Mood:  energetic

Dr. Steven Saxe D.M.D.

Posted by saxe4senate at 3:39 PM PST
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Mood:  vegas lucky

Dear Fellow Nevadan,

     We can no longer wait to have the incumbent legislators fix the problems that Nevadans will face in the future. My “platform”, it is one of common sense.  I plan to introduce common sense legislation.  Nevada’s constitution is antiquated.  Since 1864 relatively little has changed in Nevada, the fastest growing state in the US for decades, yet our legislators have failed to keep up with a demanding agenda to meet the needs of more than 2 million people.  From the Gold mining and Banking tax exemptions to the Biennial Legislative sessions,  to conduct the overwhelming legislative agenda in 4 months every 2 years and not updating our constitution makes little sense.  I guess the term limit initiative was a start but we fall far short of the needs of our dynamic state.            

   In the Nevada Assembly and Senate many of the incumbents have held office for too many years. We in Nevada have had many prosperous years with a surplus of funds for the state to spend on investing in programs to protect and improve our education, the majority of our budget, to secure Nevada's future. Where were all the incumbents then? Perhaps catering to special interests or allowing for wasteful spending or looking for lucrative offers from Lobbying firms or big corporations. Bottom line they were more concerned with their personal agendas instead of thinking out of the box on PROACTIVE legislation to protect our educational system, which was in the dungeon then and in a deeper hole now. Why then all of the sudden would these legislators be switching their political views or political positions from Senate to Assembly or vice versa, to bail out the state from all of their past errors in judgment and lack of PROACTIVE legislation? They had their opportunity. It is time for a new more intelligent force to come in to clean up their mess, considering they overlooked an $887 million dollar deficit less than a year ago. What makes anyone think that they can fix a mounting deficit that will be twice that in amount in 2011? Our children do not have the time to waste as our governor and legislators play politics. We cannot continue to hastily decide in 120 days every 2 years on our children's future as the legislators overwhelm themselves with bills directed for only their gain or special interests and not for the well being of all Nevadan's.            

   The most disturbing thing to motivate me to leave my practice for 4 months every 2 years is that our legislators have the audacity to have left Carson City in June of 2009 knowing full well that our state was facing a tremendous budget deficit of $700 million. Not to forget, in 2007 they left with $50 million increase in spending and increased the tax burden to Nevadan’s by 19% and business with an increase of 1%, and unemployment at about 9%, instead of looking at the wasteful spending as our growth was beginning to level off.  Additionally, June of 2009 our unemployment was creeping up to our current 13% and we were not as deep into this mess as we are now, lower volume tourism, foreclosure crisis leading to a decrease in tax revenues.  The legislators don’t get it, raising the sales tax to 8.1% percent did little to help when we have a narrow base to collect on.  As tourism decreases and 40% of our tax base is derived from goods linked to that industry and our decrease in consumption as residents, obviously the coffers will suffer greatly and as the decrease of new home construction which accounts for another 20% of our tax revenue, we cannot accurately project 2010 or beyond.   On the other hand the crisis may be good.  It has forced all of the state agencies to look at themselves under a microscope to operate with much leaner budgets and clean up waste in the system, improving efficiency.  Nevada has some of the lowest taxes in the US, we also have the lowest per capita spending on state services.  The former is what brought many of us to this state.  Even with this “tax incentive” our economy has become LESS diverse over the years, and the key to diversifying our economy is to bring High Tech and other businesses to Nevada.  These businesses currently go to other states even with higher taxes because their employees and their families have a better place to live because of their superior educational infrastructure.  This not only provides an incentive to the families of these businesses who can obtain an excellent education close to home but it provides a network for these businesses to expand research and development of their systems and products.  It is time to use our common sense!       

