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A black eye in medicine brings posturing, again
Putting cuts in human terms, ‘60 Minutes’ grabs lawmakers’ attention
CBS
“60 Minutes” featured the closing of the center Sunday, and though some say the program brought awareness, others are chagrined by the negative publicity for the city.
Thursday, April 9, 2009 | 2 a.m.
In Today's Sun
University Medical Center CEO Kathy Silver is interviewed by "60 Minutes" correspondent Scott Pelley in the hospital's closed chemotherapy unit for a story that aired Sunday. Some worry the piece will damage efforts to recruit companies and professionals to Southern Nevada.
Related story
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- Health care for all Nevadans (1-31-2008)
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It was yet another national embarrassment for Las Vegas health care when the closure of University Medical Center’s outpatient cancer unit was spotlighted on “60 Minutes.”
The renowned CBS-TV news program dramatically told the story Sunday of how several patients are being consumed by cancer because they are uninsured and can’t get treatment at UMC. The public hospital shuttered its outpatient cancer unit in November after severe state budget cuts. Other cancer clinics in town won’t take nonpaying patients because the chemotherapy drugs are too expensive.
The news show set the stage for hearings Monday and Wednesday in the state Assembly’s health and human services committee, where legislators are considering a bill that would require UMC to reopen its outpatient cancer center to treat indigent patients.
Wednesday’s hearing revealed several absurdities.
The first: Legislators criticized the immoral nature of leaving cancer patients without care without taking any responsibility for the crisis.
“Unacceptable,” Assemblywoman Sheila Leslie, D-Reno, told UMC CEO Kathy Silver in discussing the closure. “I just could not have made that decision and lived with myself.”
Silver noted Wednesday the county hospital was on pace to lose $51 million late last year when the Legislature made emergency cuts that resulted in an additional $21 million shortfall. UMC was left with no good options and had to make brutal reductions to stay afloat, she said.
Hospital officials decided to shutter the program because outpatient cancer services were available elsewhere in the city. (UMC’s letter to patients announcing the change was either dangerously ignorant or disingenuous when it listed other cancer providers they could contact for services. It should have been known the providers most likely would not take uninsured patients.)
The second absurdity: Assembly Bill 433, as it’s currently written, would require the county hospital to provide cancer care only for indigent patients. But the indigent patients, if they are residents of Clark County, are not the ones going without care. Clark County pays doctors to provide indigent outpatient care.
“The poor are getting care. The rich are getting care. The middle class are not,” Silver said, referring to people in the middle class who have no insurance.
The fact that the proposed legislation would only mandate that UMC provide care for patients who are being treated — and would not help those who are not — went unspoken during the hearing.
The third absurdity: Health care experts say cutting UMC’s outpatient cancer clinic is not only inhumane, it will likely cost more when those patients reach advanced stages of the disease, and the hospital will be forced by law to admit them. By then they will be more costly to treat than cancer outpatients.
“Just like any disease, it’s usually a lot cheaper to treat it on the front end,” Rick Plummer, UMC’s spokesman, said. “The bigger reason (to close the outpatient cancer unit) is that outpatient really shouldn’t be done in a hospital anyway. It was one of those services that are widely available elsewhere in the community.”
Plus, Plummer added, the patients may not come back to UMC when the disease becomes more advanced.
Silver and Justine Harrison, vice president and general counsel for the Nevada Cancer Institute, said at the end of the hearing that discussions are under way to resolve the immediate crisis at UMC.
Harrison told legislators that the problems need to be examined “so this crisis does not repeat itself in the future.”
The Assembly committee did not take any action on the bill, which will die if no action is taken by Friday.
The “60 Minutes” program was invoked throughout the hearing, with DVD copies of the show being distributed Monday by one committee member.
Lisa Stark, a Nevada Cancer Institute spokeswoman, said in an interview it was important to bring the “tragic story” to a national audience to show the effects of the budget crisis.
“This was certainly not a happy story or a positive story, but we thought it was an important one to bring the issue to the fore,” she said.
Tom McCoy, government relations director for Nevada for the American Cancer Society’s Cancer Action Network, testified in favor of the Assembly bill and thinks UMC should provide outpatient cancer care. He said “60 Minutes” helped bring the issue to the forefront, but acknowledged that the state is facing a severe budget shortfall, estimated at up to $2.8 billion.
“It’s easy to talk about this,” McCoy said. “But somebody’s got to pay for it.”
But the program will be a setback for recruiting companies to Las Vegas, said Somer Hollingsworth, president and CEO of the Nevada Development Authority. UMC should have kept its mouth shut when “60 Minutes” came calling, he said.
