Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

ruralhospitals.chqpr.org

Post reply on HN
Print view View original

41–50 of 163 posts

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#41

Post by zokier »

mikem170 wrote: post #26

How much do we want to subsidize people who choose to live in less populated areas? This will probably come up with roads and utilities at some point, also. Did we build a lot of infrastructure in less dense areas during boom times, similar to how China was recently building, with little regard for the long term sustainability costs? One day some of those currently paved roads in the country may need to be allowed to…

> Perhaps the companies profiting from these activities should pay?

This is how you get company towns, and they don't have exactly stellar history.

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#42

Post by oaktrout »

hn_throwaway_99 wrote: post #6

I don't know how you can realistically look at this without thinking of the "I never thought leopards would eat MY face!!" meme. Politics matters. Voters in rural areas (generally, of course) have consistently voted against policies that would help support health care in these rural locations, such voting in politicians who are staunchly against Obamacare, who refuse any expansion or even adequate support for Medicai…

The article is arguing that private payers don't reimburse rural hospitals enough, not that lack of medicaid or obamacare is an issue. Perhaps your premise is correct but it is at odds with the article, I would be interested in hearing more about why you disagree with the article.

From the article "The biggest problem facing small rural hospitals is inadequate payments from private health plans. Most “solutions” for rural hospitals have focused on increasing Medicare or Medicaid payments or expanding Medicaid eligibility due to a mistaken belief that most rural patients are insured by Medicare and Medicaid or are uninsured. In reality, about half of the services at the average rural hospital are delivered to patients with private insurance (both employer-sponsored insurance and Medicare Advantage plans). In most cases, the amounts these private plans pay, not Medicare or Medicaid payments, determine whether a rural hospital will have to close".

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#43

Post by sophacles »

jbm wrote: post #15
hn_throwaway_99 wrote: post #6

I don't know how you can realistically look at this without thinking of the "I never thought leopards would eat MY face!!" meme. Politics matters. Voters in rural areas (generally, of course) have consistently voted against policies that would help support health care in these rural locations, such voting in politicians who are staunchly against Obamacare, who refuse any expansion or even adequate support for Medicai…

I do not understand how Obamacare would resolve this issue. This seems to be related to the lack of income; how would Obamacare or Medicaid fix this?

The affordable care act and medicade are programs to pay hospital bills for people. Hospital income comes from someone paying hospital bills sent to people who get medical care. Since those programs pay the bills for the people who get treatment, the hospital gets its income.

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#44

Post by DevX101 »

One other factor triggering closures in the article: private equity companies have been on a buying spree for hospitals. The strategy is to buy the hospital, sell the land to a real estate co, and have the hospital pay exorbitant rates to lease the land. After they’ve extracted maximal value, the hospitals that can’t afford the lease are forced to close.

Hospital execs get paid large bonuses for agreeing to deals like this.

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#45

Post by Eisenstein »

wernercd wrote: post #16
hn_throwaway_99 wrote: post #6

I don't know how you can realistically look at this without thinking of the "I never thought leopards would eat MY face!!" meme. Politics matters. Voters in rural areas (generally, of course) have consistently voted against policies that would help support health care in these rural locations, such voting in politicians who are staunchly against Obamacare, who refuse any expansion or even adequate support for Medicai…

[flagged]

You need to do more than just claim 'government caused this', when the hospitals are private and the governments are the ones with the least regulation, while the states with 'more government' are going quantitatively better on all margins. If 'more government' was such the bane as you claim it is, why are the places with 'more government' (that isn't fixated on only enforcing christian norms) doing so much better?

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#47

Post by peepeepoopoo5 »

Loughla wrote: post #30
peepeepoopoo5 wrote: post #24

Earlier quoted context omitted.

[flagged]

>Combine this with a large influx of uninsured, undocumented migrant workers in rural areas I'm sorry to be that guy, but extraordinary claims require extraordinary proof. Claiming that the failure of rural hospitals is due to illegal immigration, even in part, is an extraordinary claim. Do you have anything at all other than anecdotes to back that claim up?

It's hardly extraordinary. This has been a major problem for decades, and it's only gotten worse. I'm sorry it disagrees with your politics, but illegal immigration is bankrupting hospitals. Here is a previous attempt to shore up some of the financial losses:

https://www.cms.gov/newsroom/fact-sheets/emergency-health-se...

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#48

Post by hotpotamus »

syntheticnature wrote: post #4
rqtwteye wrote: post #2

It’s really interesting how the US has managed to get a health system that’s extremely expensive, doesn’t cover everybody, is highly bureaucratic and complex, delivers below average outcomes and has overworked hospital staff. And somehow people defend this system because it works fine for the top few percent (especially the people in Congress) and people who have Medicare or VA.

From talking to veterans I know, "works for people who have VA" might be optimistic.

From my experience talking to veterans, they think the VA is bad until they experience the alternative. But medicine is just incredibly individualized, so it's natural that everyones' experience will be unique.

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#49

Post by one_level_deep »

jorblumesea wrote: post #9

Can we please just implement some level of universal healthcare. The fact that healthcare is tied directly to payers, who fight over how to much to pay, is ridiculous. Imagine your local hospital shutting down because the hospital charged $50 for aspirin but the insurer wanted $40.

[dead]

Re: 30% of All Rural Hospitals in the US Are at Risk of Closing [pdf]

#50

Post by notho »

swader999 wrote: post #19
hn_throwaway_99 wrote: post #6

I don't know how you can realistically look at this without thinking of the "I never thought leopards would eat MY face!!" meme. Politics matters. Voters in rural areas (generally, of course) have consistently voted against policies that would help support health care in these rural locations, such voting in politicians who are staunchly against Obamacare, who refuse any expansion or even adequate support for Medicai…

Yet in Canada we have this same issue.

[dead]
Post reply on HN