LOOKING IN ON: HEALTH CARE

Tuesday, Nov. 21, 2006 | 7:14 a.m.

Everybody loves an underdog, but there may not be one in the contract standoff between Sierra Health Services and HCA Inc., a national chain of hospitals.

If the contract impasse between the two companies continues, Sierra patients will no longer be reimbursed after Dec. 31 for nonemergency visits to local HCA facilities: MountainView Hospital, Southern Hills Hospital and Medical Center, Sunrise Children's Hospital and Sunrise Hospital and Medical Center.

Both companies say the stakes are high, but consumers might have the most to lose in the dispute. About 200 Sierra patients a day receive care - some of it specialized - at Sunrise facilities. These patients would have to go to other hospitals, which could become overcrowded.

Consumers have no voice in the negotiations, nor can they be certain about what's going on in a dispute in which there has been little transparency but plenty of public posturing by both companies.

Sierra insures about 600,000 Southern Nevadans, making it the local health care giant. But Sierra Vice President Peter O'Neill says his company is the little guy in a David vs. Goliath battle against HCA.

He may be right, according to financial information about each company. Sierra boasted $1.56 billion in revenue for the 12 months through June 30, a figure dwarfed by HCA's $25 billion in revenue for the same period.

Despite his firm's lopsided economic advantage, Brian Robinson, president of the Las Vegas market for HCA, sees his company as disadvantaged. He called Sierra the "800-pound gorilla" in the Las Vegas market.

Sierra reimburses HCA hospitals according to a 17-year-old contract that needs to be radically restructured, Robinson said.

The current rates pay the hospitals at a per-day rate, which does not take costly procedures into account, he said. In 1988, patients may have taken a week to recover, so the per-day rate was more reasonable. Now, robotic technology allows patients to recover rapidly, which means they're discharged quickly even though the cost to the hospital might be higher, Robinson said.

Sierra Chief Executive Tony Marlon said he thought a deal was coming together several weeks ago, but it fell through. He contends HCA is asking for unreasonable rate increases that would force massive premium increases for all Sierra customers. But HCA officials claim that Sierra left the bargaining table so early that no specific numbers were even discussed.

Leaders from both health care companies say they want to end the standoff. Marlon said he'll reach out again to HCA officials in the next week. But neither company is willing to bring a third party into negotiations.

Ross Brough has trapped rats, flooded them from trees with a garden hose, poisoned them, bludgeoned them with a putter and electrocuted them.

The body count is mounting - over the past two years, he has killed at least 50 - but the rats are winning.

"They're pretty durable little animals," Brough said.

Brough lives in Rhodes Ranch, near the intersection of Warm Springs Road and Durango Drive. His back yard is a tropical paradise - lush foliage, palm trees and rock waterfalls trickling into a lagoon swimming pool. It's the perfect habitat for man - or beast.

After working all day at his plastics distribution company, Brough returns home and watches the rats streak across the walls and leap between trees.

Roof rats are a nuisance - and possible health hazard - throughout Las Vegas. County health officials are monitoring the rodents to ensure that the urban roof rats don't pick up the plague from their rural cousin, the desert wood rat. If residents throughout neighborhoods don't team up on the rats, they'll continue to multiply, health officials said.

The rats have become an obsession for Brough and his dogs, Radar and Harley. Sometimes the canines corner the critters until Brough can club them. The poison worked so well the rats "ate it like it was candy," Brough said.

But after Radar almost died when he, too, consumed some poison, Brough decided to stick with rat traps.

For more information about handling roof rats, go to the Southern Nevada Health District Web site cchd.org. To report roof rats, call the district at 759-1000.