Ill wind -- Local groups fight to put health care on the political radar

Larry Wills, Las Vegas Mercury, July 31, 2003

Nearly three months ago, Ben Contine and his Las Vegans for Affordable Health Care couldn't have seemed more irrelevant. In May, Contine held a press conference calling for health insurance for all Southern Nevadans, 20 percent of whom have no coverage. Trouble was, Contine's press conference was held the same day a citizens task force was seeking ways to bail out the nearly bankrupt University Medical Center, the primary local source for indigent care. One of the solutions was to aggressively collect bills from the uninsured, bills that heretofore had been generally ignored. Expanding coverage seemed the last thing on anyone's mind.

But Contine and company didn't give up. Volunteers walked door to door in local neighborhoods, asking people if they worry about health care.

They do, a lot.

"We have over 8,000 people who signed petitions at the door," he says. Contine and up to 10 volunteers have been hitting the streets since March to increase interest in the issue. His teams have been canvassing neighborhoods three times a week when the weather is kinder.

In the summer, they man the telephones. The feedback they're getting is nearly universal. They polled residents in the area of Nellis and Charleston boulevards, and in the more affluent Peccole Ranch.

"It doesn't matter about the economics of the area. The numbers are almost identical," he says. "Everybody is extremely concerned about health care. We're not seeing any less concern at Peccole than at Nellis across the board."

Contine thinks even those with health insurance may be worried that they may not be covered in all circumstances. And he sees the degree of interest as unique. "I've done some walking for candidates," Contine says. "The majority was always undecided. But with this issue, the positive response is far outnumbering the undecided. More people are actually talking to us."

That may put the issue on the political radar screen. Jerri Strasser, a registered nurse at UMC and an ally of Contine, told a recent forum sponsored by the group that the effort is gaining more attention. "The County Commission has taken note when volunteers go door to door talking about health care," she says. She urged residents to lobby local officials for better care. "Look at their voting records. Look at those with no backbone to do their jobs."

Strasser suggested all local hospitals be required to treat the uninsured and that better ways be found to provide insurance. Many employers can't afford to carry insurance for their workers and "a lot of employers are unwilling to do it. Many of the working poor are making too much to qualify for indigent care. All businesses in Clark County should provide health care for their employees."

Whether that can become a reality is anyone's guess, especially in light of UMC's million shortfall last year, million of which was lost on uninsured care. County Manager Thom Reilly worked on the issue for about four years, heading up a consortium to find ways to improve health care access. Indigent care was improved, thanks to four U.S. Public Health Service clinics in town.

But the uninsured remain a stubborn problem. Reilly has called for establishing a mechanism where small employers can provide employee insurance, noting that there are 300,000 Southern Nevadans without coverage. In the meantime, the uninsured are finding it's harder to escape paying their bills, thanks to UMC's vigorous collection policy.

UMC is already bogged down with the large number of uninsured, Strasser says. "They clog up the system," she says. "They wait a long time before they seek help. Now, access is bad for both the insured and the uninsured. Our chances of getting into the emergency room are very difficult." Compounding the problem was the recent closure of two Quick Care clinics and 170 layoffs, which, she says, further limit access to health care.

And there's the question of how to pay for health insurance if local governments can barely fund their current operations. Robert Fielden, a local architect and urban planner, warned the forum that the health-care crisis will get worse as the population growth continues.

"Our growth consists of a senior population which brings added health-care issues, and the lower-income workers without insurance," he said. Fielden said a fundamental rethinking may be in order, since Nevada is no longer a frontier state. "The libertarian attitude has to evolve," he said. Otherwise, "maybe we should all leave."

Las Vegas for Affordable Health Care is supported by 38 private and nonprofit groups in Southern Nevada.