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Insurance plans protect profits at trauma patients’ expense

Guest Contributor
Guest Contributor
Opinion
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By Donna Mack

Last week, an opinion piece published in The Nevada Independent on behalf of the Health Services Coalition, a group of local union self-funded insurance plans urged the Regional Trauma Advisory Board (RTAB) and the Southern Nevada Health District to block the five applications from Las Vegas Valley hospitals, all requesting low-level trauma center designations.

It’s no surprise that insurance payers are scrambling to protect their profit margins and opposing expanding local access to higher levels of care, but as a teacher invested in the wellbeing of our community and dependent on union representation for adequate access to care – their blatant willingness to focus on costs, while ignoring the needs of our growing community and the reality of our state’s emergency response system is concerning.

The author of the opinion piece claimed that “the tragic events of October 1, 2017 proved that we have enough care” and stated that the last time Clark County increased our region’s trauma capacity in 2005 by granting Sunrise Hospital designation as a Level II trauma center and St. Rose Dominican Hospital - Siena Campus designation as a Level III trauma center resulted in “unneeded trauma care” and was a “poor political decision” that should not be repeated.

Nothing could be further from the truth. The unmet need for expanding trauma care capacity in Clark County is undeniable.

One can’t help but wonder what would’ve happened on the tragic night of Oct. 1, 2017 if our state hadn’t made their “poor political decision” to expand trauma care in 2005.  

That night, Sunrise Hospital leveraged their Level II trauma designation to mobilize more than 100 physicians, including physician residents, 200 nurses and six trauma surgeons to perform 58 operations and treat the 212 injured patients received (twice the number of patients treated by our region’s only level I trauma facility) in the first 24 hours following the tragedy.

UMC failed to follow county procedure and called an “internal disaster” alert, effectively signifying patients should be diverted from the only Clark County hospital with a Level 1 trauma center within an hour after the deadliest mass shooting in modern U.S. history. But this communication lapse is just a symptom of a bigger capacity problem; the gap in access to care has been growing for years.

The coalition of insurance plans was wrong to attack the Regional Trauma Advisory Board for reviewing the trauma center applications while “not having completed a needs assessment.” In the past, when members of RTAB have proposed removing the option for hospitals to submit applications at-will, legal counsel advised the RTAB board that they did not believe it was the Health District’s role to restrict trade. The Board is following the trauma needs assessment process -- it has always been the responsibility of the board to conduct ongoing assessments of our trauma system. If the board had enough information to evaluate the trauma applications for reauthorizations that were approved last July – it should be in a position to process the trauma applications without further delay.

I know that some critics opposed to expanding access to local trauma care join the insurance plan coalition in their belief that time in transport is not important to all patients, but when I look around at the students in my classroom, it’s hard to justify that to them and their families. I earnestly hope the Health District’s Regional Trauma Advisory Board and Board of Health remembers that as they’re distracted with unnecessary discussions about the process intended to delay a decision, there are real lives on the line.

The last time Regional Trauma Advisory Board and Board of Health considered applications to expand trauma care, a member of the Southern Nevada Health District staff was asked what would be the tipping point that would make it clear that we need another trauma center, to which he replied “an increase in mortality.”

The idea that the Health District’s Regional Trauma Advisory Board and Board of Health should wait and watch for more fatalities before reviewing applications seeking to start the two to three-year process to establish another trauma center is unacceptable. If we continue to wait, the consequences could be fatal. Shame on us for taking that as an acceptable reason to delay expanding access to trauma care in 2016 – we can and we must make this decision about patients not the process this time.

Donna Mack is a retired Clark County School District teacher.

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