Rural Hospitals and Maternal Services, Good Blood Pressure News
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Rural Hospitals Not Delivering
Less than half of rural hospitals in the U.S. still offer labor and delivery care and hundreds more may shutter services due to financial challenges, according to a new report from the policy firm Center for Healthcare Quality and Payment Reform. 200 have closed labor and delivery centers in the last 10 years restricting prenatal and postpartum support for their communities.
It isn’t very complicated. There is an infrastructure cost the hospital incurs for keeping labor and delivery open, including staff. However, the hospitals are paid on a fee for service basis. Not enough deliveries means that labor and delivery is not a self supporting profit center.
Nationwide, 30% of rural hospitals are at risk of closing due to inadequate revenues. That’s 600 hospitals. The more hospitals close, the more these maternity services will be unavailable, the more likely it is that people will have to travel more than 40 minutes to receive care. Longer commutes to hospitals are associated with higher-risk pregnancies, complications and death, both for the birthing parent and the child, according to the report. Making prenatal care hard to get also increases risk.
The report recommend moving from a fee-based system toward a standby capacity payment model that makes sure the infrastructure is in place.
I know who proposed that - Right it is HR 3421 the greatly improved Medicare for All Act. I’m pretty sure our elected representatives aren’t aware. Let’s let them know.
(Here is a link to a reference news story).
ACTION
Let’s take a moment to let our Senators and Member of Congress know that the loss of maternity services in 200 rural hospitals is putting maternal and infant health at risk and can increase their chances of death.
Their contact info is in the Resources Section Below.
Or Use RESISTBOT to send the email below. Just text SIGN PTJBTQ to 50409.
“ I am your constituent and I just learned that in the last 10 years 200 rural hospitals have closed their maternity services - infrastructure costs are too high for them to be profitable. Another 600 rural hospitals are at risk of closing altogether. This will increase time to get maternity services, and the longer the time the greater the increase in maternal mortality and infant mortality.
Here is the report for you to read. https://ruralhospitals.chqpr.org/downloads/Rural_Maternity_Care_Crisis.pdf
Good news - you can fix it with HR 3421, the much improved Medicare for All Act. It supports global budgets that are regionally administered to provide that infrastructures are in place to serve their community. You have a chance to save women and babies. Step up and implement HR 3421. Thank you.”
High Blood Pressure News
This is big news. A single dose of an experimental drug helped lower blood pressure for 6 months. Here is a link to the full story.
Over 1 billion people globally have high blood pressure. Hypertension places a person at a higher risk for various health issues throughout the body. Salt reduction, diet changes, increased exercise can all help, but there are still many who are unable to get their blood pressure where it needs to be. Over 70% of people with hypertension have a hard time keeping up to date on daily blood pressure medication and they are at risk.
Now a new investigational drug called zilebesiran has been found to be safe and effective in reducing systolic blood pressure in people with mild-to-moderate high blood pressure for up to six months with just one injection.
These findings from the drug’s phase 2 clinical trial were recently presented at the American Heart Association’s Scientific Sessions 2023. After six months, researchers found participants who received zilebesiran were significantly more likely to experience 24-hour average systolic blood pressure reductions of 20 mm Hg or more without needing to take additional high blood pressure medications. Hope springs eternal.
Cutting Down Salt Might Help
A novel study sponsored by Vanderbilt University Medical Center found that a low sodium diet can reduce blood pressure as much as a prescription drug. These findings appear in JAMA Network.
They studied 213 people and found that a low sodium diet reduced blood pressure in nearly 3 out of 4 people compared to a high sodium diet. The decline in blood pressure was independent of hypertension status and blood pressure medication use.
High-salt diets are commonly associated with increases in blood pressure and risk of cardiovascular mortality, even among individuals with healthy blood pressure.
Nine out of 10 Americans eat too much sodium, according to the American Heart Organization and middle-aged and older U.S. adults consume an average of 3500 mg of sodium, which exceeds sodium reduction guidelines set by the World Health Organization. Guidelines are 2500 mg if you have no issues and less than 1500 mg for those with high blood pressure. One teaspoon of salt is about 2500 mg of sodium.
I will try to reduce my intake of potato chips and ramen.
RESOURCES
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Website
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Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
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In the face of an appalling maternal and infant mortality in a wealthy it seems absurd that a needed healthcare service, maternity care, is simply dropped because it doesn't make enough money.
Need I comment on a major city hospital that closed an excellent maternity service to make way for a cardiac intensive care service. Both probably needed but the latter makes much more money.
As you note in your report "The report recommend moving from a fee-based system toward a standby capacity payment model that makes sure the infrastructure is in place."
Those elected officials in Congress would have to be brain dead not to “know” what is happening in their rural districts--It’s about Medicaid. Doesn’t anyone wonder why this nation’s wealthiest spend BILLIONS on the RNC and yet states are pinched for the most basic infrastructure needs?