“I just unequivocally would have said: ‘No, I’m not talking to you.’ It’s not a story that needs to come out nationally,” Hollingsworth said.
Hollingsworth said he’s still answering questions about the medical malpractice crisis five years ago and the hepatitis C crisis last year.
And now the “60 Minutes” segment.
“It’s almost impossible to counter that,” he said. “You don’t have enough marketing money to go out nationally and say we have great doctors and it’s a wonderful place to be.”
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Living in a community is about caring for our selves and each other. A change in our current core belief of selfishness, anger and profit at any cost must change from the Governor down to the indigents. A belief in God is helpful, if not, we are not much better than animals.
Where I grew up, they are trying to help everyone by mandating universal health care. Taxachusetts. Drooling liberal land. Where that damn Ted Kennedy lives. But you know what? At least they are trying to give everyone access to affordable health care. Here in Redneck heaven, of course, we'd rather let people die in the desert. But someday, Mr. and Mrs. Clark County, you'll be getting hounded by bill collectors and hospitals because you got sick. So you'll lose your house and whatever else you own. And of course, in your Rush Limbaugh world, it will somehow be the fault of that damn Ted Kennedy, and of course, Harry Reid. But if you make it to 65, you won't be complaining about Medicare. Right?
Somer Hollingsworth and the Nevada Development Authority should be ashamed of themselves. What an asinine assertion--sweep this problem under the rug because we don't want the world to know the truth about how inept and dysfunctional our local and state governments are in Nevada??? Are you kidding me??? Shame on you.
We shouldn't allow our health care professionals to talk to the media because of the PR ramifications??? Wow, the very idea just betrays just how backwards our collective mentality is here in this state.
Wont it be nice when the government controls all of health care. Every time there is a budget crunch we can all wait and die.
UMC went on 60 Minutes to look victimized and that back fired. They did a poor job of communicating with those patients. They just listed other area clinics knowing they wouldn't take them and that is pitiful and lacked good judgment on their part. I notice they still have ads running in the area media. Cancer patients or PR/marketing, seems like the county hospital is losing sight of their role.
"Wont it be nice when the government controls all of health care. Every time there is a budget crunch we can all wait and die."
And how is that different from what's happening now?
This infrastructure in this state is horrendous after years of budget neglect and now when there is a crisis that lack of adequate funding has come front and center. As a result of all the "easy cuts" last fall and winter, UMC was looking at a $71 million shortfall. Where were they to make up the difference? They made on of probably many equally bad decisions. Good for them going on 60 minutes and letting the word know how bad things are in Nevada. Maybe they'll come and look at our schools and social services. Then maybe the legislature will be embarrassed enough to change the tax structure to pay for adequate infrastructure that will make quality companies want to relocate here.
The ultimate answer is National Health Service - like they have in Canada, and, England.
I have stayed in England....not so great. It is still the haves and have nots. Richer pay for private care and move to the front of the line for life saving measures.
Somer Hollingsworth should be ashamed of himself. Who appointed him guardian of public health? He should keep his mouth shut when he hasn't the slightest clue about the problem.
Kathy Silver did absolutely the right thing by going on 60 Minutes. It called attention to the Legislature and Governor's efforts to gut funding of public health. Our state elected officials are the only ones who should have been embarrassed, and it is apparent they are embarrassed.
I have news for Assemblywoman Sheila Leslie: it is the cuts that you, the Legislature, and the Governor have made that have caused this situation. You plainly have been living with yourself, so get over the phony, holier than thou attitude and take responsibility for creating the shortfalls that caused the cuts.
And then there is Nevada Cancer Institute, which took $10,000,000.00 in public money from the State, but refuses to treat the indigent. What is Nevada Cancer Institute doing with the public's money, other than lining their own pockets and building a marble-floored cancer treatment palace for the wealthy? What is a private enterprise like that doing with $10,000,000.00 in public money, and no accountability to the public? I guess it pays handsomely, Jim and Heather Murren, to have paid for your elected "friends."
Marshall Allen, if you really want to do a story, find out how a private enterprise like Nevada Cancer Institute got $10,000,000.00 of the public's money over all other private oncology practices. Maybe you should look into why Nevada Cancer Institute is getting at 25-acre parcel of public land in Summerlin, free of charge, over any other private practitioners. Why is the government playing favorites? Could it be that Jim Murren, MGM CEO, is the founder of Nevada Cancer Institute? I dare you to do some real investigation.
Health and Human services appears to be getting an extra $400 million over what was spent last year. So why was this getting cut?
