Panel outlines rising cost of medical care in Nevada

By Cy Ryan (contact)

Wednesday, Nov. 4, 2009 | 5:58 p.m.

CARSON CITY – Health care costs are rising but half of Nevada hospitals are losing money.

Senate Majority Leader Steven Horsford, D-North Las Vegas, said some charges by physicians are "exorbitant" and the problem exists primarily in Clark County.

The Legislative Committee on Health Care, in its first meeting, heard testimony that the major problem involves specialists working in hospitals that don't have contracts setting their charges.

Bobbette Bond, legislative liaison for the Health Services Coalition in Southern Nevada, said these doctors can treat five patients and charge as much as a physician in a hospital under contract who treats 20 patients.

The committee was directed by the Nevada Legislature to study methods to set a “fair and equitable system for the payment of medical service.”

Other things the committee will be looking at include:

-- State Health Officer Tracey Green reported there have been 21 deaths due to the H1N1 flu virus and more than 2,200 have contacted the swine flu. She said the state has received 20-40 percent less of the vaccine that was promised. She said she hopes the full allotment is delivered by June. And she said she expects a repeat of the swine flu in the next flu season. Green said she hopes the swine flu vaccine will be included in one flu shot.

-- The percentage of Nevada children who are obese is slightly higher than the national average. More than 18,000 children in grades four, seven and 10 were measured for weight and height. Alicia C. Hansen, chief biostatistician of the Health Division, said the 2007-2008 data show 20 percent were obese, 18 percent were overweight and 60 percent were at a healthly weight. National figures show 16.3 percent of children ages 2-19 were obese. Dr. Lawrence Sands, chief health officer of the Southern Nevada Health District said the tests showed 25 percent were obese in the fourth grade, 21 percent in the seventh grade and 22 percent in the 10th grade in Clark County.

-- The committee heard testimony that the law does not allow medical assistants to administer dangerous drugs. Sara L. Partida, principal deputy legislative counsel, said the state Board of Medical Examiners has adopted a regulation to gain control of the assistants. But she said lawyers in the Legislature are concerned it conflicts with the law. There was controversy earlier this year of medical assistants administering such drugs as Botox without being supervised or overseen by physicians. The committee is going to look at potential licensing or certification of the medical assistants.

On the rising cost of medical care, Horsford said there was regulation previously by the state permitting increases tied to the medical cost of living, but those laws expired. He said some of the increases are “exorbitant,” but he wants to make sure the physicians are paid a reasonable rate.

And in a rare compliment, Horsford has praised the office of consumer health assistance in the office of Republican Gov. Jim Gibbons. He said that Consumer Health Director Valerie Rosalin has done more than her share in helping consumers facing medical bankruptcy or loss of their homes because of the high cost of care.

Rosalin told the committee her office has been able to save consumers $109,000 in medical bills.

Bill Welch, president and chief executive officer of the Nevada Hospital Association, said he will be willing to work with the committee. But he said the hospitals give away $1 billion a year in free medical care.

Welch said Medicare reimburses only 81 percent of the treatment cost to hospitals; Medicaid pays only 65 percent of the hospital costs and hospitals collect only 10 percent of the cost from uninsured patients.

In 2001, Nevada hospitals were earning more than 4 percent profit but this year they have fallen to a 3.9 percent loss.

Welch said Sunrise Hospital in Las Vegas was operating at a 13 percent loss and the hospital in Battle Mountain, Nev., is suffering a 29.5 percent loss this year.