Facebook
Fark
Digg
Reddit
StumbleLas Vegas Valley hospitals politely shamed into improving
Group of insurance providers proposes new payment system, pushes for transparency
Sunday, May 23, 2010 | 2 a.m.
LOW RANKING
Hospitals in Las Vegas rank among the lowest in the nation in the number of readmissions — or patients who have to return to the hospital within 30 days, according to a recent report prepared for Health Insight, a government-contracted quality-improvement organization. Among the findings: • 25 percent of Medicare fee-for-service beneficiaries in Las Vegas are readmitted within 30 days, compared with 19 percent nationwide. A significant majority of cases are unplanned.Sun coverage
A coalition of 24 self-funded insurance plans is urging Las Vegas hospitals to improve their quality of care — which is ranked as some of the worst in the nation — to earn the business of its 260,000 patients.
The Health Services Coalition is telling 13 acute-care hospitals that there is room for improvement, and is pushing for transparency and asking for ideas to change payment incentives to encourage improvement.
And if the Las Vegas hospitals don’t want to play ball, the coalition is open to sending patients out of state, suggesting it may send them to St. George, Utah, 120 miles northeast of Las Vegas, where nationally respected Intermountain Healthcare operates a facility.
“Depending on the situation, it might be less traumatic to help a patient get to St. George, get their treatment, not have a complication, and be done,” said Leslie Johnstone, executive director of the coalition.
Intermountain Healthcare would be happy to take paying customers from Las Vegas. “That would be outstanding,” a spokesman said.
The coalition’s initiative proposes transforming the normal method of paying hospitals, which includes standard day rates and a percentage of billed charges. The system does not reward quality and gives hospitals and providers the perverse incentive to perform procedures whether or not they’re in the best interests of patients. In a macabre sense, it rewards hospitals for poor performance by paying them additional money to fix their mistakes.
Health care experts say the coalition’s approach is on the cutting edge of a national trend. Employers are getting buried under the rising costs of health care and demanding better value for their dollar. The cost problems sparked the recent health care reform legislation in Congress, where discussions included realigning incentives to encourage hospitals to provide better care.
By many measures, Las Vegas hospitals are among the worst in the nation. Nevada ranks worst for readmissions — patients who have to return to the hospital within 30 days, according to a recent report prepared for Health Insight, a government-contracted quality-improvement organization in Las Vegas.
The report found:
• 25 percent of Medicare fee-for-service beneficiaries in Nevada are readmitted within 30 days, compared with 19 percent nationwide.
• 90 percent of the readmissions are unplanned and half might have been preventable.
• In 2009, Medicare paid $203 million for Nevada readmissions, and correcting the problems could save up to $102 million.
Health Services Coalition data show that from June 2008 to May 2009, there were 984 30-day hospital readmissions — 11 percent of the total cases. To say nothing of the human suffering caused by readmissions, each cost an average of $17,767, which puts the total one-year cost at nearly $17.5 million. That’s 7 percent of the $242.8 million the coalition spent with Las Vegas-area hospitals.
Johnstone points to several other indicators that show problems with Las Vegas hospitals. The Leapfrog Group, a national hospital quality organization that uses self-reported hospital data, reports that only four of the 13 Las Vegas hospitals had fully implemented its safety standards for preventing pressure sores in 2008, and none had in 2009.
Five hospitals had fully implemented Leapfrog’s injury prevention standards for 2008, and the number dropped to two in 2009. Seven hospitals did worse in the two categories in 2009 than in the previous year.
The Health Services Coalition was formed in 1989 and includes Boyd Gaming Corp., MGM Mirage, Metro Police and NV Energy. It is trying to balance calling attention to the problems with providing incentives for improvement. Johnstone said the coalition is shaming the hospitals, but “trying to be nice about it.”
The goal is collaboration, she said: Rather than the usual haggling over rates, the coalition is asking the hospitals to provide plans and information, some of it proprietary, to verify quality efforts and show efforts to improve.
