So, Nevada has the Senate Majority Leader in its ranks, who is well known for his proclivity towards earmarks - you’d think we’d be rolling in federal loot, right?

Wrong.

Nevada is dead last in money from federal agencies. Why? Well, there are a few reasons:

The reasons included the state’s tight purse strings and demographics.

It often takes a commitment from the state to give money to get federal money, and Nevada isn’t spending the money, administrators say. With Nevada’s percentage of senior citizens isn’t as high as the rest of the nation, there’s less Social Security and Medicare money flowing to the state.

Also, it turns out the Navy doesn’t spend enough here:

While Nevada lags in spending by the Army and Navy, Air Force spending is higher.

Yeah, I know about Fallon NAS, but still… we’re landlocked, people! We have absolutely zero navigable rivers in this state, unless you count the Lake Mead part of the Colorado River that forms our southern border. Of course Naval spending in this state is weak.

Meanwhile, Medicaid in Nevada just isn’t getting the job done, apparently:

Nevada’s Medicaid program — which provides medical insurance for people who don’t have health insurance — is close to having only the coverage required by federal law, said Charles Duarte, administrator for the Nevada Division of Health Care Financing and Policy.

“The bottom line is that we have a relatively basic program,” Duarte said. “When you look at spending per capita on Medicaid services, we routinely rank near the bottom or at the bottom.”

For instance, 28 other states have the Medically Needy Program for people not eligible for Medicaid to deduct what they spend for medical treatment to qualify for Medicaid. The federal government requires state governments to match Medicaid contributions and Nevada does not have money set aside to do that, Duarte said.

Nevada’s lack of Medicaid programs shows up in higher health insurance premiums, said Dwight Hansen, director of financial services for the Nevada Hospital Association.

When people have no medical insurance, their health worsens and they seek treatment in emergency rooms. That care is more expensive and the uninsured can’t pay, so the hospitals have to look for other places to recover the costs for their more expensive treatment, Hansen said.

“That cost then gets shifted over to the only people the hospital can shift it over to and that’s the insured population,” Hansen said.

And as health insurance costs rise, fewer employers can afford it, leaving a higher percentage of the population without insurance, he said.

“You get into this cost spiral that makes things worse,” Hansen said.

One of these days, I’m going to go off on why it’s absolutely asinine we’re making hospital emergency rooms pay for the uninsured. This is the equivalent of saying, “Okay, we know you can’t afford food, so here’s the deal - if you go to a Red Lobster, you get free food. Otherwise, you’re on your own.” Uh… what?! On what planet does this policy even come close to making sense? Yeah, I get that we’re trying to make sure that everybody has some basic level of care and that people in need aren’t getting thrown out of the hospital, but forcing hospitals to throw the uninsured in the most expensive part of the hospital seems somewhat counterproductive to me. Then again, I’m mildly mystified why hospitals don’t just remodel their ERs and have a little community health center right next to it - whenever someone uninsured comes in with the sniffles, they get taken to the community center where, what the hell, they can get treated for “free”, just like the E.R. It would be cheaper for the hospital, I’m sure. Or, better yet, we could just get over this idea that people should be providing goods or services for “free”. That would be helpful, too.

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