Good afternoon. Thank you all for coming here today.
I am State Senator Joe Neal, candidate for governor on the Democratic
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
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.
more about it
Health System, Lessons for Lawmakers
state has had success over 35 years of requiring
employers to provide health care benefits.
York Times / 10-17-2009
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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
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
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.
more about it
proves liberals and conservatives are both right
Health Care Action Network
governor's actions on LV trauma center closure
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
Let me reiterate the tasks at hand:
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
If we stay unbought and unbossed, it can and will be done.