      My most important issues are Education and Health Care for obvious reasons, and the areas that I feel that I have the most knowledge in.  To begin with the majority of Nevada’s budget goes to the support of our education and health care, both of which have been far less than mediocre for decades.  Recently, last year our state was offered a large federal financial incentive given to the most poorly performing academic states.  One of the stipulations was that teachers would be evaluated and incentivized on their students performance and other minor changes to our current system.  It fell on deaf ears because of “politics”.  We now saw the politicians scrambling in the “special session” to pass legislation to change the rules to accommodate this obvious “no brainer”.  Again, nothing PROACTIVE being accomplished in Carson City, it is always reactive to the myriad of problems that face our state.  Even with education being our major expenditure our system is badly broken and requires an extensive overhaul not only K-12 but our system of higher education.  Only 21.9% of our state’s population over 25 years old has a bachelor’s degree or higher, 7% have an advance degree which ranks at the bottom of the US.            

     In Clark County we currently spend $12,307 per enrolled student of that $2,143 goes toward repayment of debt.  We are out spending some of the highest performing school districts in the country and getting little for our investment.  It is time again for “common sense” tactics to be implemented. The first would be to start at the top.  We have too many administrators and too big of a school district with ridiculous waste.  We need to look at the numerous working models across the U.S. that will give us a more talented 12^th grader with a limited and more effective budget. There are many examples some of which we do utilize, for example charter schools.  The cost for a private education in Clark County mirrors that of our public system, without the waste.  So, let’s implement a voucher system to address cost containment and improve efficiency.  I am sure it can be done for less than $10K per student.  As of 2004 only 15% of private schools in the U.S. charged more than that for a year’s worth of far superior education than what are children receive today.  Considering that 24% Clark County graduates require remediation in reading and math at UNLV and UNR which ads further to the costs of our inefficiencies.

     Education goes hand in hand with health care.  The federal government does control our healthcare on the state level. The current Federal health care bill will of course surely die.  Nevada must work to fix our own system first.   The current state of health care is not being measured and examined appropriately. The true problem lies with the insurance company’s lock on the system, they own the votes of congress to maintain their hold on society.  We must level the playing field by passing laws in our state to stop their hold on the system, which ultimately manipulates society.  Profits at 10 of the country’s largest publicly traded health insurance companies rose 428 percent from 2000 to 2007, while consumers paid more for less coverage. One of the major reasons, according to a new study, is the growing lack of competition in the private health insurance industry that has led to near monopoly conditions in many markets in the US including Las Vegas, where if you are a health care provider you must take Unitedhealth or one of their subsidiaries in order to make ends meet in our community as a practicing healthcare provider or work as a slave to the insurance companies. The insurance companies claim they have meager profits… the truth of the matter is they hide behind a huge self-inflicted bureaucracy to hide huge profits and to deny benefits to their insured. The majority of their funds go toward their lobbying expenses and their executives all making 7-9 figure salaries yearly. The most outrageous account of these ridiculous salaries occurred in 2006 when United healthcare CEO William W. McGuire was forced to resign due to securities fraud, and was finally given more than a 500 million dollar severance pay.  While the guy who is paying his insurance premiums on a timely basis cannot even get a $1,500 MRI approved for his child who gets frequent headaches. Go figure… As I see it.  We have 2 choices #1. We have socialized medicine which cannot happen in our free market system, or #2 we fix what we have by making the insurance companies function by the same set of rules that we run our businesses under. When people’s lives are at stake there must be limitations on the lobbying of legislators they out spend the public and the doctor organizations by a wide margin the first quarter of last year.  Last year $1.4 million per day was spent on healthcare lobbying, a billion dollars since 2007.  How many lives could have been saved, how many families made whole, how much pain could have been avoided with that billion dollars.      As you know it starts with education, when one works especially hard to achieve the great accomplishment of being accepted into a Medical or Dental school it comes at a great price. The fact that a Medical or Dental education costs in excess of a quarter million dollars. The controller of the federal purse strings to pay doctors, Medicare/Medicaid insurance system, then drives these newly trained doctors to become specialists, who seek private patients in lucrative areas, this leads to a shortage of general practitioners and creates a shortage of primary care doctors and educators, which place a burden on the system to provide care to the poor and underinsured. Doctors have been funneled into this system for many years, needing to cater to only those who could afford insurance benefits or live in affluent communities; so doctors can pay their high overhead expenses and their educational loans, which now leave us in our current crisis. This is only a part of the problem, the following is a list of some of the healthcare system conflicts that must be addressed on each level with experts in their respective fields coming to the table to formulate a common sense approach to resolve current our system.                    

