Rural Hospital Closings Prove Fatal
By Dr. Kenneth Rothaus
A Texas newspaper ran a disturbing story about the ramifications of the closure of rural hospitals. The story may be about Texas but I bet it is not unique and is occurring in many other states as well. As the article points out. the situation in Texas may be worse as Texas is the state with the highest percentage of uninsured. Dannie Tiffin, a 62 yo electrician, suffered a heart attack. Because the closest hospital had recently closed (and that was 30 miles away), Mr. Tiffin had to be taken to a town 60 miles away for care. The EMT in the ambulance had no training besides basic CPR!
The rural hospitals are closing for many reasons:
- Tight state budgets are eliminating funding for many small hospitals
- Medicare cuts were negotiated by the American Hospital Association with Congress during the passage of the AHA. The rationale was that in exchange for “accepting” the cuts, hospitals would spend less on charity care because more people would have insurance.
- Federal health reform mandated penalties for hosptials with too many readmissions
- Federal sequestration included a 2 percent cut to Medicare payments
Unfortunately, the closure of the local hospital proved fatal for Mr. Tiffin. It is an obvious and well-known fact that minutes make a difference in the treatment of heart attacks, strokes, trauma, and many other medical problems.
Rural areas with small populations may not need a full-blown hospital to service their community. One solution might be to establish small urgent care centers with medical personnel (MDs., RNs, or EMTs) trained to resuscitate and stabilize patients with life-threatening illnesses. They could be assisted by data, video and audio communication with physicians from the larger medical centers. Time of transfer could be expedited by helicopter as opposed to vehicles driven on rural roads.
I certainly think this is not beyond the capabilities of a country with our resources and technology. Do you?
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