LETTERS: Nevada health care crisis predates ObamaCare

To the editor:

Never missing an opportunity to deride President Barack Obama or his signature legislative accomplishment, it is nonetheless disappointing that a Review-Journal editorial references our report, “Health Workforce in Nevada,” in its latest swipe at ObamaCare and other purported threats to the republic (“ObamaCare Looms,” Wednesday Review-Journal).

Since the release of that study, my colleagues and I have taken great pains to point out that by any measure, and well before the passage of the Affordable Care Act, Nevada had a health workforce crisis characterized by chronic shortages of primary care physicians, nurses and other health professionals. In the best of times, Nevada lawmakers chronically underfunded undergraduate and graduate medical and nursing programs, ignored abundant mental health workforce needs and failed to develop opportunities for Nevada residents in key fields such as pharmacy and optometry.

While neighboring states such as Arizona, Oregon and New Mexico were ambitiously building clinically integrated, state-of-the-art academic health science centers in the 1980s and 1990s, Nevada’s publicly funded health professions programs were barely keeping pace with population growth. The fact that state lawmakers supported the creation of a dental school a decade ago remains a minor miracle considering our state’s pennywise, pound-foolish approach to health education and promoting the public’s health.

One of the most odious features of debates on dealing with the uninsured and the proper role of government in healthcare is that those debates are dominated by policymakers, industry hacks and pundits who enjoy the good fortune and peace of mind that comes with gold-plated health insurance coverage. The daily indignities and financial burdens faced by the uninsured are typically lost in most of these discussions.

At the end of the day, our report underscores the urgency of confronting, not stepping away from, our state’s health workforce crisis, noting that the depth of the longstanding aversion to adequately funding health sciences education in Nevada will soon be exposed, with the anticipated increase in insured Nevadans associated with the expansion of Medicaid eligibility and implementation of the Silver State Health Insurance Exchange in early 2014.

JOHN PACKHAM

Mr. Packham is the director of health policy research at the University of Nevada School of Medicine.