By Senator Catherine Cortez Masto
America is the only developed country in the world where maternal mortality has increased in recent decades. Almost two American women die each day from pregnancy-related complications, according to the CDC, and more than 50,000 every year suffer life-threatening complications like heavy bleeding or heart attacks. But the maternal health crisis facing our nation disproportionately impacts women in rural areas.
Disturbing statistics illuminate just how hard accessing essential health care services can be for pregnant women in rural communities. Less than half of rural women live within a 30-minute drive of a hospital offering perinatal services. Just 6 percent of the nation’s OB-GYN’s live in rural areas, despite the fact that 15 percent of the population resides in remote communities. That trend rings true in Nevada, where more than two-thirds of rural counties entirely lack obstetric services. And though it has improved drastically under the Affordable Care Act, the uninsured rate remains higher in rural areas, compounding the struggle new mothers face when trying to access quality maternal care. In fact, rural mothers are far less likely to obtain prenatal care during the first trimester, limiting their ability to reduce the risk of pregnancy complications and learn about steps for a healthy pregnancy. Broader women’s health is also invariably impacted, with fewer rural women receiving recommended services like cervical cancer screenings and mammograms. The consequences of these limited maternal services are severe. The heart-breaking reality is that the maternal mortality rate is 38 percent higher in rural areas than in metropolitan areas, and the infant mortality rate exceeds the national average in 51 percent of nonmetropolitan counties.
Nevada’s women and babies deserve better. This administration’s repeated attacks on family planning programs, cuts to Medicaid and rollback of maternal health benefits under the ACA threaten to only intensify the health crisis. Expectant parents have plenty to think about without the added worry of whether they can make the three-hour drive to the nearest doctor or afford high out-of-pocket costs for basic prenatal and postpartum care. That’s why I’m using my voice in the Senate to stop these policies and stand up for rural families in Nevada, and across the country.
I’m fighting at every turn to protect the ACA, which guarantees maternity care and prevents women from being charged more for insurance simply because they’re women. Pregnancy should never be viewed as a pre-existing condition to charge women higher health premiums. The ACA offers critical health benefits like free birth control, cervical cancer screenings and yearly wellness exams. These are services that women in every zip code across Nevada deserve. That’s why I’ve joined resolutions to fight legal challenges to the ACA, and I’ve challenged this administration’s attempts to gut ACA funding. I’ve also supported the No Junk Plans Act to eliminate inferior health plans that don’t offer robust protections for maternal care enshrined in the ACA. And I’ll continue to support any legislation that strengthens the quality of care and provides greater access to maternal health care, like the Healthy Mom Act that expands health care coverage for pregnant mothers and women with postpartum depression. Under this bill, women can change their health care plan when they become pregnant and retain a guaranteed 12-months of continuous Medicaid eligibility after giving birth. Additionally, I recently joined forces with Senator Jacky Rosen to reverse the Trump administration’s decision to bar nurses from providing family planning counseling under Title X – a decision that places significant strain on rural health clinics that may only have doctors and physician assistants on site once a month to counsel women on pregnancy options.
I’m also fighting to protect Nevada’s Medicaid expansion, which is key to expanding insurance to vulnerable pregnant women and has helped rural hospitals and community health centers keep their doors open. Pregnant women enrolled in Medicaid can start prenatal care earlier than uninsured women, and they can receive care for problems like depression and hypertension following childbirth. Research shows maternal and infant mortality rates plunged in states that expanded Medicaid, and I’m so proud that Nevada chose to extend health care to another 200,000 Nevadans through the Medicaid expansion. The uninsured rate in rural communities in Nevada fell by 14 percent between 2015 and 2016, expanding access to critical services for rural women. This has helped shore up rural hospitals that previously delivered uncompensated charity care to low-income patients, like expectant mothers, who would previously have only obtained care through emergency rooms visits. Uncompensated care costs that harmed the operations of rural hospitals have decreased by almost 49 percent statewide. That’s why when the Administration proposed a budget that would result in $130 billion in cuts to Medicaid over the next decade, I fought to preserve current funding levels. I’m also supporting the incredible work spearheaded by the majority-women legislature in Nevada, which recently passed legislation to establish a board to review maternal mortality issues. In states like California, maternal mortality review committees have resulted in a 55 percent decline in maternal mortality rates, and I’m hopeful similar results can take root in Nevada.
