Saving UMC: Death of tax hike should revive reform efforts

The four-member majority of the Clark County Commission that voted against a property tax increase for University Medical Center last week did the right thing, and not just because residents and businesses can’t afford yet another tax hike. There are myriad policy questions that need to be answered before a tax increase is even considered.

First, proposed changes to the hospital’s governance were short-circuited at the Nevada Legislature last month by a minority on the commission, the very same minority that wants the property tax increase. Although a majority of the commission voted to approve a change in the hospital’s management structure — a change that included a board of directors with experience in health care — the minority testified against that change and helped kill the bill. Improvements to the hospital’s governance weren’t resolved, only postponed.

Second, the uncompensated care at UMC includes big bills for the treatment of immigrants living here without legal permission, who by federal law may not be turned away when in need of lifesaving care. If the federal government won’t enforce or reform immigration laws, shouldn’t it be asked to share in those costs? Perhaps a high-ranking Nevadan in federal office could be found to advocate more forcefully on UMC’s behalf?

Third, is UMC finally doing all it can to collect payment — any payment — from all patients?

Fourth, the county still doesn’t have control of its rising personnel costs across all services. The commission is expected to boost the sales tax rate to fill a police budget hole, pending legislative approval. Commissioners simply can’t raise every tax to avoid tough budget decisions.

Also, as the Review-Journal’s Paul Harasim reported last week, a federal study of hospital prices shows UMC’s are among the lowest in the valley. And that’s not because of cut-rate service, either. UMC has the region’s only Level 1 trauma center and is home to the American Heart Association’s most highly awarded cardiology center. The image of UMC as an aging, urban hospital that caters primarily to poor patients who cannot pay is belied by patients who sing its praises after experiencing top-notch care.

So why not market that advantage? Low prices for high-quality care is a compelling sales pitch. UMC has been trying to increase its number of insured, paying patients to offset the charity care it provides, and a new campaign could help. (The overall lack of transparency in health care costs — most people don’t know what they’re being charged and aren’t able to make rational decisions about purchasing it as they would with any other commodity — still needs to be resolved.)

All these issues must be addressed before the commission resorts to raising taxes to support UMC. The dissenters on the commission would do well to remember that.