HCCD Report Nevada 89131

Health Care Community Discussion

How many people attended your health care community discussion?

20-25 people

Summary of Responses from Discussion Questions:

What does the group perceive as a problem in the health system?

Because of the group’s particular interest, we discussed trauma, injury care, and public health issues.

Pre-injury: the issue is injury prevention. 33-50% of potential EMS patients die before the paramedics arrive on the scene. Injury prevention of those injuries – automobiles accidents, gunshot wounds, falls, work injuries, and accidental drownings – through education, and public health programs, needs to be part of our health care plan.

Trauma: the issue is payment. Most traumatic injuries occur in 15-45 year olds. These people are often the working poor and can be uninsured. A traumatic injury prevents them from working, thus cutting off entirely, or in part, their family income. Whatever the system morphs into it, injury/trauma treatment and the return to full functionality must be included.

Post-injury: the issue is rehabilitation. Only 7% of Nevada trauma patients are discharged to rehab facilities, yet statistics reveal that one year after a simple limb fracture a staggering 30% of the patients have not returned to work. It is not enough to treat the initial injury, patients must be rehabilitated so they can return to their highest functionality.

Last, it was noted that there was no federal oversight of trauma or burn unit programs. No one was advocating extensive federal regulation, but rather an oversight function that assured consistent, quality of trauma and burn care in facilities scattered throughout the USA.

Were attendees familiar with the types of preventive services Americans should receive? How can public policy help? How can public policy promote healthier lifestyles?

Yes, the group was aware of preventative services available. As President-Elect Obama considers a stimulus package focused on restoring infra-structure, serious consideration should be given to public health issues. The federal government has recently promoted corporate agendas, over than public health agendas. Public services provide the basics of a dignified, quality life for every single American. Public schools; public hospitals; public utilities, including water mains; public water supplies, sewage systems, and waste treatment plants; public parks and recreation; public roads, bridges, and levees; public safety through fire, EMS, and police; as well as public health services (the multiple functions of the federal, state, and local public health departments) have all been neglected, understaffed, and under funded in recent decades.

Public health services are part of the “good” government that we all expect our tax dollars to fund. It isn’t sexy or glamorous, but it allows citizens to head off to work sure that their children are being educated, their family is safe with good food, water, and toys, protected from preventable injuries, communicable diseases, and hazards, and cared for in case of an emergency. Life may not be perfect, but it gives us the feeling that life is good.

Knowing that both jobs and health care funding are significant priorities, it is important to note that the middle class populates most public service jobs. Furthermore, our health care system is built upon consistent, viable public health services. We assume that our water is safe and doctors rarely have to consider that contaminated public water is a disease source. Bolstering the public functions, especially public health, will provide middle class jobs and a basic foundation for any type of insurance/healthcare system.

Public policy can help by:

Setting federal minimum standards that assure health (i.e. reasonable standards for arsenic, medications, and other toxic substances in water; land fill standards for the water table seepage; improved air quality, including car emissions, etc)
Grants to every state and local health departments for missing or new functions, including surveyors and inspectors for expected public services
Health education, for all types of government programs, from nutrition for WIC recipients, basic child care classes, lead testing, and injury prevention

One need only look down the list of functions covered by a state public health department to see where modest amounts of money can be spent to impact every American’s quality of life.

Thank you for listening.