Rural Health Care Band Aids Don't Cut it

March 1, 2023

Mar 02, 2023

Good Day Healthcare Advocates

I am so thankful for all of you and for the actions you take to move us towards a universal healthcare system. Some of the topics in work are:

Hospice Fraud revisited - this is worse than was reported. I received an update on this from a friend of mine and will cover this shortly (thank you, Dr.)
Rural Healthcare (a little today)
How Universal Healthcare can affect a variety of industries.

Please send topics to me via the chat button and I will research and report. If you need assistance in other ways, lectures, presentations, etc. Just let me know, I’m happy to help.

Rural America Needs Universal Healthcare

About 180 rural hospitals have closed in the last decade. It is a miserable situation that requires attention. Imagine that appendix acts up, you have chest pains, the baby is coming, you’re severely injured and the hospital is 3 hours away.

The federal government designated 80% of rural America as medically underserved in 2019. A Washington Post investigation, then, found that in Texas 59 of the state’s 254 counties have no general surgeons, 121 have no medical specialists, and 35 have no doctors at all.

20% of us live in rural areas and only 10% of the doctors are there. Here is an interesting link to a chart of the US counties with primary care shortages IN 2022. It is huge!!

We have already seen that private equity funds have been squeezing dollars from rural hospitals and forcing them into foreclosure and bankruptcy while the funds make billions.

We have seen administrators try to cover staff positions with mid level providers instead of physicians. That technique results in poorer care, significantly higher readmissions within 30 days, and longer wait times for patients. It does save a lot of money since mid level personnel earn ⅓ of what a doctor earns and the hospital bills at 85% of a doctor’s charge.

Let me point out that if we had Universal Healthcare (like Washington Congresswoman Pramila Jayapal’s Enhanced Medicare for All), this would be addressed. She took care to include sufficient funding to provide care in rural areas in her bill.

However, until we get there all we will have are band aids. Here is one. It is a piece of bi-partisan legislation quietly introduced in Congress recently that claims to try and address the rural hospital closure issue. It’s not even a start.

On February 8th Congressman Sam Graves (R-MO) and Congressman Jared Huffman (D-CA) reintroduced the Save America’s Rural Hospitals Act. They claim its purpose is to rescue rural hospitals on the brink of bankruptcy and help put these critical care providers back on solid ground. Here is a link to the highlights and the bill.

The bill notes that between 60% and 70% of rural hospital funding is often Medicare. The bill would

Remove Medicare for rural hospitals from sequestration (across the board federal budget cuts).
Make Medicare telehealth service enhancements permanent for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs)
Permanently extend increased Medicare payments for rural ground ambulance services currently set to expire December 31, 2024
Expand access to certified registered nurse anesthetists’ services by removing physician supervision

All nice ideas but is not significantly increasing funding to those hospitals except by allowing nurses to take over for anesthesiologists, they charge less but remember they bill nearly what a doctor bills. It would keep funding coming in the event of mandatory government cutbacks. That almost never happens and that doesn’t prop up any hospitals today. And it does nothing for the ones that are ready to close or help open the ones that did close.

Get the picture? This is a sound bite band aid that does not fix rural healthcare. Do you want to fix it? Get your representatives to push through Congresswoman Jayapal’s Enhanced Medicare for All when she reintroduces it in a few weeks.

What You Can Do

Contact your Congressional Representative and ask them to not support the bipartisan Graves-Huffman “Save America’s Rural Hospitals Act”. Ask them instead to be cosponsors the Enhanced Medicare For All Act when it is reintroduced.

You can reach them by phone at (202)224-3121 or by email at this link.

Or use Resistbot instead and just Text the phrase, SIGN PNYMVQ to 50409 to send the message above to your congressperson.

Here is a template text.

I’m _____________(name) and live in zipcode__________. Rural hospitals are a shambles. 20% of us live in rural areas and only 10% of the doctors are there. 180 rural hospitals have closed in the last decade leaving so many without any real healthcare. I don’t want you to support band aid fixes for rural healthcare, like the Graves–Huffman Save America’s Rural Hospitals Act. Instead, I want you to co-sponsor Congresswoman Pramila Jayapal’s Expanded Medicare for All Act.. 70 million Americans need help in rural areas now and we all need Universal Healthcare.