No Matter How Much Money You Make, You and the Poor Have Something in Common

[McCamy Taylor]

Yes, you, the one with platinum plated health insurance through your job. You, the one with all those millions of dollars in the bank and the sound real estate investments (property is always a good bet). You, the socially responsible one who runs the organic farm and makes pretty good money doing it--enough that you could afford "silver" insurance through the ACA. You, the retired teacher with Medicare and a supplemental.

It does not matter if you have health insurance. If there is no place nearby where you can use that insurance in an emergency, you could die.

Just like Portia Gibbs in North Carolina. Four days before her heart attack, the local hospital closed, a victim of lack of funding. So, when Ms Gibbs had her heart attack, it took a Medevac helicopter more than an hour to arrive. She died just as the helicopter was about to lift off. Would she have survived had there been a closer ER?

“Before, she would have been given nitroglycerin, put in the back of an ambulance and been to a hospital in about 25 minutes,” said Belhaven Mayor Adam O’Neal. “In that hour that she lived, she would have received 35 minutes of emergency room care, and she very well could have survived.”

http://www.newsobserver.com/2014/07/28/4036141_rural-hospital-closures-strand.html?rh=1

The pace of rural hospital closures has accelerated in recent years. And while many factors are to blame, one of the biggest is the decision by some states to reject the Medicaid expansion. Take a look at the map of closures in this article and you will see the pattern.

http://www.usatoday.com/story/news/nation/2014/11/12/rural-hospital-closings-federal-reimbursement-medicaid-aca/18532471/

Texas and the Deep South have been especially hard hit. Texas and most of the Deep South rejected the Medicaid expansion. They claimed it would cost taxpayers too much money. They did not mention that rejecting the expansion might cost taxpayers their lives.

When hospitals close, people die. Not just one or two people here or there. Here is a study from California about the effects of ER closures.

http://www.cnn.com/2014/08/05/health/emergency-room-closures/index.html

They found that 4 million of those admissions were to hospitals located near another emergency department that had closed. Patients at the affected hospitals were more likely than patients at unaffected hospitals to be black, Hispanic, female and under the age of 65; they were also more likely to be uninsured or on Medicaid, and to be sicker overall.

Even after adjusting for the different patient and hospital characteristics, however, the researchers found that among inpatients at hospitals affected by an emergency room closure, 5% were more likely to die than patients at other hospitals. The increase in the risk of death for affected adults under 65 was even greater: their risk of dying in the hospital increased by 10% compared with similar patients who were not affected by a closure.

And heart attack, stroke and sepsis patients faced a 15% greater risk of dying in the hospital if there had been a closure nearby, when compared with similar patients at unaffected hospitals.

Keep in mind that the people 15% more likely to die made it to another hospital. If you can not get to the closest hospital because your disease will kill you in 60 minutes after presentation---like, say for instance, a heart attack, the number one killer in the country--- and the closest ER is 90 minutes away, your chance of death is 100%.

Do you hear that? The silence? That is how your heart monitor would sound if they bothered to hook you up to one after you arrived at the closest rural ER by ambulance thirty minutes after dying. But they won't bother. You'll be pronounced DOA, and once you are dead, you will not be able to raise your voice and demand that your state officials do something to improve your access to care. You will be as voiceless as all the poor folks that no one seems to notice got left out of so called "universal healthcare."

So, use your voice while you still have one.