The Eyewitness News I-Team invited every major hospital group in Las Vegas to participate in a discussion about health care reform. Some claimed scheduling conflicts and another said it didn't want to talk about the issue.
Only Kathy Silver from University Medical Center agreed to share her perspective on the reform effort likely to affect us all.
Colleen McCarty: "Do you think we need health care reform?"
Kathy Silver: "Absolutely, there's no doubt in my mind something needs to change."
University Medical Center CEO Kathy Silver sees the evidence on the bottom line of the budget for Clark County's only not-for-profit, public hospital. It's been in the red more than 10 years running, with $200 million last year alone in uncompensated care.
"Part of the financing proposal that's been floated around out there is well, we'll just cut some of the Disproportionate Share Payments to hospitals. Well, we're the beneficiary of those types of funds and without those funds, we couldn't begin to provide a lot of the care we provide already," Silver said.
The disproportionate Share Hospital program, known as DSH, compensates facilities like UMC for the costs of treating low-income and uninsured patients. Cuts to DSH and to other federal hospital reimbursements are one way reform supporters propose to fund universal health coverage.
"The danger to this is if they're driving down costs simply by denying care of reducing reimbursement to providers, then we're kidding ourselves. Because that's going to come back to bite us. If providers can't cover their costs, one of two things will happen. They'll stop investigating in technology or they're going to reduce services," she said.
Reform supporters argue billions in cuts will be off-set by the expansion of health coverage to tens of millions of patients. Many who may be eligible for insurance through government's "public option." That part of the equation gives Silver pause. She argues Medicaid and Medicare already reduce costs on the backs of providers like UMC Yet she acknowledges the potential cost savings created by a pool of paying customers.
Colleen McCarty: "Do you look at this and think if this happens we could be profitable?"
Kathy Silver: "If it happens and we could take care of all of the segments of the population that we're trying to care for, yeah, I think that's a possibility. We're never going to be wildly profitable, but hey we would be happy to break even."
Silver contends health care reform should include a discussion of immigration reform. UMC spends millions on people it believes are undocumented immigrants. The hospital can not say exactly how much because legally it can not inquire about a patient's legal status.
