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November 24, 2014

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Poll finds ill feelings on health care

Taken after the hepatitis C scare, it reveals mistrust and cynicism — and a desire for stricter regulation

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Leila Navidi

A packed hearing room watches Gov. Jim Gibbons comment by video link from Carson City during a special hearing on the hepatitis C outbreak held by the Legislative Committee on Health Care on March 24, 2008, in Las Vegas.

BROKEN TRUST

A UNLV survey of public opinion about the hepatitis C crisis shows a high level of mistrust of the health care system, and a willingness to pay for better oversight.

73 percent of respondents would pay more or higher taxes for stricter regulation.

78 percent agreed or strongly agreed that the health care system puts making money above patients’ needs.

72 percent agreed or strongly agreed that the health care system covers up its mistakes.

65 percent agreed or strongly agreed that the health care system lies to make money.

67 percent of respondents said they would be less or much less likely to give blood because of the hepatitis C outbreak

57 percent said they were less or much less likely to get a colonoscopy in Las Vegas.

93 percent of respondents were aware of the hepatitis C crisis.

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A UNLV survey — the first of its kind — of public opinion in Clark County about the hepatitis C crisis shows a widespread distrust of health providers, a demand for accountability and, perhaps most surprising, a willingness to pay higher taxes for stricter regulation.

In a state where taxes and regulation are anathema, about three of four respondents said they’d reach into their wallets if it would lead to stricter regulation of outpatient surgery centers like the one that caused the hepatitis C outbreak.

More than 80 percent of the respondents said the doctors and clinic owners responsible for the crisis should be punished.

The survey was paid for by UNLV’s School of Public Health and Cannon Survey Center, and conducted by the center.

A survey company computer-generated a list of random phone numbers — listed and unlisted, business and residential. It took about 4,800 numbers to conduct the 400 interviews. The survey has a margin of error of plus or minus 4.9 percent. Pollsters finished gathering the data May 14 and are now analyzing the results.

Interpreting the broader implications of the poll’s findings is limited because the demographics of the group surveyed do not mirror the community. For instance, 61 percent of respondents were female; the Census estimates that 49 percent of county residents are female. Additionally, about 6 in 10 respondents made at least $60,000 — 40 percent made more than $80,000 — compared with the county’s median family income of $53,536. And 42 percent of respondents had at least a four-year college degree, compared with the census estimate of 20 percent.

Common sense would say that wealthier and better-educated residents would hold opinions about the hepatitis C crisis.

Beyond their anger over the hepatitis C outbreak, the respondents showed great cynicism toward health care providers.

• About 78 percent agreed or strongly agreed that the health care system puts making money above patients’ needs. “It’s all about the cash and co-pay,” one respondent said.

• About 72 percent agreed or strongly agreed that the health care system covers up its mistakes.

• Nearly two-thirds agreed or strongly agreed that the health care system lies to make money. Assemblywoman Sheila Leslie, a Reno Democrat who leads the Legislative Committee on Health Care, said she was shocked by the overwhelming sentiment that the health system is corrupt.

“What it does is shatter the myth of the doctor in the health care system being above reproach,” Leslie said. “This shows that people are extremely cynical about the for-profit health care system.”

Holly Sweetin, a registered nurse who also works as a patient advocate, disagrees that doctors, hospitals and other providers value profit above patients, and suggests the survey results reflect anger over the hepatitis C outbreak.

About 50,000 people in Southern Nevada have been advised to be tested for hepatitis B, hepatitis C and HIV, the largest patient notification of its kind in U.S. history.

The warning followed the discovery that patients at the Endoscopy Center of Southern Nevada, a outpatient surgery center, were infected with hepatitis C when anesthesia was administered by staff who reused syringes and single-use medicine vials.

More than 8 of 10 survey participants blamed doctors and the clinic’s owners for the outbreak and said they should be criminally punished for it, even though certified nurse anesthetists administered the injections.

Still, the nurses didn’t get off the hook. More than two-thirds of the respondents said the nurses’ licenses should be revoked and more than half said criminal charges should be pursued against the nurses. (Five nurses voluntarily surrendered their licenses pending the outcome of the investigation.)

“The excuse that ‘I was just listening to orders’ does not fly with our respondents,” said Pamela Gallion, director of the Cannon Survey Center.

About two-thirds of respondents said they would probably not give blood because of the hepatitis C outbreak, and about 57 percent said they were not likely to get a colonoscopy in Las Vegas.

“This gave us insight into what people are thinking and how they might act in the future,” Gallion said. “It’s a scary picture” — both because of the effect on the community’s blood supply and the risk to people who aren’t checked for colon cancer.

Leslie said the sentiments expressed in the survey mirror many of the policy discussions taking place now among legislators. She said she’s surprised but pleased to see how many people are willing to pay for better regulation because it shows they understand the connection between their taxes and government regulations to protect the public.

The state needs to start by performing the inspections required of outpatient surgery centers, Leslie said. Regulators also need to be more aggressive, she said.

Sweetin said she’s not sure higher taxes would help the problem because there are already agencies that should be conducting regular inspections and enforcing regulations. Nevada needs competent people in those positions, not higher taxes, she said.

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