Las Vegas Sun

May 24, 2019

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Commentary: Thom Reilly on the importance of addressing Nevada’s health care crisis now, before it’s too late

Editors note: In August the Where I Stand column is turned over to guest writers. Last week AARP President Erik Olsen focused on one of the biggest challenges facing health care making prescription drugs more affordable for seniors. Todays columnist, Thom Reilly, will zero in on two other critical health care issues lack of access to medical care and a shortage of health care professionals in the Las Vegas Valley. Reilly, the former county manager of Clark County, currently is vice chancellor for the Nevada Health Sciences Center for the Nevada System of Higher Education.

Despite a sustained period of economic prosperity and substantial job creation in Nevada for the past decade, our state faces serious challenges related to our health care system, including an unacceptably large number of uninsured and underinsured citizens and a serious workforce shortage of health care professionals.

Although there are myriad health care-related issues and concerns in Nevada, I would like to focus on the two aforementioned challenges that I believe have grave consequences and seriously jeopardize the safety of all Nevadans who need access to timely, effective and quality health care.

There are more than 390,000 citizens in Nevada who lack health care coverage. In Clark County alone, the number of citizens without health care coverage exceeds 275,000. These uninsured citizens often defer medical care and preventive services, which in turn jeopardizes their health and the development of their children. Additionally, due to a lack of access to primary health care, there is an over-reliance on emergency rooms for primary health care needs. This is not only more costly, but it also places a significant burden on our emergency health care system, which is already overwhelmed.

Over two years ago, as county manager, I declared a state of emergency at the urging of area hospitals and local health care officials when one-third of our emergency room beds in Clark County were occupied by individuals with mental health illness. These inappropriate uses of our emergency care system place all Nevadans at risk because a bed may not be available should you or your loved one need emergency medical care.

The number of community health centers operating in Nevada is woefully inadequate. Nevada Health Centers is the only federally supported community health center network operating in this state. While it does an excellent job targeting the medically underserved and uninsured throughout Nevada, there remains a critical need to develop a network of strategically placed and financially viable community health centers where the uninsured and underserved may address their primary health care needs.

The vast majority of Nevada's uninsured citizens are employed. There needs to be increased efforts at the local and state levels to expand health care coverage to various populations as well as increase enrollment of eligible residents in private and publicly funded health care coverage programs. This includes creating new venues that allow Nevadans to pool risk and obtain group insurance, making health care more affordable and obtainable.

Finally, the shortage of physicians and health care professionals in Nevada is among the most acute in the nation. Nevada is also one of the least healthy states, as measured by several indicators including heart disease, cancer, death by firearm and suicide. There is a growing recognition that a small medical school with limited programs is currently not meeting, and will not ultimately meet, the needs of Nevada.

A new and expanded vision is emerging in our state with the creation of the Nevada Health Sciences Center. By partnering with the private and nonprofit health care community, and bringing together the health sciences programs including the medical, nursing, public health, pharmacy and dentistry schools operating within the eight universities and colleges of the Nevada System of Higher Education, it will make way for a higher caliber of health care for Nevada and its citizens.

Specifically, the Nevada Health Sciences Center will integrate health care education, research and patient care, resulting in improved community health outcomes, increased biomedical research, enhanced access to research-driven, evidence-based care and disease prevention, and an expanded workforce of physicians and other health professionals.

To be successful, this overall effort will require a significant financial investment and an ongoing collaboration between various public entities, and the nonprofit and private sectors.

There is no question that the future will present a very different set of demands on our health care delivery system to meet our rapidly growing population, which also includes a large aging demographic. Consequently, reducing our uninsured and underinsured population, and aggressively supporting the Nevada Health Sciences Center's efforts to increase the number of health care professionals and provide access to quality health care are critical and vital to our state's future.