Tue, Nov 18, 2008 (2:06 a.m.)

Nevada typically ranks near the bottom nationally in health care spending per capita. One example was in a 2006 survey by the nonprofit Public Policy Institute of New York State Inc., an economic research organization affiliated with the Business Council of New York State Inc., that state’s largest employer advocacy group.

That survey ranked Nevada dead last among states, with $472 per capita in state spending for Medicaid, the program that serves the medically indigent. That was less than half the national average of $1,015 per person.

Another study, published last year by the journal Health Affairs, covered 1991 through 2004 and ranked Nevada among the bottom five states in combined Medicaid, Medicare and personal health care spending. Nevada in 2004 was found to have spent only 86 percent of the national per capita average on health care.

In that context it was upsetting but not much of a surprise to read the article by reporter Marshall Allen in Sunday’s Las Vegas Sun on Nevada budget cuts that have left the state’s Medicaid program in limbo. University Medical Center says it can no longer afford to provide cancer treatment because of reductions in Medicaid payments. Medicaid cuts, in the form of lower reimbursements to physicians, also may force low-income parents to leave town to seek treatment for children with bone and spine problems.

When you don’t spend much money on a program to begin with, any cuts are bound to have severe consequences.

While a substantial amount of media coverage has focused on the draconian impacts the state budget cuts are having on education, let’s not forget that low-income Nevadans are also being hurt because of the state’s penny-pinching philosophy when it comes to Medicaid spending. The reason that should concern taxpayers is that the money we choose not to spend now on programs such as preventive care and disease management will come back to haunt us later in the form of far higher costs for more acute medical conditions. So much for the virtues of limited government.

“The state doesn’t get off cheap,” Larry Matheis, executive director of the Nevada State Medical Association, told Allen. “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.”

UMC administrators today are scheduled to tell Clark County commissioners about the medical programs the hospital may have to drop because of an estimated $20 million in Medicaid cuts. The commissioners should use their clout as the most powerful body of elected officials in Southern Nevada to convince state lawmakers that they have a humane obligation to shore up Medicaid spending.

Choking off access to health care by cancer patients, children and other low-income individuals is deplorable.