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

ruralhospitals.chqpr.org

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

#131

Post by rtkwe »

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?

A big drain on hospitals are treating uninsured people who they can't reliably collect payment for treatment from. Expanding insurance through public exchanges and wider employer healthcare requirements plus bringing more people on to Medicaid decreases the number of people who are uninsured. There's also the effect that if you catch issues with diseases sooner they're usually cheaper to treat for obvious reasons, same goes for chronic issues that may be poorly managed because the patient can't afford to go to a doctor regularly or keep up with their medication.

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

#132

Post by rayiner »

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.

And in blue states in America that voted for Medicaid expansion we have the same issue. It’s almost as if the problem is escalating costs for skilled workers, lack of economies of scale in rural areas, and wealth/job flight to urban areas.

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

#133

Post by jbm »

rtkwe wrote: post #131
jbm wrote: post #15

Earlier quoted context omitted.

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?

A big drain on hospitals are treating uninsured people who they can't reliably collect payment for treatment from. Expanding insurance through public exchanges and wider employer healthcare requirements plus bringing more people on to Medicaid decreases the number of people who are uninsured. There's also the effect that if you catch issues with diseases sooner they're usually cheaper to treat for obvious reasons, sa…

This is extremely informative. I never lived in the US and was unaware of this possibility. Thank you!

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

#134

Post by dragonwriter »

gs17 wrote: post #126
akuchling wrote: post #84

Earlier quoted context omitted.

I don't see how this is the hospital's fault: they can't keep patients indefinitely. Today's Washington Post has an article on the increasing number of homeless seniors https://wapo.st/3q8Gzeb which includes this passage: "After treatment for an acute illness, hospitals often discharge homeless patients, who wind up back in shelters or even back into their sidewalk tents and makeshift lean-tos, in what health practit…

I would consider it VA not being an example of "it works fine" if they can sometimes get some help after waiting a long time, then get dumped out in the street to rot. Maybe the specific hospital itself isn't at fault, but the program in general is contributing to the exact issue you're quoting, which is more or less what I'm talking about.

Seems to me it is a poverty support/housing problem, not a healthcare problem (which, sure, impacts healthcare, in the same sense that poverty/housing issues impact education and pretty much every other aspect of society.)

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

#135

Post by tstrimple »

bombcar wrote: post #79
HEmanZ wrote: 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.

The same reason rural areas are a net drain in other ways. They have no efficiencies of scale and since everything is spread apart, providing services becomes more expensive and difficult.

https://www.brookings.edu/research/why-rural-america-needs-c...

> "This pattern holds for state government spending, too. Studies in Minnesota, Georgia, and Wisconsin reveal that metropolitan areas contribute more to state coffers than they receive in education, infrastructure, and other public services investments. In Georgia, for instance, metropolitan Atlanta provides 61 percent of state revenue but receives just 46 percent of state investment. State spending on roads, broadband networks, schools, and other public services in small town America is funded, in part, by the economic prosperity of cities."

There's no way the majority of rural communities in this country could cover their own infrastructure costs. Those are heavily subsidized by the state. In the state I live in, Iowa, there are nearly 100k miles of rural roads to support a population of roughly 1 million rural residents. Meanwhile there are about 16k miles of road to support the other 2 million urban and suburban residents. Roughly 1/3rd of those rural roads are considered to be "farm to market" roads which facilitate delivery of farming goods to markets. The other 70k miles of roads are just to support rural residents. And while there's an argument that rural gravel roads are cheaper to build, that ignores the total cost of ownership as those roads need annual maintenance. Even things like electricity are heavily subsidized because residents pay a similar rate regardless of where they live, and rural residents require substantially more infrastructure to get the power to them in the first place. Those additional costs are borne by all residents. At least part of that "cheap rural lifestyle" is paid for by folks living in cities.

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

#136

Post by lowercased »

notaustinpowers wrote: post #129
lowercased wrote: post #123

Earlier quoted context omitted.

Pfftt.. they'll just have a church fundraiser! Then maybe a gofundme to top it off! I had some family members similar to this, and that was their actual thinking. "God will handle it. Our church always helps its folks". 30 years later... well.. pastor's changed, the focus is always on the younger families with kids and... my relatives, now in their 70s... just don't go to their church of 30+ years because "we don't f…

What's so sad is that is what happened to a grandma of mine. I had come out of the closet (she supported me 100%) and she spoke about it to her church friends and talking about how much she's learned in supporting me. Well, I guess one of those friends didn't share the same beliefs. And the pastor met with her and my grandpa and said that they were no longer welcome at the church. The church they've both attended sin…

Amen.

Sorry your grandparents had to deal with that.

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

#137

Post by i2cmaster »

notaustinpowers wrote: post #28
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 have so many rural family members that are like this. And so much of it is because they just actively and brazenly do not want to help anyone. Their individualistic ideology runs so deep that they view people homeless, struggling, or unable to afford healthcare as a moral failing. To them, the system is working as intended. They're cleaning out the moochers and welfare queens. But by the time they notice they need…

[flagged]

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

#138

Post by timbo1642 »

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…

[dead]

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

#139

Post by bcrosby95 »

explaininjs wrote: post #8
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.

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!"

My employer pays $36k/year for my family's health insurance, it doesn't cover everything I want, and we still have to justify treatment options.

Doctor visits are still hundreds of dollars out of pocket.

I'll take 1 out of 3 instead of 0 out of 3.

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

#140

Post by peteradio »

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 doubt you had much empathy to begin with if you can cast it aside based on a passing reading of the title.
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