Johnstone said the innovations could take a variety of forms. Hospitals that provide superior care for certain procedures could earn bonus payments and receive the greatest share of those cases. Hospitals could partner with doctors to accept a global payment for a procedure, receiving a higher reimbursement on the front end, but nothing extra if the patient needs to be readmitted for the same problem.
Payments could rise for facilities that improve over time, and patients would be steered toward the best hospitals, she said.
“If we can be successful with getting the hospitals to take this seriously and make it a win-win for both sides, then other payers are likely to take the same steps,” Johnstone said.
All the hospitals attended an informational meeting this month, and their proposals on how they would work with the coalition are due June 2. New contracts are due by the end of the year.
The hospitals that responded to the Sun’s request for comments were positive about the initiative.
Representatives of St. Rose Dominican Hospitals and Sunrise Health System said they are committed to quality and look forward to participating in the process started by the coalition.
Kathy Silver, CEO of University Medical Center, the only public hospital in Las Vegas, said the coalition’s proposal will create competition and may lead to some hospitals not being included in the contract because of cost or quality problems.
Kathy Silver
“It’s a new day and a new way of looking at the business,” Silver said. “I have to applaud them for thinking out of the box and a little bit ahead of everybody.”
Harold Miller, president and CEO of the Network for Regional Healthcare Improvement, a coalition of health care patients, payers, purchasers and providers working to improve quality and lower costs, said the Health Services Coalition’s proposal is part of a larger national movement but unique in that the insurance plans are asking hospitals for ideas to improve value.
It’s also different because the coalition represents the companies that are actually purchasing health care — as opposed to third parties such as Cigna or Aetna that administer health plans on behalf of payers. National health plans administering local benefits packages have not shown the same ability to innovate, he said. It’s unique and an “important step” to have payers directly communicating with providers, Miller said.
Discussion: comments so far…
Comments are moderated by Las Vegas Sun editors. Our goal is not to limit the discussion, but rather to elevate it. Comments should be relevant and contain no abusive language. Comments that are off-topic, vulgar, profane or include personal attacks will be removed. Full comments policy. Additionally, we now display comments from trusted commenters by default. Those wishing to become a trusted commenter need to verify their identity or sign in with Facebook Connect to tie their Facebook account to their Las Vegas Sun account. For more on this change, read our story about how it works and why we did it.
Only trusted comments are displayed on this page. Untrusted comments have expired from this story.
No trusted comments have been posted.
Post a comment
Most Popular
- Viewed
- Discussed
- E-mailed
- Photos: Olivia Culpo, 20, of Rhode Island is crowned 2012 Miss USA at Planet Hollywood
- US Navy hopes stealth ship answers a rising China
- Learning about Electric Daisy Carnival fans will help Las Vegas court them
- On the horizon: A quick look at projects poised to shape downtown
- Clark PG Kentrell Washington heading to Hofstra basketball
Everything Under the Sun
Blogs
The Kats Report
Joe Pesci remembers his own honeymoon in Vegas -- meeting the Rat Pack
Las Vegas Philharmonic says search for new music director to begin 'immediately' (1 Comment)
With Shenandoah project stalled, Wayne Newton hits back legally (7 Comments)
Where does a Playmate play when she turns 21? Vegas! (3 Comments)
Ice Ice Billy
The road to six-toed cats and Mayor Bubba
The Kats Report
David Itkin tells L.V. Philharmonic officials he's on his way out (14 Comments)
Diamond Dave sells it well as Van Halen pours out the power at MGM Grand (2 Comments)
- Locally owned and independent since 1950; Winner of the Pulitzer Prize for Public Service, best news website in the nation & DuPont Award for broadcast journalism
Former GOV Keenny Gwinn, after taking tobacco settlement money, that was supposed go for medical programs, used it for an ego-scholarship to give him a "legacy."
Then he went to SOCAL for medical treatment.
