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

ruralhospitals.chqpr.org

71–80 of 163 posts

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

#71

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.

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

#72
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.

Is there any country with a medical system that people don't complain about? For instance is there anyone in the world that would agree: "Gee, my healthcare is so cheap, it's surprising that it covers everything I want it to without me needing to go out of my way to justify my treatment options and I have so many medical professionals available to me at a moments notice!"

France is #1 in care according to the world health organization for 1/2 the cost per capita. It is all private, well-regulated, and provides universal coverage (your company pays your premium; if you have no employer, the govn't does).

We are #37 according to the world health organization and we cost twice as much.

I'm sure people in France complain, but they have way less of a reason to.

Some reasons for the cost savings: universal, portable medical record, insurance companies have to remit with three business days, reference pricing, one system not medicare, VA, private. Private insurance companies don't make tons of money they are so well regulated...

Old source but still painfully relevant. I have seen these stats elsewhere as well: https://www.npr.org/2008/07/11/92419273/health-care-lessons-...

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

#73

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…

That part of the article makes no sense at all and appears to be pushing a biased political narrative. Private commercial insurers already pay more than Medicare / Medicaid for the same treatments. Patients with private insurance are effectively already subsidizing those on public plans.

Why should the burden of keeping small rural hospitals open fall entirely on private health plans? Perhaps hospitals should advocate for higher Medicare reimbursement rates.

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

#74

Earlier quoted context omitted.

The NHS is one of the most beloved institutions on the planet AFAICT. Of course everyone would prefer if everything were better all the time, but complaints about the US system and clearly not on the same plane as those about UK’s.

Unless you're reading news items about no ambulances or beds, being left on trollies in corridors, waiting lists for procedures lack of available GP appointments. Before covid not as a result.

Just anecdotally, all of these things happened to multiple family members last year, in the US, in a major metro area.

It was sad when we had to use personal connections to get grandma a meal and room after 12 hours in the corridor.

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

#75
post #67
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.

My opinion of VA healthcare dropped a lot living next to a VA hospital. There were a lot of homeless nearby who seemed to be veterans who had come for the hospital.

Seems to me that the problem there is the non-healthcare part of how America provides for veterans (and citizens in general). If the same veterans with the same healthcare weren't homeless...

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

#76

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…

> 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

If 50% are private insurance, what are the other 50%? Wouldn't that other half influence whether the hospital has to close?

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

#77

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.

Its also incredibly expensive (500k) to become a doctor.

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

#78
post #31

This is "too big to fail" logic applied to hospitals. How do our basic life services always become captured by huge organizations that are poorly run and require bailouts by the government? Or is "too big to fail" just a ploy by those organizations to entrench themselves even further in our lives?

Putting on my economist's hat for a second: Services like healthcare inherently have extremely inelastic demand, and are difficult to serve to a large number of people without a large number of resources, which makes it naturally easy to build a monopoly. A monopolicist is incentivized to increase fees and/or reduce spending on the quality of service as long as the demand is inelastic... and here we are.

Admittedly, I never got past ECON 201, so I'm probably wrong on something here.

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

#79
post #59

People here seem to go straight to politics on US healthcare, but does anyone ever stop to consider that this really is a complicated problem? I’ll look at two political extremes: - in a pure-market healthcare situation, these hospitals likely wouldn’t exist in the first place. Health services would be worse than they are now in rural areas, to the point that many probably wouldn’t have “real” health services at all…

I'm not exactly sure what would drive rural hospitals to be a net drain unless they are "built too large" for the population, or are usually empty.

Most of the rural hospitals I know will send you "to the big city" anyway for specialized procedures.

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

#80
post #56

I'm not 100% sure about the conclusion, in which we force private insurers to cover the cost for rural services. I suggest there is a middle ground where rural life is reformed slightly to become economically sustainable. Rural America is in many ways ridiculously expensive to serve, and not just for health care. Consolidating populations into compact towns that have several thousand people fixes a lot of those cost…

This, especially for aging populations (who may lack reliable transportation) and have higher needs
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