Updated 10-25-2009
NEW: Foresight: Sen. Neal used Hawaii as an example in 2002.
Now look who's chiming in.

Rep. Dennis Kucinich, D-Ohio, has introduced legislation resembling Neal Care 2002

Nevada's experiment in hospital cost mitigation worked — so the legislature repealed it, naturally. Download .pdf summary

Neal announces new long term campaign to bring universal health insurance coverage to all Nevadans

Holiday Inn
Reno, Nevada
October 29, 2002

Good afternoon. Thank you all for coming here today.

I am State Senator Joe Neal, candidate for governor on the Democratic ticket.

For the past four years, our ship of state has been without a captain to chart a course which would have protected you, our citizens, from the pillage of many schemes which bore the label of free enterprise or privatization or deregulation. Instead, our state has been left adrift in a sea of exploitation controlled by an elite few.

In past years, we have seen the privatizing of our injured worker insurance system only to see small businesses burdened by increased premiums. We have seen middlemen, such as managed care organizations, taking exorbitant fees supposedly to reduce our medical expenses, only to see a precipitous rise in health care cost.

A number of years ago during the Bryan administration, my colleagues at the legislature were persuaded to do something progressive. We passed a health care cost containment program over the objections of the industry. It worked well, but the powerful were able to muster enough votes several years later to see that it was not renewed (.pdf).

If there is one issue cross-cutting all the others which face us today, it is health care. How many here have witnessed the sight of a senior citizen at a drug store making the painful choice between medicine or food? Last winter, we heard of many cases throughout the state of people having to choose between prescriptions and heat.

Unless we act, Nevada will do what it always does: prescribe a one-size-fits-all Band-Aid for every injury from a paper cut to a gunshot wound.

Nevada has always been slow to move on any progressive legislation. Usually, we just react to a crisis, and often only with the same old box of Band-Aids. Our recent special session did not bring down malpractice insurance rates. It took not one but two fatal high rise fires to get my fire sprinkler bill moving in 1981. We ended up with the toughest fire codes in the world, but only after the state's high rise owners fought us every inch of the way.

Only when most other states have put a proven program in place does Nevada become convinced. Right now, 14 states are pursuing implementation of universal health care for their citizens. Texas, of all places, is the newest on the list. The others are California, Colorado, Illinois, Maine, Maryland, Massachusetts, New Mexico, North Carolina, Rhode Island, Vermont, Washington and Wisconsin.

The most intriguing is the referendum next Tuesday in Oregon. Activists circulated an initiative placing Measure 23 on the ballot. It asks voters to set up a single-payer financing system using progressive income and payroll taxes to provide full health care, including long term coverage, for every state resident. This would include the several hundred thousand Oregonians currently with no health insurance, many of them children.

With Nevada's constitutional prohibition against income taxes, we would have to find other means of financing. I can think of at least one major Nevada industry which is severely undertaxed.

Read more about it

In Hawaii's Health System, Lessons for Lawmakers

The state has had success over 35 years of requiring
employers to provide health care benefits.

New York Times / 10-17-2009
Free registration may be required


One state is not on that list of 14 — Hawaii. Our 50th state has had the closest thing to universal coverage for years. Some say that as many as 98 percent of Hawaiians are covered and the remaining 2 percent are too rich to need it.

That brings me to the federal component needed to enable any comprehensive Nevada plan: state exemption from the Employee Retirement Income Security Act, better known as ERISA.

Hawaii was able to secure an exemption in the 1970s which allowed the state to require employers to provide prepaid health care insurance to any person working more than 20 hours per week.

That exemption allowed much greater flexibility to Hawaiian business and union health care programs. Right now, many of their Nevada counterparts would welcome such relief.

I know of some union health plans which had 18 months of liquidity in reserve last year. They are now down to three months and are having to raise the amount of money their members contribute.

One Las Vegas health care activist told my campaign this week that Nevada has a crying need for an accurate overview of the situation. No one has taken a comprehensive look at comprehensive care. I propose to remedy that the old fashioned way with a bill draft request taking the first steps toward universal health coverage.

The information gathering process may begin now so that by the time the legislature schedules hearings, perhaps the state's health care professionals and reformers will have concrete information upon which to build.

The needs are manifest. Some 400,000 Nevadans are said to have no health insurance. That means you and I eventually pay the bill. Health care is an example case of "pay me now or pay me later." The right question to ask is "What is the cost of NOT SPENDING?

A few blocks from here on the streets of Reno works a man of humble means who sells newspapers on a street corner. He makes a little too much to qualify for Medicaid but not enough to pay for his own health insurance.

Officially, he is an independent contractor. His job provides him no health care benefits and no Social Security matching payments. He's on his own.

Recently, he fell ill. He went to a local health care clinic founded to help people of limited means. But he needs a CAT scan or an MRI. The public service cannot provide it. He cannot afford it. What will be the cost to the taxpayers the day he arrives at the emergency room of Washoe Medical Center?

What will be the cost of not spending?

There will be those who decry any such proposal as wrong because of the timing. The state is already in a fiscal crisis, but that is a dilemma of our own making. Our principal industry spurs growth and creates a large number of low wage jobs. That has finally come back to haunt us.

Read more about it

State study proves liberals and conservatives are both right

Universal Health Care Action Network

Neal challenges governor's actions on LV trauma center closure

A 1999 Guinn-Hunt administration study proves that point. Low-wage jobs place many demands on government, increasing its size and cost.

The time is perfect to study and move forward on a serious and broad-based expansion of health care. If we are in the middle of a comprehensive review of tax revenue, we must also review spending.

No one has looked at the total health care bill and what efficiencies may be achieved through a morecomprehensive system.

If the old-fashioned bill draft request fails to move us forward, there is an even older remedy: the same one used by Oregon consumers, an initiative petition. I will work with a wide range of organizations which are already reviewing this process and looking at an initiative if the legislature is unresponsive.

Let me reiterate the tasks at hand:

     1. On the federal level, exemption from ERISA like Hawaii.

     2. In Nevada, a state prescription drug purchasing program whereby the public could benefit from large volume purchases. The pharmaceuticals could be distributed by county-owned University Medical Center in Las Vegas and by the state health care office in the rest of the state.

     3. At the 2003 Nevada Legislature, a bill to move us toward a comprehensive system so that no one, adult or child, goes without health care. Part of that process will be to develop a broad picture of the resources available and the current amount of spending.

     4. A 2004 initiative petition if the legislature fails to advance the process.

Let me conclude with this: Justice Thurgood Marshall was called the Great Dissenter. He lived to see many of his great dissents evolve into great majorities.

I have seen such things in my 30 years of state service. For instance, two of three Nevadans now support an increase in the gross gaming tax.

There is no work more worthy than promoting the health and well being of our citizens, from the greatest to the least among us. I ask your help in this very important task. Assist me in dissenting from the status quo. Help me form a great new majority for a healthy and prosperous future.

If we stay unbought and unbossed, it can and will be done.

Thank you.


Back to Home Page

Site designed & maintained by Deciding Factors
Comments and suggestions appreciated