Las Vegas Sun

August 22, 2019

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Answers: Clark County:

Health care costs continue to soar

Some say that the millions of dollars Clark County taxpayers pay to care for those without health insurance make a convincing argument in favor of “Obamacare” or some form of national health insurance.

Regardless of the national policy, the county’s funding of indigent health care will continue.

Why is it an issue now?

At Tuesday’s County Commission meeting, elected officials will be asked to augment University Medical Center’s indigent care. The matter arises in a cursory request to add money to the Medical Assistance to Indigent Persons Fund (also known as “Fund 2380”). The request is for an additional $1.1 million.

How much did Fund 2380 receive before the request for additional money?

About $56 million. Fund 2380 is replenished with property taxes.

If the commission approves an increase, it still requires approval of the state Taxation Department.

Is it likely to be approved?

Yes. Commissioner Steve Sisolak said the county has an obligation to care for those in need.

“If there was ‘Obamacare,’ it might ease some of the county’s burden,” he said. Congress approved the new health care law, which will require all Americans to be insured, in March 2010. Since then, it has faced about 20 legal challenges.

The U.S. Supreme Court will likely decide the constitutionality of its most controversial aspect — the requirement that people purchase health insurance or pay a fine.


A typo in a backup document for the commission meeting makes it appear that the Clark County Regional Flood Control District would be saving a whopping 30 percent on construction of the Duck Creek Retention Basin.

What does it say?

That project costs were reduced by $1.696 million to $4.055 million. Missing is a 1 before the 4. So the actual percent saved by reducing project costs is closer to 11 percent, from $15.750 million to $14.055 million.

Still, that’s pretty big. What accounts for the large reduction?

In an email, Gale Fraser, general manager of the district, said that “the county does not need the contingencies that were originally anticipated and funded.” The savings will be used for other flood-control projects, a spokeswoman said.

Does that mean the county can expect those contingencies to be cut from other retention basin projects?

Maybe. Contingency fees equaling 10 percent of a project’s anticipated cost are built into most county contracts. In this case, the extra money wasn’t needed. County commissioners are also paying more attention to the bottom line and trying to ferret out bad expenses, so it could be that contractors are trying to work as efficiently as possible.

But isn’t that where the profit comes in for construction companies?

Not according to our contractor sources. The “real” money comes in the form of “change orders,” which bedevil many a County Commission meeting. After a contractor wins a county contract, the contractor sometimes returns, hat in hand, saying unanticipated expenses crept into the project, so they need more money.

Are you saying change orders aren’t always what some contractors would have the public believe?

Could be.

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