Wednesday, April 25, 2001
Copyright © Las Vegas Review-Journal
Group of doctors wants to change way clinics operateBy JOELLE BABULA
A group of local physicians is trying to change the way University Medical Center's Quick Care clinics are operated, claiming the system currently forces doctors out of business and limits patient choice in health care.
The private-sector doctors say they can't afford to offer the same types of benefits and salaries to employees as provided by the county-operated medical center, so competition is impossible. The doctors are pushing two bills in the Legislature they claim would help level the playing field between the 14 Quick Care clinics and the private sector.
One, Senate Bill 355, would force local government to pay fees or taxes when providing goods or services in competition with private entities. The bill applies to all government entities, however, and not simply the health care industry. The intent is to ensure that Quick Cares are not subsidized with taxpayer money if they don't show a profit.
Meanwhile, Assembly Bill 52 would limit the fees health care providers that accept insurance payments may collect from patients. The bill also would require an internal audit of University Medical Center.
"Quick Cares are putting doctors out of business," said Dr. James Hogan, who supports both bills. "UMC has an unfair advantage and patients are losing their choice in care. I've been taking Medicaid and Medicare patients for 15 years and now some of those patients can no longer see me because UMC has an exclusive on them under managed care. These guys are competing with the private sector by using the public coffer."
University Medical Center and its Quick Cares received approximately $70 million in taxpayer funds last year.
Hogan argues the medical center is charged with taking care of the indigent, not routing paying patients from the clinics to the medical center and bypassing private doctors. "If the Quick Cares are supposed to make money for the hospital, why didn't they just open a casino instead to underwrite them?"
William Hale, the chief executive officer of the medical center, acknowledges the playing field is uneven, but says the Quick Cares bring in money every year to the hospital that would otherwise have to come from taxpayers.
The clinics lost $8 million last year but at the same time they provided $17 million to the medical center through referrals, adding $9 million to the hospital's profits.
"There is never going to be a level playing field as long as we have the mandate to take care of everybody and they don't," Hale said. "The Quick Cares save Clark County $9 million a year. They are subsidizing UMC so taxpayers don't have to."
Dr. Brad Walker, head of the doctor's section of the National Services Employees Union, says the union is adamantly opposed to both bills. Walker is also a local Quick Care physician.
"Competition between government and private is always unfair, but there is a logical basis for what was done with the Quick Cares," Walker said. "They were established to bring money to UMC so the county wouldn't have to dump so much money into the hospital. Folks are just going to have to deal with the competition and adjust."