Women across rural America deserve access to quality, affordable care for themselves and their babies. Zip codes shouldn’t determine quality of care. We must work in bipartisan ways to strengthen the ACA and Medicaid and pass legislation that improves maternal health, especially for vulnerable women in rural areas. We must stop putting women and babies in life-threatening situations. I’m fighting every day to protect the Affordable Care Act and put an end to the maternal health crisis.
Let’s talk about the failure of the Mesquite City Council to enforce the contractual requirement of Mesa View Hospital to provide both Obstetrics and Pediatric care. I would like to emphasis this was a contractual requirement of Mesa View Hospital, and the Mesquite City Council failed in their fiduciary responsibility to the citizens of Mesquite. Now our young families, besides not having OB services, they do not have a local Pediatric physician to care for their children. What a sad commentary for the future of Mesquite.
The big economic boom that is happening in St George and Las Vegas is bypassing Mesquite. We need affordable housing and we need much better health care. Our for profit hospital is not helping us attract new employers. No pediatrician or OB services is appalling. I am on my way for my yearly check up at Mesa View and I know I will have to get blood work. I know I speak for hundreds of other Mesa View patients when I state that they have the worst run lab in the state. Plan to spend hours or make an appointment for next month. Our city council needs to do a better job in making sure we have adequate health care. As an aside, it took me two months to get an appointment.
David,
You do realize that City Council has absolutely NO say in what happens with Mesa View Hospital’s owners’ decisions on who their health care providers are don’t you? It’s a private business, what doctors, lab techs, housekeepers they hire are their business, not city council’s. Just how exactly do you propose that city council provide better health care services? I think you need to speak to the folks at Quorum Health Care; the people who actually own the hospital. Last I heard, there isn’t a city council in the country that is involved in private business matters except to provide regulatory building/city code inspections and licensing and I haven’t heard of any, especially our city council, that has a hand in providing health care to residents.
And FYI: ANY hospital in any rural setting benefits the entire community regardless of their profit/not for profit status. There are many residents who have moved here JUST because Mesquite had a hospital. You may not like Mesa View Hospital but try getting an appointment at any other location, the time frame will be the same and you’ll drive for an hour or more to get there. Mesa View has provided my mother in the past with life saving treatment, me with a wonderful surgery team during my carpal tunnel surgery, great emergency medical care for myself or other members of my family on numerous occasions and it provides my husband employment with great pay and benefits as it does for many families in Mesquite and the surrounding area.
When Mesa View provided the Maternity services, people still chose to go to St. George. And let’s get something straight, they didn’t give up the ability to deliver babies, they still provide Ob/Gyn services they just closed the “Maternity Ward” and made better use of the beds, staff and equipment that was wasted on the designated “Maternity Ward.” The community made the decision for Mesa View to shut it down because THE COMMUNITY chose not to use it when it was there. You know the saying, “Use it or lose it.” David what would any prudent business owner/manager/CEO do to a department/employee that didn’t hold it’s weight? That was rhetorical, of course they would shut it down for the good of the whole. We’re not talking a minimum wage salary that’s being wasted here David, we’re talking about two 24/7 nurses to staff the department, Ob is a specialty, those salaries aren’t cheap. Then there is support staff like NAs and housekeepers. Let’s talk about materials that are ordered and NOT used which do have an expiration date. Diapers, formula, pediatric specialty stuff…They need to keep them on hand just in case but if they aren’t used, they have to be disposed of…waste of money and that trickles down to our higher cost of health care (they have to make up that loss somewhere) Mesa View is a 25 bed facility, you can’t hold those beds and not utilize the potential they have for making money?
