Cuts threaten rural hospitals 'hanging on by their fingernails

[PatrickforO]

Source: CNN

The Senate bill could cut revenues to rural providers by $1.3 billion each year, according to the Chartis Center and its partner iVantage Health Analytics. Roughly 34,000 jobs are also at risk, according to the analysis.

Nearly two-thirds of the lowest performing hospitals are in states that didn't expand Medicaid, according to a previous Chartis report. One case-in-point: the state of Georgia, which did not expand Medicaid and where over half of the state's 73 rural hospitals are in danger of closing. Six have closed since 2010.

Raju knew that Richland's Stewart-Webster Hospital was "financially strained." Even for those patients covered by Medicaid, low reimbursement rates did not make a big enough dent. But Raju did not turn away any patients, even if they couldn't pay, he said. Rural hospitals take a financial hit when they provide care to uninsured patients who can't afford it, said Elehwany. By insuring poorer patients, the Affordable Care Act hoped to remedy that. Despite its positive impacts, she said, it wasn't the magic bullet rural communities had hoped for.

"We strongly support the goals of the ACA," Elehwany said. "Everybody admits there's a few problems with the ACA, and unfortunately ... they seem to be magnified in rural America." Some of these problems, she said, stem from high-deductible plans with rising premiums, as well as few choices on the private exchanges. This may make insurance out of reach for an aging rural population, who are poorer and sicker on average than their urban counterparts, and who bear the brunt of the opioid epidemic, according to experts. Sen. Shelley Moore Capito, a Republican from West Virginia, came out against the Senate health care bill this week for these reasons.

Read more: http://www.cnn.com/2017/06/30/health/rural-hospitals-medicaid-cuts-health-care/index.html

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Funny...all those RURAL voters voted for Trump by wide margins cuz they don't like no city slickers and carpetbaggers.

Ironic, then, isn't it, that those very voters will be f**ked by the very party they support.

As Trump would say....SAD.

[Docreed2003]

1. This is going to be a massive crisis for rural communities across the US

Many of these rural communities have limited ambulance services as well and patients will be forced to travel via private cars to the next closest hospital when their community hospital closes. In TN, a state already hit hard by rural hospital closures, its predicted that most of the remaining community hospitals in upper west TN will close. Most of those communities are an hour or more from the closest regional hospital, which is already working at mass capacity. This will be a massive crisis which will have ripple effects from overwhelming of regional hospitals to the economic impacts of the hospital closure themselves..and that doesn't begin to calculate the patients who will suffer. People will die.

[DURHAM D]

4. I posted this in a thread the other day

re: rural hospital closing and ambulance availability in western Kansas.

https://www.democraticunderground.com/10141806991#post10

[dixiegrrrrl]

6. Rural hospitals are also where mentally ill people are taken by police.

We used to have a free standing MH Crisis center, something like 12 bed capacity, staffed by MH therapists,, able to provide 72 hour hold on suicidal/off mends/drugged people.
The centers came out of legislation in the 1980's, I was involved staffing them in 2 states.

Medicaid funding.
Now no longer funded.
and the local docs who voted for Trump, are asking me...why can't we have the centers open anymore? We need them, too many are coming to the ER and we don't have people to triage/evaluate them.

My answer....ask your ex-governor who was so busy cheating on his wife why he did not defend/allow Medicaid expansion, because state level mental health services are funded mostly by Medicaid.

[Alwaysna]

19. Ripple effect?

More like a tsunami! It will be easier to buy meth than an asthma inhaler or antibiotics. Maybe You Tube will have tutorials on how to set broken bones or how to grow your own penicillin to cure syphilis .Can you imagine the next serious flu or pandemic and they merely tell you to wash your hands and drink water? Do the rich not understand contagious diseases don't care who you are or who your daddy is?

[Skittles]

2. they will get what they voted for

[PatrickforO]

14. Yeah, but the horror of that is that WE

will ALSO get what they voted for. And that sucks.

[Alwaysna]

3. I live in rural USA

and I voted against the Tweediot in chief and being disabled me and my children are on medicaid. I have been so disgusted that I couldn't talk sense to any pro Trump people in my area.

[calimary]

13. Welcome to DU, Alwaysna!

Sorry the plague has to come down on you, too. I feel for the red-staters who really did see reality and didn't vote with the mob. Kinda makes one wonder what it will take to get through to some of the trump rabble. Because they're the ones who stand to be hurt most by what trump and all his little friends in the GOP are leaning toward. He just broke a MAJOR promise with that tweet about "hey, let's just vote for repeal and do the replace part sometime later". I wonder how that's going over with some of them now. Did that wake them up yet?