     Hospital Issues • Patients uninsured and underinsured • Insurance company reimbursements • Federal and State regulatory issues • Medicare and Medicaid reimbursements CMS • The joint commission on accreditation • Access to electronic medical records • Emergency / Trauma/ Mental Health} coverage and dumping • Performance pay / complication rates • Liability costs

Health care provider Issues • Medicare and Medicaid reimbursements CMS • Insurance company reimbursements Monopolies, HMO • Costs of Education/ quality of calibration of US higher education • Costs of Malpractice insurance • Government regulation HIPPA/OSHA • Access to electronic medical records • Performance pay • Providing services to the Uninsured 

Insurance company Issues • Limitations of eligibility and coverage, lack of prevention / Pre-existing conditions • Doctor fraudulent billing practices/ bundling and unbundling • Fraudulent claims of patients • Government regulations • Providing qualified practitioners • Mental health coverage • Chronic illness continued care/ Nursing Home long-term care • Workman compensation • Cost of medication • VA medical system 

Pharmaceutical company Issues • Cost of R&D • FDA/ Regulation • Liability costs • Quality control/ drug re-importation • Why pay to advertise to lay public? They should instead promote their products through sampling AND THE EDUCATION OF DOCTORS. Doctors waste a lot of time explaining why a patient does not require a medication seen on the news last night.            

    I know that this proposal is immense but we must be allowed to properly debate the solutions to these problems without the influence of special interest to corrupt the final product.  This is only an outline of the problem but, I feel that it is necessary to begin addressing the details of all of these issues in order to properly correct this monumental mess, they will not be corrected in a 2,000 page bill, written by the insurance companies, that even the people who wrote it cannot explain.      

    In Nevada, for example we need to have more transparency of Insurance companies profits requiring only 10% of insurance premiums be spent on administration and the remainder spent on patient benefits. We need to repeal the McCarran-Ferguson Act exemption from federal antitrust laws. A higher reimbursement for those doctors who serve the poor and indigent. Your doctor needs to concentrate on your health care needs to bring you the state of art care that you deserve, and not focus on how many patients they need to see in one day to make ends meet.  The list goes on, I am open to your suggestions to make real change to revolutionize health care in Nevada.  These issues can only be addressed by having legislators who are educated and are familiar with these specific problems formulate solutions. The current state legislators in Carson City are poorly educated on these issues and rely on special interest to give them information on how to formulate legislation to benefit their profits, not your health.

   As Yucca mountain goes…How about turning this governmental money pit, into one of the biggest Nuclear, Solar and Wind energy farm in the country and Exporting energy to California, Arizona and Utah.     

     I hope that this helps you to see some of my platform.  I have no personal agenda I currently have been practicing for the past 18 years, I have a career, I do not want to be a politician.  I will become the District 9 Senator because I have a deep personal passion for the improvement of our state.  I really feel the next legislative session will require fresh new minds to deal with the massive problems of our state.  I do not have all of the answers but I am smart enough to listen to the people who for vote me, and to be inspired by their innovating ideas. I look forward to talking with you via my Blog page. I would also encourage you to tell your friends about me and vote in the primary as a fellow Democrat on June 8^th, 2010.  If you have any questions please feel free to contact me at any time.  

Respectfully submitted,  

Posted by saxe4senate at 3:33 PM PST
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