You need to look at the big picture David before you begin criticizing our city council or Mesa View Hospital for everything. There are many articles you can read on the subject, it’s not just happening to our hospital here in Mesquite, this is a nation wide concern these days; it’s been happening for the past several years across the country. Here are a couple of the articles that might enlighten you on the situation: https://www.ruralhealthweb.org/blogs/ruralhealthvoices/december-2017/revealing-the-scope-of-rural-ob-unit-closures; https://www.npr.org/sections/health-shots/2016/02/24/467848568/more-rural-hospitals-are-closing-their-maternity-units.
When it comes down to it David, which would you rather have, a hospital with Ob/GYN services or no hospital in Mesquite at all? When you’re throwing away roughly 60,000+ dollars a month, how long do you think a business would willing or able to sustain that? If the hospital is ever sold, as it’s been a couple times in the past, the next owners may or may not see the need, you never know… but keeping a maternity ward open is a growing concern for the entire population of rural hospitals.
Terri:
Unfortunately, you choose to editorialize without the prerequisite knowledge to offer such opinions. Your position is based on a false premise. Mesa View never claimed they would go out of business if they had to maintain an OB/GYN & Pediatrics services. They wanted to make more money because they were the least profitable services. Also, in official court filings, Quorum Health Care declared under penalty of perjury that all decision were made by Mesa View management. As a business owner, I honor my contracts; it is too bad that Mesa View decided for the sake of convenience to chose to abandon their responsibility to the long term detriment of Mesquite.
David,
I just can’t stand it when people are smug enough to assume they know anything about me and what I know; especially those who have never taken the time to know me and then make public statement trying to make me look stupid. I have been in Mesquite for 12 years, I have seen Mesa View Hospital go through two sales and have been personally impacted by both. My position is not based on false premise of anything. I never said Mesa View claimed they would go out of business, I said “David what would any prudent business owner/manager/CEO do to a department/employee that didn’t hold it’s weight? That was rhetorical, of course they would shut it down for the good of the whole.” I NEVER said anything about Mesa View claiming anything…YOU put those words out there; they’re not in my comment. If your going to argue with something I comment on, please be accurate. It is also YOUR OPINION on what Quorum wanted (more profits) they didn’t personally tell you that, did they? Talk about basing something on false premise.
Quorum did allow Ned Hill to make that decision, they’re a good employer and stand by the decisions of those they put in charge of their hospitals. Think about it David, Quorum didn’t make the decision but they didn’t stop it either, neither did they get rid of the man who did make that decision which tells me that Quorum was all for it and they support the CEO for his decision. It’s not rocket science. What in the world makes you presume I have no prerequisite knowledge to offer such opinions….I personally worked in the health care field…hospitals, nursing homes, labs and private from the time I was 17 years old until I was 36…don’t presume to know what I know about health care institutions of all kinds; I know plenty and I’m certain much more than you do. I believe my education and 19 years in the medical field qualifies me for having prerequisite knowledge. How many years have you devoted to education and working in the medical field?
Quorum, Ned Hill and present Mesa View staff had nothing to do with the original contracts that were signed over two decades ago…that was then, this is now. Present owners, CEO and staff didn’t set those contracts; why should they be obligated to honor them… Again, the community didn’t use it so they lose it; that doesn’t take a rocket scientist or anyone with prerequisite knowledge to figure out.
Rural demographics have more whites and Native Americans, fewer Asians, so people that live longer (genes, diet?) such as Asians live in metropolitan areas – Eureka County is the”whitest” and older, Clark – more Asians and young people. building a 4 lane supper highway between Reno and Vegas would allow for better access and less expensive to medical care. Plus it would have other commerce benefits. Sometimes a simple solution makes moe sense than fancy tele medicine, or subsidizing medical facilities – look at the past rip off Tonopah medical facility.