There are many who will go to the ends of the earth and suffer mightily - rather than admit they were wrong. Or worse - having to admit they've been HAD.

[Matthew28]

5. Yet, they voted 70-80% for the guy that wants them to die

Sad...

These people need to wake up and start realizing that we do need government. They will lose brothers, sisters, dads, mothers, grandmothers, grandfathers because they won't be able to get to a doctor in time because of their own idiocy.

Wake up rural folks!

[msongs]

7. maybe prayer would work. dont need doctors nt

[NCjack]

10. ... or, maybe prayer fails, enough trumpsters die prematurely, and enough are horrified that they

are on the path to die for the GOP that they turn to support the public option single payer. The GOP then fails to control any power center of US Govt for a century.

[dreamland]

8. And yet these tRump voters will never make a connection..

..that they voted for this. They are not told that tRump has supported the cuts to their health insurance. Even when we told them so, they refused to believe it. Can't fix dumb, and their stupidity is hurting a lot of people.

[calimary]

16. Welcome to DU, dreamland!

And yet they did vote for this. And yes, we tried to warn them. We tried to talk sense into them. We tried to be honest. But we were trying to reach people who'd rather believe the lies than face reality. Now, reality threatens to punch them directly in the nose.

[mwooldri]

9. Maybe we're looking at healthcare reform the wrong way.

The thing with the US health care system is that it is all on driving up demand for services. If you get more people on insurance then you get more "customers" and thus health care providers are more likely to set up shop in an area to provide service.

So maybe the solution in rural areas is to have a government Rural Health Authority who hires doctors to staff government health clinics and hospitals. Sort things out on the supply side. If there's enough supply maybe they'll come?

Sure the voters wouldn't vote for it, but we need a solution to healthcare in a way that Apple comes up with products - that we don't know we need them until we get them.

[BumRushDaShow]

20. The model is there with the Indian Health Service

https://www.ihs.gov/aboutihs/

... and could be used as a template.

[benld74]

11. This is 1st mention of rural areas getting hit hard

From Senate bill I have seen by the fake news media.

2 scoops will tweet crazily over this

[brewens]

12. What you would think would really make the shit hit the fan and stay hit! I know one couple,

wife was a nurse at the local rural Washington state hospital and the husband owned a biker bar. Well it was a regular bar most of the time, biker bar when events brought in the riders.

The bar went under and the husband who had nurses training from the military, is now also a nurse at the same hospital. Like may small communities lucky to still have such a facility, if that goes, so do many of the good jobs they still had there. I can name several communities where it's absolutely certain that the hospital pays on average, the highest wages in town and it's not even close! They go under and pretty much all of those people have to move away. Then see what happens. Half the remaining businesses will go under too. In towns where they are still lucky enough to have one real grocery store running, kiss that and those jobs goodbye as well.

[PatrickforO]

15. Yep. Hospitals and schools. Lots of those little towns where they don't want no

big gummint are like that. The only jobs are in gummint funded hospitals and public K-12.

[brewens]

17. Sure as shit not the bars, auto shop if they have one, farm co-op, none of them pay

good. A bar owner makes wages if he can keep the doors open, but not for long either if the hospital goes.

[OldRedneck]

18. Kilmarnock, Lancaster County, VA

Rappahannock General Hospital, recently incorporated into the Bon Secours Hospital System, is about to close for financial reasons.

RGH-BS serves several rural counties on Virginia's Northern Neck. RGH is closing its ICU, ending its traveling nurse and doctor programs, and will not schedule surgery after 3:00 PM.

Patients brought to the RGH ER who cannot be treated there will be held in the old ICU until they can be transported -- by ambulance or helicopter -- to a Richmond hospital -- at added expense to the patient ($40,000 for a helicopter, much of that not covered by insurance).

Thanks to the GOP-controlled Virginia General Assembly, VA did not adopt Medicaid expansion. Instead, Virginia Republicans called on "neighbors and family" to help out.

[beachbum bob]

21. the GOP zeal's in destroying govt will only dig them holes with their base, once the pain

is felt. Rural hospitals serve rural constituent which are majority of conservative voters. Once these people realize their safety net is destroy, the story is going to change. Right now, its racism bloodlust to end everything that assists minorities......in the mind of the conservative, govt help = welfare for blacks, hispanics and illegals...not the whites living in their trailers in the backwoods of Tennesssee, Arkansas or Kentucky....

[AllaN01Bear]

22. we lost our public hospiatal due to a "not for profit" aventist health.

if they go down ,the nearest hospital is a 1 hour away by ground ambulance . that is scary." it took the us 20 years to recover from trumps policies ." lisa simpson.( first 'straight " female prez) cartoon airdate was in the 1980s