Pick something visible hardly anyone would object to, cut its budget and plaster it on the news - then ask for tax increases.
I also wonder what has Nevada Cancer Institute done to perpetuate this problem. They have done absolutely nothing to fix it. NOTHING I beleive they got about 60 million over the last 4 years.
You feel comfortable quoting Heather Murren's girlfriends Lisa and Justine about averting future crisis...what are they doing to help?
They pulled their physicians out of UMC before the contract ended, they took the insured patients from UMC over to NVCI, they have blasted through medical professionals of their own who quit because they couldn't run the place like a medical facility rather than a hotel.
How many medical facilities do you know of that have the money for a Chief Experience Officer? They do.
I dare you Marshall...do a story on Nevada Cancer Institute. A true story on their behind the scenes workings. Where has all that money gone. Let's see what they spend on recruiting dinners and what does it cost to move people to LV and then lay them off? Come on, show us their dirty laundry.
John Murren, the real founder of NVCI would roll over in his grave if he knew what Heather has made of it.
They were taken to UMC ...where they later died.
RE: Mr. Somer Hollinsworth
Your statements are in the public domain, and noted. Perhaps, even, 60 Minutes can afford your statements a moment of national exposure in a future segment.
Somer! It's easy!
Tell your friends to quit harping on "government waste" and RAISE THE FLIPPIN TAXES! Nevada didn't just become an embarrassment by accident! It made itself that way!
Fix it!
Somer Hollingsworth: "UMC should have kept its mouth shut when '60 Minutes' came calling."
Just as you should have done when the Sun came calling.
Despicable.
@betterhealthcare
I agree that UMC didn't handle this in the best possible way. On the other hand, I'm not sure if there are any real solutions for these folks--if their going to the county hospital, they probably don't have too many other similar options out there--UMC is the safety net.
To your point about marketing, I disagree--marketing is a drop in the bucket when we're talking a shortfall of tens of millions of dollars in operational revenue. It's customary to think of advertising as a four-letter word, but I'm okay with using my taxpayer money to try to increase awareness that the hospital does offer other specialties and to try to increase revenue--often medical specialties that are generate more revenue help offset the cost of other specialties that are not. There's nothing dirty about talking dollars/cents here, because it's not like UMC is raking in dollars in one area and disregarding others. They may increase revenue but they're certainly not profiting--no one's getting rich here by marketing.
Holingsworth:
It' because we don't have great doctors and it is not a great place to be. Putz
I just found out that Assemblywoman Sheila Leslie sat on the State Assembly's Ways and Means Committee and she voted to approve giving $10,000,000.00 to the Nevada Cancer Institute on June 4, 2007 (see http://www.leg.state.nv.us/74th/Minutes/... at p. 14). She also voted in favor of generously giving the public's money to a private cancer institute that refuses to treat the indigent when SB 443 came before the Assembly (see http://www.leg.state.nv.us/74th/Reports/...).
Ms. Leslie, do you realize that $10,000,000.00 could have kept UMC's outpatient oncology afloat for four years? You cannot blame this problem on UMC. If you are truly outraged, then you had better look no further than the mirror to find someone to blame!
To Marshall Allen: this is just one example of the research and investigation that you could be doing to call out these hypocrites who gut funding for a public hospital, give public money to the "Gucci" Cancer Institute, and then feign outrage when the public hospital doesn't have enough money to be all things to all people.
By the way Marshall, by using a little thing called the Internet, I was able to learn that the Nevada Cancer Institute has received other millions of dollars of public money prior to the 2007 legislature. Maybe SOMEONE could find out if any of it has been spent on treatment of the indigent.
How about taxing the for-profit ("proprietary") hospitals in Clark County that remove their profits from the state? Use those taxes to fund care for the uninsured.
Valley Hospital System owned by Universal Health Services in King of Prussia, PA.
The Sunrise Health Hospitals: Sunrise Hospital, MountainView Hospital, Southern Hills Hospital,
Sunrise Children's Hospital owned by HCA, Nashville, TN.
This is a result od greedy republican healthcare for profit only system.
Belief in god is not the answer. Keep your fantasies and foolish beliefs to yourself. People need and deserve meicine.
Getting adequate medical care in Las Vegas is about as likely as winning the Megabucks.
All you right wing red-neck nut jobs whining about socialized care need to learn to internet.
Cuba has a health care system that makes ours look like a 3rd world country. And it's all for free. So stop with the 'for profit' is best lies already. Health care is a basic human right in civilized countries. Here in the warrior nation of greedy bastages, adequate medical care is just another way to fleece the public.
If our govt would let me, I would go to Cuba for all my health care needs.