Scene in Passing: Spades dig it, clubs can bring trauma

It’s time to call a spade a spade and a club a blunt instrument.

Obamacare is a blunt instrument. It flies in the face of market forces, inviting blunt-force trauma. It tries to club young people into buying what some don’t want, some can’t afford and — despite most needing it eventually — some won’t comprehend until assets make risk management imperative. Coming out of a recession, many late-20s or early-30s Nevadans and Americans struggle with every cost-of-living burden and decision.

Obamacare also tries to club doctors into general practice rather than medical specialities and push physicians into working as part of health care teams in centralized situations, such as hospitals, rather than as private practitioners in business. That might happen, so budding doctors may increasingly choose urban areas elsewhere, even more than currently, rather than come to rural spots in states such as Nevada.

The law of unintended consequences looms large.

The Private Bank by Nevada State Bank recently released a High Net Worth Report analyzing health care challenges and attitudes of well-off Nevadans. Tucked in it was this fact cited by Russell Price, bank president: “Nevada reports only 66 medical specialists per 100,000 residents, compared with the national average of 97.” This invites the wealthy to leave Nevada for health care procedures, he said.

The American Medical Association, meanwhile, projects a national shortfall of 62,900 doctors by 2015, and double that figure by 2025. This comes as boomers retire — including boomers who are doctors — and health care demand surges. Nevada’s medical practitioner plight, general and specialty, will only grow.

Leaders in Carson City, a health care haven with many aging folks, must keep such trends and crosswinds in mind.

Speaking of Carson City leaders, now let’s move to calling a spade the digging tool it is. This city’s Board of Supervisors Thursday begins spadework to find a new city manager because Larry Werner, the current manager, has resigned effective Dec. 19. The digging process takes time, but parameters come soon. One needed parameter: the next city manager must live in the city he or she runs, whether that person is a local or an import.

Werner lives in Douglas County. He wasn’t required to move to Carson City when he was elevated to manager. That was then, this is now. Calling a spade what it is, what was then becomes bad policy now.

Supervisor Jim Shirk, branded wrong earlier in this space for pushing immediately to get a national search firm cracking to find a new manager, is right on the residency issue. He’s calling for a requirement that Carson City’s next manager live in the community. Dig it.

John Barrette covers Carson City government and business. He can be reached at


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