The ‘safety net’ hospital should not be expected to break even

To the editor:

In reference to your Tuesday article, “Hospital’s future up for debate: Commissioners trying to decide how to reverse bleeding budget”:

UMC is a “safety net” hospital in the broadest sense. In the context of a safety net hospital, it does not lose money. Do we consider the police department as losing money simply because it depends on public money to maintain its solvency?

UMC is responsible to take care of people regardless of ability to pay. Nevada and Las Vegas have one of the highest rates of uninsured in the country. A careful review of the financials of UMC reveal that approximately 55 percent of its patients are unable to pay their bills. Further, it is clear from the hospital’s financials that somewhere between $250 million and $275 million in costs are expended on people who do not pay.

The total operational costs at UMC, including paying and non-paying patients, are approximately $550 million. I would argue that the people of Clark County and the County Commission are in fact getting a bargain at UMC. You state in your article that there is a deficit of $70 million. If you take the position (as I do) that such costs are a responsibility of our community, we are getting a bargain.

It is simply inconceivable that the Clark County Commissioners would abrogate this responsibility. For care that costs more than $250 million, the county and the taxpayers are paying about $70 million. Unfortunately, that leaves no money for capital improvements, putting UMC in a position where it cannot compete for patients who can pay their bill. This must be changed.

I do not believe that closing the hospital is really an option. Sick patients would be left to their own devices unable to pay private hospital costs. It is a strong possibility that if UMC closed, the county would pay substantially more than it currently does.

The hospital is currently discussing a change in governance. Many if not most of the hospitals that were county owned in this country have changed governance. Such a change would in no way materially reduce the cost of serving the uninsured or the uninsurable.

A way must be found to properly fund UMC into the future regardless of a change in governance. Such a change would make UMC more nimble, less bureaucratic and more able to compete into the future. A further benefit would be the hospital’s ability to garner community philanthropic support.

If we would view University Medical Center as a public benefit the way we do police and fire service, we all would be better served!

ANTHONY M. MARION, M.D.

LAS VEGAS

The writer is the former chief executive officer of Sierra Health Services Inc.

Man urged to report hospital

To the editor:

Regarding the problems encountered by patient Ivan Fankuchen at Summerlin Hospital as related by health columnist Paul Harasim (“Hospital visit leaves Las Vegas man feeling downright ill,” Sept. 2):

An independent organization, the Joint Commission on Accreditation of Healthcare Organizations, accredits hospitals in the United States based on quality standards designed to maintain and improve the quality of care in these facilities.

JCAHO periodically inspects facilities and meets with their staff over a several-day period and then issues a detailed report indicating areas where the facility is performing well and areas where improvements can be made. Although the Joint Commission does not have the power in itself to close down hospitals that do not meet minimum standards, JCAHO accreditation is coveted by all hospitals because it certifies that the facility and its staff have met these generally accepted standards of care.

The Joint Commission maintains a website with a place where staff and/or patients can report situations that they believe to be dangerous to the well-being of patients (or staff). I am a health care professional (now retired) who worked for 35 years in dozens of developing countries in Asia, Africa, Latin America, Oceania and Europe to help them improve quality of care. As a result, I am acutely aware of poor quality of care when I encounter it in an American facility.

No hospital in the U.S. should tolerate the conditions described by Mr. Fankuchen, even if they occur “in the old wing.” I myself have seen problems at Summerlin and, though we live nearby, my wife and I have avoided, except under the most exigent circumstances, using that facility.

Please, Mr. Fankuchen, for the sake of all of us who would like to know that we have a high-performing hospital here in the Summerlin area, please take the time to go to the JCAHO website and report what you saw. There is a chance that they will appoint an independent evaluator to work with the Summerlin staff to make the necessary changes. Your neighbors will be indebted to you.

STEWART N. BLUMENFELD

LAS VEGAS