I knew someone who cut his arm and a local hospital put staples in it. When he went back to California, Kaiser said they never saw staples used in an arm, just heads.
Jeez. Another scare tactic news article on healthcare. Nevada healthcare.
When I first moved here a few years back, a former co-worker came out for some gaming. He became ill,
was hospitalized, and died a few days later.
I visited him twice in the hospital, and was horrified at what appeared to be "less than ideal"
care.
No diagnoses was ever made, no real effort that I saw was made to do anything beyond trying to stabilize the man.
I bugged nurses on the floor, talked to a doctor,
NOT ONE impressed me as someone who I would want
caring for me in a medical emergency.
If, for some heretofore unknown reason I become ill enough to require hospitalization, I pray I'm well enough to leave Nevada for proper care.
We're in a race to the bottom with our school system, and how the hospitals are in a race to the bottom. Pretty soon we'll be at the bottom of everything! GO VEGAS!
St. Rose Hospital folks. I stand by this hospital 100%.
During my horrid 5 day stay at a local 'hospital', suffering life-threatening clots (diagnosed on day 3 of my stay...) I saw a doctor for 5 minutes a day.
5 different opinions on my condition. Waited 2 days for cough medicine, and was told I was lucky to be alive.
Oh, and I waited 9 hours in the ER waiting room (almost empty) waiving my insurance card and barely able to breath. At one point they did tell me I should be seen (for the first time) as soon as the nurses got back from lunch.
I know several folks who go to St. George, and even my cardiologist indicated he might send me out of state if advance care was needed (it wasn't).
Congress fixed health care. Certainly included in the thousands of pages of this bill the quality of care was addressed. Perhaps a call to the IRS is in order.
120 miles is not a bad drive for excellent care. If it kept me alive I would do it.
The lack if care here is frightening-but life is cheap in Las Vegas.
This is definitely George Bush's fault.
No, not Bush's fault, his great honor! Also, the honor of Ronald Reagan and George's father to keep the great unwashed from accessing health care in the USA.
If God wanted them to have health care insurance they would have been born with it, like in Europe.
There is plenty of health care available to those who want it, and can pay for it.
So what if health care costs sent GM into bankruptcy. The USA does not need to build cars and trucks, our former and current enemies can do it for us.
Be happy in your work!
Folks,
Many of you seem to be missing the point of the story, which is fascinating and, I think, worthy of some discussion:
A group of insurers (who provide coverage for employees of Boyd Gaming, MGM Mirage, Metro Police, NV Energy and others) are telling hospitals: If you don't improve the level of health care, we'll send our patient-customers elsewhere.
What are your thoughts about insurers telling that to hospitals? That's what we ought to be discussing. Keep it focused, folks!
Tom...the indictors in the article are common key measures for quality of care and it appears many of our hospitals have room for improvement. I support payor's ability to create a reimbursement system that rewards quality of care... it's a win-win for all of us.
However, our health insurance system, which isn't really an insurance system but a payment system, is riddled with politics. I would suspect this is just a ploy to push down costs, but the indicators are fairly basic ones the hospitals should have been looking at themselves.
Comment removed by moderator. Flaming.
They overbuilt; there is too many hospitals. For profit hospitals stink and the non-profit ones are non-profit in name only. The physicians in Congress or ,running for office. ought to quit their self dealing and stick to doctoring. How about health care that takes care of the sick and doesn't prey on them ?
The physicians said we wouldn't have enough doctors to take care of people if we had the public option. I found them in Congress and the State Houses
My general impression with Las Vegas hospitals is that they are overloaded with foreign nationals for employees. The horrendous problem in our urine-poor immigration policy comes back to bite us in another area of our society.
If we have to spend tax money for social services, then spend it for the training and education of American citizens to perform those kind of jobs. I'm getting sick and tired of seeing inferior immigrants trying to perform hi-tech work like healthcare.
Pierre,
If hospitals are hiring people who are unqualified to do the work, isn't that a problem with the hospitals, not the employees being hired?
