STATE HEALTH NatioNal health care comes up agaiNst a very sick state. What’s iN it For us? BY DENNIS MYERS
PHOTO ILLUSTRATION BY BRIAN BRENEMAN
Dr. mary guiNaN Was laughiNg.
“Did you see the—I recommend you looking at Jimmy Kimmel Live, this YouTube on ‘Obamacare’ vs. the Affordable Care Act. It’s so funny! They interview all these people and they say, ‘Which one do you support? And they say, ‘Oh, Affordable Care, not Obamacare.’ ‘No, I don’t like anything about Obamacare, I want the Affordable Care Act.’ I mean, it’s sad, but it was very funny.” It’s a quality that so many politicians lack these days, the ability to joke about things that, as issues, they consider serious. Guinan has seen some deadly serious things in her career, but her sense of humor remains intact. She’s a typical Nevadan—a transplant. Born in Brooklyn and educated at Hunter College, the University of Texas Medical Branch, and Johns Hopkins University Medical School, she worked early in her career in smallpox eradication in India. Then after a fellowship at the University of Utah, she became a prominent herpes expert. She was a member of the early Centers for Disease Control team working on what would become known as AIDS. Somehow, in 1998, Nevada bagged her as its first woman state health officer. She said then that though other states had elaborate and planned health systems, Nevada did not, and it was a place where she felt she could help. “I thought I could make a bigger impact in Nevada,” she said. She brought fresh eyes to a Nevada whose health care community was often discouraged by the state’s miserly ways and poor reputation. She didn’t realize then that Nevada’s health care system was not primitive by happenstance. It was by design. For decades, the Nevada Legislature had starved all human resource spending. There has long been a faction in the state that opposes social programs, tried to prevent their establishment, and contain their sizes when they could not be stopped. The legislature would create certain levels of service, and stop there. Conservatives complain that Nevada receives far less from the federal government than it sends to Washington, D.C. The reason, though, reflects back on the state’s conservative policies—Nevada declines to participate in many federal programs, kissing off its residents’ share of federal benefits. “Other states are cutting things we don’t even have,” Sen. Sheila Leslie said in 2011. When the state did participate in federal programs, it was often after years of ignoring problems they addressed instead of dealing with them on a state level. For at least 60 years, Nevadans have found remedies to problems ranging from civil rights to pollution only after the federal government entered the picture. Nevada is one of the most unhealthy states—one of the biggest challenges for the new national health insurance program. If that program works in Nevada, it can likely work anywhere. But there are plenty of people who are so jaded to Nevada’s lousy quality of life that they are not expecting another program to change anything fundamental. Mary Guinan is not one of them. Her arrival in Nevada in 1998 was exactly what the state needed. Endlessly optimistic, she never doubted that the state’s poor quality of life and health could be improved.
“STATE OF HEALTH” continued on page 14
OPINION
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NEWS
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GREEN
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FEATURE STORY
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ARTS&CULTURE
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ART OF THE STATE
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FOODFINDS
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FILM
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MUSICBEAT
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NIGHTCLUBS/CASINOS
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THIS WEEK
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MISCELLANY
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OCTOBER 10, 2013
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RN&R
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