Nevada ranks at or near the bottom of almost every list that measures health care. Among the lowlights: poor rates for immunization, cancer screening, and hospital re-admissions. With nowhere to go but up, a group of local doctors say health care reform may be the boost Nevada needs.
Unfortunately, the bad news about health care in Nevada isn't really news at all. National measures of the system's quality, funding, and access rarely show any movement from the bottom rungs.
A group of local doctors suggests healthcare reform may provide the resources Nevadans need to be healthier.
"We're 50th or 51st in nation, DC being the 51st state so to speak, in so many public health measures, it's embarrassing to recount at this point," said Dr. Carl Heard with Nevada Health Centers.
"This isn't a recent development. This was true three, four, five years ago when we were a bustling economy and really had no reason to be at the bottom of these areas," said Dr. Frank Nemec.
The state of health care in Nevada looms like an elephant among a group of local doctors -- Richard Chudacoff, Carl Heard, Joe Hardy, Beverly Neyland and Frank Nemec offer a physician's perspective on the overhaul promising to improve medicine.
The new rules propose to pay doctors for good patient outcomes instead of per visit or procedure, among other changes. "We need to talk about what we're paying for in healthcare. At this point, we're paying for encounters and we're not paying for patients getting better and in fact, most of the study right now indicates the more treatments you get, the less likely it is you're going to have a healthy life," said Dr. Heard.
A shift in focus from encounters to outcomes is among the goals of health care reform. All four proposals provide for an investment in electronic records to improve efficiency, to enhance continuity of care, and to amass data.
"As an individual physician you are going to have somebody looking over your shoulder whether that's the private industry or whether that's the government saying, ‘What did you do?' We are going to be more outcome-oriented, no matter what happens with quote, health care reform," said Dr. Joe Hardy.
Critics contend the shift toward outcomes has already begun, evidenced in part by improved longevity. Reform, they argue, could instead provoke rationing. "I think it's a realistic fear that we already have. Insurance companies already ration care. Insurance companies already prohibit much experimental care to our patients. It's not a covered benefit," said Dr. Nemec.
The doctors believe increased access to care in whatever form it may take will strain a system already plagued with shortages. To strengthen the healthcare workforce, some reform plans provide for additional training. But the doctors fear existing proposals fall short.
"We have to have physicians to do the job. We have to make sure that there's access to care, good quality care, that there's preventive medicine, not just in pediatrics but across the board," said Dr. Dr. Beverly Neyland.
The doctors says the reform effort has all but ignored a key contributor to the rising cost of healthcare -- medical malpractice suits. They say a successful overhaul must include tort reform.
Thursday night we examine how reform efforts may impact local hospitals, including county funded University Medical Center.