At most, there may be issues with understanding the accents of some workers, but to say they are unqualified seems a reach. And to call them "inferior" is, I hope, just a bad choice of words and that you meant to say "under-qualified."
@PierreBeauRegard:
These "immigrants" that you want to make the scapegoat in this situation have to pass the national board exam for their respective specialty. Board exams surely count for something, no? It's ignorant to think that the solution to this problem is as simple as you describe it to be. These immigrants function very well in places that one would consider top notch hospitals, like Stanford, UCSF, etc. How would your simple bigoted mind explain this?
Bull regard even though your racist you make some good points, Foreign workers are less likely to demand single payer. Sweeney former head of AFL/CIO said that the medical industry mines the world for cheap labor. The antagonism towards foreigners is right out of the rich elites union busting manipulating play book; thats how they keep all we great unwashed ,whatever our origen, down.
We tried the laissez- fair "competition " thing ; we need regulation. Why is Desai or Thomas not in jail ? Why does a drug company have 500 million dollars to settle a lawsuit ?
Health Care costs are approaching 20% of GDP for what ? spotty chaotic or no treatment
Let's back up and remember why we needed health care reform. It was because the insurers have been killing and ripping off WE THE PEOPLE for years denying care for pre-existing conditions, and denying care for those who are dying because they are purely and simply GREEDY. They needed to be shaken down from top to bottom. Now they are creating this kind of subterfuge by attacking the hospitals who have been chained and bound by their outrageous rules and regulations. It is WE THE PEOPLE who should hold these jerkball insurers to the fire and continue to demand they treat us as we should be treated because the hospitals are trying and have been hampered by cheap, tawdry greedy health insurers who have been fined, chastised but never cared. It's the old trick: divert attention away from the real problem. Attack the firefighters instead of the arson who in this case are BIG INSURANCE. Let's stay focused on the truth in spite of them.
Foreign nationals in the healthcare system are not as qualified as the native born citizen who works in that same system. Ask any American citizen who has been there and done that, as I have listened to their horror stories relating such incompetence, by the foreigners.
For profit hospitals,physicians,and drug/medical device companies are preying on us too! Mr Strayrational
If we want to reduce costs these lobbys should be addressed too! This is why Obama's reform is so lame.
@PierreBeauRegard:
It figures that you'd resort to the good ole red herring when someone calls you out on your baseless claims. You have just confirmed my suspicions about your character. Instead of asking you yet again to explain why these immigrants from other countries do very well in the top hospitals, I'll play your simple little game and follow your herring. I assume that somewhere along your college career you learned that anecdotal evidence are given little credence in an argument. I can match every "foreign national" horror story with a "native born" one, whatever that means, lol. So really, what is your point? Your case for blaming the evil immigrant contingent for the poor performance of the hospitals in the Valley is very cute and child-like.
my wife had a complication with her medicine had to go e.r. went to NORTH VISTA hospital. we were emergency for 6 1/2 hours. b 4 she was sent up to her room. a lady who in charge and i said that lightly. ask a co-worker what should she do. send my wife to a room or release 2 other patience home. e.r. doctor said why is my wife still in the e.r. the lady should be in charge. i really feel sorry for this city.
It's not just our city. It's the end result of the no taxes deregulation globaloney. I dred to think what the medical equivalent of the oil slick is ; but it's coming.
Hospitals should not limit their services based on who's paying the bill. Medicare seems to be a factor here; seems that the hospitals in LV have got stuck in a rut and the lack of motivation to excel has dwindled down to it's just a job attitude, where service is getting poorer and the quality as well.
"A group of insurers (who provide coverage for employees of Boyd Gaming, MGM Mirage, Metro Police, NV Energy and others) are telling hospitals: If you don't improve the level of health care, we'll send our patient-customers elsewhere." says a lot. You are talking about local groups and organizations that are speaking out and are demanding better service and quality of service. I think they deserve it, we all do. If the hospitals are hiring under-qualified personnel, they need to start a training program and get them up to speed or let them go for poor performance.
