalition members packed a room and part of a hallway at the Sawyer State Office Building where the legislative meeting was being teleconferenced from Carson City.

Coalition member Anthony Gleim, who is a chief shop steward at the Sahara, said he is relieved that the contracts were negotiated because he and his wife, Rose, would have had to find new doctors who have privileges at the three hospitals that had reached agreements with the coalition. One of those changes would have included a new obstetrician to deliver Rose's baby in a few months.

David Amador, an Excalibur employee, said he does not think the problem is resolved, but it is "going in the right direction."

"If they raise prices, we cannot afford it," he said. "They (hospitals) don't care about you. They care about their pocket."

He said he has been hospitalized three times in the last year for sinus-related problems and has four children who may need medical care so costs are a concern.

Andy Brignone, lawyer for the coalition and some of its members, told legislators that although the coalition successfully negotiated new three-year contracts with most of the Las Vegas Valley hospitals, the "crisis is not over."

"There's truly something wrong with a system that staggers from crisis to crisis every three years," Brignone said, adding that in three years another crisis would occur if changes were not made.

In the latest round of negotiations, which are ongoing with Catholic Healthcare West, one hospital was asking for rate increases of as much as 130 percent, Brignone said. He declined to say which hospital requested that increase.

The coalition understands that costs went up for hospitals, but the hospitals' rate proposals were "unjustified and simply could not be sustained by Nevada's workers," Brignone said.

Bill Welch, president and chief executive of the Nevada Hospital Association, said hospitals' profit cycles are very cyclical and there are many factors that increase costs in Nevada.

He added that Nevada hospitals have spent about $2 billion in the last seven or eight years to keep pace with the state's population growth.

Rusty McAllister, a trustee on the Las Vegas Fire Fighters Health and Welfare Trust, said the coalition is grateful for the upgrades and new hospitals in Las Vegas, but "if they weren't profitable, they wouldn't be building them."

The coalition began negotiations four months ago and asked for rate increases of less than 10 percent from each hospital operator. The coalition continues to negotiate with Catholic Healthcare West, which owns St. Rose Dominican Hospitals -- Siena and Rose de Lima campuses. A contract extension is scheduled to expire midnight Monday.

Brignone suggested that legislators and health care providers look for "creative" solutions to affordability and accessibility, which could include a private-public community hospital that operates more like University Medical Center.

He and many legislators said hospitals should have to provide more data on their revenue and how much of it is reinvested in the community versus sent to out-of-state corporate offices.

"I'm not against people making money, but I am against people not having access to affordable health care," Leslie said.

Some legislators implied hospitals were playing "a shell game" that made them look less profitable than they really are.

Assemblyman William Horne, D-Las Vegas, suggested that hospitals answer to a board similar to the Public Utilities Commission of Nevada before increasing rates.

Assembly Speaker Richard Perkins, D-Henderson, said earlier this week that he plans to introduce a bill that would require Nevada health care providers to reinvest a portion of their profits into the local community before sending millions of dollars to out-of-state corporate offices.

The proposal would be modeled after the federal Community Reinvestment Act that requires banks to make a percentage of their loans -- roughly 60 to 70 percent -- within the communities in which they accept deposits.