THE BURNED OVER DISTRICT

The Las Vegas Sun reports on the consequences of the latest Medicaid cuts in Nevada and it isn't pretty.

Cancer patients who had received outpatient treatment at University Medical Center, for instance, will have to seek treatment at other hospitals and clinics because UMC, citing reductions in Medicaid payments, says it can no longer afford to offer cancer treatment.

Low-income children with bone and spine problems may need to leave Las Vegas altogether for treatment, because pediatric orthopedists are no longer accepting payment from Medicaid because of cutbacks to their reimbursements.

So these good doctors will no longer treat patients when their problems are more amenable to treatment and it is wishful thinking that they can go somewhere else. And this so clearly illustrates the penny wise and pound foolish approach to health care in this country.

Health care experts — including the Medicaid administrator — say the cutbacks are a shortsighted way to save money at the expense of patients who have dire medical needs. Such reductions will lead to increased costs down the road when those patients — having gone without intermediate care — end up receiving costly emergency room care.

Bottom line: Nevada is in the throes of a growing crisis in providing health care for those who can’t afford it, and faces dire consequences in years to come. It’s an ongoing cycle of inefficiency.

The cutbacks illustrate a chronic problem with health care. Health care financing is driven by annual budget cycles that discourage paying now for services such as prevention and disease maintenance, even if the short-term cost will save money in a future budget cycle. Thus, reimbursements are slashed by Medicaid and services are cut by providers to meet immediate shortfalls, even though it will likely increase costs in the future.

“The state doesn’t get off cheap,” said Larry Matheis, executive director of the Nevada State Medical Association, which represents doctors, and a former administrator of the Nevada State Health Division. “It just fails to meet its obligations in a timely way and then has bigger costs. And in the meantime a lot of people have been hurt.”

And in the meantime a lot of people have been hurt. And it is true that people and communities and states don't have the money now, but will they really have it later when the bills are higher? We need universal single payer health insurance , now.