We can shame the shiftless hospitals into improving just like we're shaming the oil out of the Gulf of Mexico ! I'm not talking about the workers though, I'm criticizing the people in charge, often from out of state.
In my hometown one day I felt a pain in my back on my left side behind my heart and went to the emergency ward at the local hospital. For the next three hours I had a doctor or nurse with me the whole time while on oxygen while doing numerous tests. All tests were negative and I was released. The total bill for the three plus hours of care was $925.00. About a year before I fell on my steps because of ice in the morning before my trip to las vegas to visite my son who lives there. I knew I broke some ribs because I hit on the corner of the step and felt them pop. I went to las vegas anyway and after the third day, I couldn't stand the pain any longer even with some pain pills I had from a previous perscription. I went to the emergency ward at one of the hospitals and was admitted to the emergency ward. I sat in a room with about twenty other people hacking and coughing in old chairs that looked like they were donated from the goodwill. none of them matched and some having arms while others didn't. After about an hour, a doctor comes out and asks me what happened and after about 3 minutes, leaves. two hours later, the call my name for xrays and I led to a room with two young girls who didn't seem to know what they were doing. They had me laying on a stainless steel table and rolling over for xrays on my sides and back. I was practically in tears it hurt so bad. I was sent back to the waiting room and sat there for another hour and finally the doctor comes back and tells me I've got three broken ribs. Boy was this guy sharp, After me telling him that I broke my ribs and waiting for four hours along with the x rays, he figures out that it wasn't a broken ankle or sore throat. I can understand now why they go to medical school for six years.
He says that he's going to give me something for the pain (Finally) and they give me a shot of morphine that looked big enough for a horse. I'm released and when we get to my sons house, I walk in the door and fall on the couch and pass out for 6 hours waking up and immediately throwing up. I discussed this with my doctor at home and he told me that they overdosed me with the morphine and I could have died. Also, they should have done the x rays standing up. Rolling around on a table with broken ribs could have injured internal organs if the ribs were seperated. The hospital didn't forget me though, I recieved a bill for $3350.00 for their service.
The break down was something like $55.00 for the morphine and $180.00 for the x rays. I guess the other $3115.00 was for the pleasure of sitting in their waiting room.
Health care in Las Vegas is the worst I've ever seen. People left to die in the emergency room, reusing needles to spread deadly virus. The Health Board is the good old buddy system.
It's about time someone, in this case the insurance companies, threatened to take action on something that anyone who has stayed in an area hospital knows:
The quality of medical care here is, in many cases, criminal.
I hope I'm not sounding like bull regard too much but you got to wonder about a doctor that comes from a country where people are left to die in the street. We're headed there !
There is only one real 'body' that will scare a hospital to death, Joint Commission on Hospital Accreditation.
They prepare for this visit for weeks. I know a risk manager who was going crazy over the impending visit.
That's the best time to wind up in them, during the visit.
Joint commission is a rubber stamp; It's like a triple A rating on a credit default swap.It's wolves guarding the hen house. Can't you see private industry can't regulate itself. Sound regulation is the function of the government.
What's the joke?
"Q: Where do you go for medical care in Las Vegas? A: McCarran airport."
Las Vegas' extraordinarily bad health care system is merely an extension of its larger extraordinarily unhealthy status as a community: educationally, socially, economically, intellectually, politically. Increasingly, you live here at your own risk.
I bet that most people here doesnt even realize that most Er's, Urgent Care's, Clinics(both specialty and primary) are be being staff by midlevel providers ( Physician Assistants, Nurse Practitioners and not by MD's. Patients just assume they are MD's and most doesnt correct patients when they are addressed as "doctor". Of course there are good ones but unfortunately they are the very minority. The concept of having midlevel providers are actually great, in concept.They run around with very poor to nonexistent supervision. Why their proliferation? You guess it money and greed. Insurance cuts payments to hospitals and Clinics, both hire someone who can "man" the place with less pay as they cant afford to hire more MD's, patients be damn. On foreign grads, are there stupids ones? Of course, maybe just a bit higher than there is in US grads I got to admit, both groups do take and must passed the same tests by the way. A lot of them(foreign) becomes leaders and chiefs of their division(supervising US grads) so generalization is really not applicable. Go and try it, next time you visit any "provider" at least try what those initials after their name really meant, you maybe be surprise.
