Cancer in Rural America
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Cancer in Rural America
Hospitals and other medical facilities are at severe risk in rural America.
According to the University of North Carolina, 195 rural hospitals have closed or converted to emergency-only care since 2005.
The Center for Healthcare Quality and Payment Reform reports that more than 700 rural hospitals are at risk of closure, which is over 30% of all rural hospitals in the United States. Of those, 360 are at immediate risk.
For rural patients, getting cancer treatment close to home has always been difficult. But in recent years, chemotherapy deserts have expanded across the United States, with 382 rural hospitals halting services from 2014 to 2022, according to a report published this year by Chartis, a health analytics and consulting firm. It is worth noting that those facilities also treat many patients who have blood-borne illnesses as well as Lupus patients. Pretty much anyone who needs infusions.
Texas led that list, with 57 rural hospitals — nearly half of those statewide that had offered chemotherapy — cutting the service by 2022, according to the analysis. Rural hospitals in states like Texas, which hasn’t expanded Medicaid, have been more likely to close, according to data from the Cecil G. Sheps Center for Health Services Research.
To keep the doors open, financially strapped facilities in small communities nationwide continue to shed basic health care services, like obstetrics and chemotherapy.
Loss of chemotherapy services can signal other gaps in cancer care, such as a shortage of local specialty physicians and nurses, which is bad news for patients, said Marquita Lewis-Thames, an assistant professor at Northwestern University in Chicago whose research covers rural cancer care.
Rural patients are less likely to survive at least five years after a cancer diagnosis compared with their urban counterparts, concluded a study co-authored by Lewis-Thames and published in JAMA Network Open in 2022. While the rural-urban survival gap narrowed over the nearly 40 years researchers studied, the disparity persisted across most racial and ethnic groups, with only a few exceptions, she said.
Many cancer drugs are now given orally and can be taken at home, but some treatments for breast, colon, and other common cancers must still be administered intravenously inside a medical facility. Even distances of an hour or two each way can strain patients who already may be coping with nausea, diarrhea, and other side effects. (KFF)
What is needed is more care in rural areas. Here’s an idea. What if there were a way to make sure that shortages were addressed by keeping facilities open. If there were a plan to make sure that the basic infrastructure costs, facilities and labor, were covered so that the services could be available to rural communities - that would help.
Examine “SEC. 611. Payments to institutional providers based on global budgets” of HR 3421, the Improved Medicare for All Act of 2023. It identifies how infrastructure costs would be covered. Then examine “SEC. 403. Regional administration.” to discover that the regional administrators can identify shortages in their region and have the ability make sure that facilities can care for patients correctly using the methods identified in Special Projects section. Here is a link to the text.
My own member of Congress (CD3 WA) and Senators shy away from such a designed system. and favor band aid approaches, like many of yours, but it is time to fix what is broken. The current system allows too many people to suffer needlessly and too many to die too soon.
ACTION
Let’s let our representatives in Washington know that people in rural areas do not have the same access to cancer treatment as those in urban areas and die sooner as a result and that Universal Healthcare has the ability to build back the healthcare infrastructure so desperately needed in rural communities and medical deserts. You can reach them here, https://www.usa.gov/elected-officials.
Or use RESISTBOT via [Apple Messages / WHATSAPP / MESSENGER] or by texting SIGN PLQTAA to 50409 on your cell phone to send this message.
“I am you your constituent and I want you to know that there are so many rural hospital closures and so many facilities no longer offering cancer treatment or infusions in rural areas that it presents a health risk and danger to rural Americans. Many have to spend all day driving to and from treatment and worse yet their 5 year survival rate is lower than their urban counterparts because of this disparity. You and your legislative staff can read about it in this Kaiser Family Foundation Report, https://kffhealthnews.org/news/article/cancer-care-chemotherapy-rural-patients/.
We all deserve to be able access effective treatment and that’s where you can help. I want you to examine HR 3421, the Improved Medicare For All Act. Here is the text for you, https://www.congress.gov/bill/118th-congress/house-bill/3421/text. Specifically, check how global budgets cover infrastructure costs, so cancer treatment centers can stay open. Examine how the regional administrator can determine if there are shortages and people in their area are not getting the care they need, then examine how the special projects section allows them to build up those functions needed, especially in rural areas and medical deserts, to make sure people get the care they deserve.
I want you to actively support universal healthcare, like HR 3421, a system designed to address every American’s access to healthcare, urban, rural, cradle to grave. Without it you are condemning those in medical deserts and rural communities to suffer needlessly. I fully expect you to take action and get this to a vote. Thank you.”
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Done!✅ An issue near and dear to my heart. Have seen in rural and tribal areas where care is simply not available. No car, bald tires, no money for gas, o place to stay overnight or money to pay for a hotel, and no one available to drive the patient the 5 hrs on gravel and lonely highways to the nearest cancer center. It’s a travesty in our nation to so many people. Unless you’ve tried to problem solve helping someone get to their scheduled chemo or follow-up appt, you just cannot appreciate how insurmountable getting this care can be. Thank you for bringing attention to this issue.