The article is reporting those with the local bank, i.w. gaming, are kindly pushing UPWARD at those who provide local healthcare delivery.
That is the crux of the story, not national healthcare reform, not the legal or socio-economic status of those seeking care.
This is POSITIVE.
However, the real solutions (plural, for diverse specialties) will begin (a real start) when there is more than one banker in the room to solve the problem, and that means a nationally reputable healthcare delivery brand is up and operating in Southern Nevada with a hospital and clinic (preferably teaching hospital and clinic), within a cost structure that is acceptable to both in the regional market.
Such a development will raise all boats in the Valley.
There is no question with two million residents in Clark County that there exist significant demographic and/or cost prohibitors, otherwise such branded providers would already be on the ground, up and running, providing better outcomes for hospitality workers and greater Southern Nevada.
And this is where gaming (and it's primary partners), the one significant industry in Clark County, need to look itself in the mirror over the past 20 years of rapid growth. Note: It's hard to look at home builders or national call centers for hospitals. Because in other American cities with two million people and more diverse economic bases, EVEN MUCH SMALLER PLACES LESS THAN 500,000 PEOPLE, there is access to quality care somewhere in which outcomes are much better, in diagnosis, treatment and long term care, if needed.
NOT to have a working cost structure meshed with high tier quality-teaching healthcare availability in broad-based specialties, especially tied to a larger system, goes against the libertarian values of many Nevada citizens. Because no matter how many patient cases and/or Nevada residents are exported to other states because of healthcare needs, those who do remain in Nevada will have higher, even unnecessary if they had been treated right in the first place, long term costs on Nevada society and social nets.
I am amazed at the financial expertise, marketing expertise, and food and beverage expertise that operates in Las Vegas. But, on other challenges, such as healthcare, the expertise to generate solutions has simply not been there to date, too slow on the big target. This outcome is a direct reflection on one of the negatives, among some positives, of being a one industry region. Credit Oscar Goodman for his strong efforts to bring the right changes to hit the big target. He needs broader, more resolved support and resources from others.
I beg to differ from you. Our lack of a proper health care system is a national problem. Vegas suffers more because it bought into the no government globaloney. The powerful elites are stronger under such a regime.
Desrt Vu hit the nail on the head. Las Vegas is an inherently unhealthy place to live. We have more smokers, obese people, high school drop outs, drinkers etc than anywhere else in the country. The readmission rate is not surprsing given this population. The insurance companies are part of the healthcare system. They contract with the lowest bidders. Sending someone 120 miles away will, of course, show a decrease in readmission to the the St George hospital, because patients are unlikely to make that trip again if they need additional care for a botched procedure.
Hi Fred_Flintstone, thanks for the comment on my story. Just to clarify, the readmits would show up in the data because they are based on the insurance company's data, not an individual hospital's data. The payers can tell when their patients are readmitted, even if it's to a different facility.
You make a good point about the insurance companies contracting with the lowest bidders, and that's what makes this story so unique. The insurance companies are pledging to find ways to pay more for getting it done right the first time and finding innovative ways to improve.
I just got out of St. Rose San Marten. This hospital and its staff treated me very well. They were friendly and knowledgeable. The doctors spent time with me and listened to me. I have been to many hospital in the valley (I have an incurable cancer)and I have found both the San Marten and Sienna campus' of St. Rose Dominican Hospitals were outstanding. Thanks to the best nurses in town (3rd floor, San Marten).
And pierre ,
In case you get hospitalised here in California , a lot of our top noth nurse here are Filipinos working in UCLA , CEDARS -SINAI , UCI , name it . There are a lot of Filipino nurses in California , but healthcare here is one of the best in the land . Dont make us the scapegoat to your problems .What is this the THIRD REICH when the NAZI blammed all their economic problems to the JEWS .
@PIERRE
This a commment on pierre`s statement that the cause of the problems here are the Foreign born nationals which he referred to as " inferior " . Mr. Pierre just in case you dont know , A foreign born national has to pass a battery of test prior to being allowed to come here and work . They have to be board certified RN from the country where they came from . Secondly they have to pass the CGFNS , a pre NCLEX test given in the country of origin third they have to pass the NCLEX RN here , and lastly they have to pass the TOEFL and TSE english proficiency test to get their green card . That is a lot of test and to tell you they are not easy to pass . So your assumption that they are " inferior " is baseless unless you`re basing it on their race or skin color .
The real cause of the problems are your Native Born Americans , who wants to get the most for their buck. They understaffed the hospitals and increase the nurse patient ratio . So instead of 1 nurse with 4 patients ,they make it 1 is to 7 . Instaed of 1 nurses aide to 10 patients , they make it 25 . so who is to BLAME when it comes to poor quality of healthcare in Vegas , is it the immigrant nurse you called inferior or the White CEO , who controls the hospital staffing and budget ? get real . Research has found out that the smaller the nurse patient ratio the lesser is the mortality rate . So tell me is it the CEO or the immigrant nurse to blame ? of course it is the CEO , and the CEO is controlled by the corporation . So next time stop racial racial profiling because I am an Immigrant nurse too , and we Filipinos are not inferior to white nurses either . California has a lot of Filipino nurses and yet our healthcare is one of the best in the land . It`s because we care of our nurse , we dont understaffed them or abuse them like here in Vegas .
Maybe the new V.A. hospital will put some pressure on these bums.
I LOVE THE STAFF ENGAGEMENT!!! TAKING COMMENTS TO A NEW LEVEL!
I agree with Tom's comment about the "point". The point is that when the medical insurance industry is telling your medical services industry to "get it together" you live in an area that has not made quality medical care a priority (duh). We can point fingers all we want but we are the voters, we ultimately are the government and our electeds are pathologically disengaged in what matters to us because WE are disengaged!
This push by the insurers is clearly a direct result of the federal healthcare legislation that was passed and *certainly not* out of an altruistic concern for our community. The federal government has turned up the heat on the insurance industry and the industry has done the same to our medical providers. So despite our collective lethargy we may see improved services. Imagine if some of us gave a hoot and put real pressure on our electeds to get us off the bottom of every list! Contact your legislators and tell them to help us climb the ladder! We could easily be 10% improved on all the lists in 4 years - education, healthcare, incarceration, mental health, quality of life...
How about it Las Vegans? Tell the stuffed shirts to climb the ladder 10% a term or YOU ARE OUT!!! Political party is irrelevant!
I had a case of tertiary syphilis, I tell ya the doc was all over it, and cleared it right up.
Fred_Flinstone, we do not have "more obese people...than anywhere else in the country." According to the CDC, in 2008, 25% of Nevada's residents were obese, compared to Mississippi (32.8%), Alabama (31.4%), West Virginia (31.2%), and Tennessee (30.6%). Of course, we are no match for Colorado residents at 18.5%, but we are in the middle of the pack, along with many Western states, such as Washington, Oregon, and New Mexico. http://www.cdc.gov/obesity/data/trends.h...
To avoid moving toward the Mississippi benchmark, we must take steps to redesign the built environment to encourage walking and biking.
Tom Gorman:
"What are your thoughts about insurers telling that to hospitals? That's what we ought to be discussing. Keep it focused, folks!"
When you write a headline with the word "shame" in it, you have to expect readers to respond as they have. A better headline would have included the concept of economic coercion, which is what self-insured employers threatening to take business away from hospitals is.