Rural Hospitals and Medicaid Need Our Help
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Medicaid Unwinding Update :(
Nearly a quarter of adults disenrolled from Medicaid in the past year say they are now uninsured, according to a survey released Friday that details how tens of millions of Americans struggled to retain coverage in the government insurance program for low-income people after pandemic-era protections began expiring last spring.
To put a fine point on it check theKFF chart below
20 million of us lost Medicaid coverage, 46 million had it renewed and states are “thinking about the applications of 34 million.
This is an egregious waste of time and money. It causes stress and anxiety for those who don’t know if they have coverage and for those whose coverage was removed.
Universal Healthcare. Cheaper better coverage everyone in no one out. The United States is the only wealthy nation in which a large proportion of people lack health insurance coverage. We should all be able to get and afford the health care we need, when we need it.
ACTION
Let our members of Congress and Senators know what a waste it is to not have Universal Healthcare
Rural Hospitals, Global Budgets and NSP
NSP is National Single Payer HEalth Insurance. 600 rural hospitals, totaling 30% of all rural hospitals in the U.S., are at risk of shuttering. The crisis preceded the pandemic: fewer rural hospitals shut down during COVID 19 due to special financial assistance all hospitals received during the pandemic. But now that the public health emergency has “ended,” rural hospital closures are on the rise.
Note that part of the problem is because it is costlier to provide services to a smaller number of patients relative to the fixed costs of the services. According to the Center for Healthcare Quality and Payment Reform (CHQPR), the primary reason rural hospitals are at risk of closing is that private insurance plans (including Medicare Advantage) pay them less than what it costs to deliver services to patients. The biggest shortfalls are not from uninsured or Medicaid patients, but losses on privately insured patients are the biggest cause of their overall deficits.
Why not use a time-tested, evidence-based solution, like hospital global budgets? Hospital global budgets are used successfully by our own Veterans Health Administration (VHA) and around the world by 16 OECD countries.
Closure of rural hospitals has outsized consequences for isolated rural communities: residents who live in communities where their hospital closes need to travel longer distances for emergency or inpatient care, they lose places where they obtain laboratory tests or imaging studies, and often, their only source or primary care. And for the country, the closure of rural hospitals threatens the food supply and energy production, because farms, ranches, mines, drilling sites and energy facilities are located predominantly in rural areas. Who looks after these workers when they get sick?
According to the Center for Healthcare Quality and Payment Reform (CHQPR), the primary reason rural hospitals are at risk of closing is that private insurance plans (including Medicare Advantage) pay them less than what it costs to deliver services to patients. The biggest shortfalls are not from uninsured or Medicaid patients, but losses on privately insured patients are the biggest cause of their overall deficits.
A study published by Dr. Kahn and others found that single payer with global budgets could reduce 10-year hospital spending by $3.3 trillion while achieving universal coverage and equitable funding of hospital infrastructure. Instituting an integrated health care system like the VHA, away from historically hospital-based, specialty-focused health care to one based in ambulatory care where primary care is at the center of all care, in addition to hospital global budgets, could further result in better outcomes and lower costs.
Global hospital budgets increase efficiency through the reduction of administrative costs such as billing, the elimination of profits, including marketing, and the exclusion of profit-focused expansion. Health quality increases due to the focus on improving and tracking clinical quality processes and outcomes. A guaranteed budget, with necessary adjustments for unexpected increases or decreases in demand, assures stability. Global budgets guarantee equity regardless of the patient population or location and finally, hospital global budgets would ensure hospitals as a local resource to all communities, rural or not. (Thanks to National Single Payer)
Summary
Here we have two stories about the loss of healthcare. In one people are denied health insurance because of procedural errors or they make slightly more than poverty wages. In the other, private insurance companies are forcing rural hospitals to take less than they need for the services or get nothing at all (a common insurance scam).
Either way patients are who are screwed. What’s the answer.? Universal, National Single Payer Health Insurance, like HR 3421.
HR 3421 has the global budgets we described so rural hospitals can stay open and it covers everyone. AND since overhead will drop to about 2% fro the 17% to 20% it is now for commercial policies, it saves $400 billion in the first year and every year thereafter.
ACTION
Let’s remind our Members of Congress and Senators of the problem and the solution.
Their contact info is in the Resources section or you can use RESISTBOT and text SIGN PITOOW to 50409 to send the email below.
“I am your constituent and I want you to know that 600 rural more hospitals are at risk of closing because commercial insurance won’t pay enough. Here is a link so you can read about it. https://nationalsinglepayer.com/april-2024-newsletter/
I also want you to know that according to the Kaiser Family Foundation, using US Government data, 23% of the adults who lost Medicaid due to the unwinding HAVE NO INSURANCE.
Look, Universal National Single Payer Insurance fixes both of these problems. HR 3421 provides global budgets so that hospitals can afford to stay open. It makes sure that Everyone has insurance, and it does it for $400 billion per year less according to the Congressional Budget Office.
I know you’re busy, I know democracy is on the line, but lives of Americans are at risk because health insurance is not serving them well. Please serve your constituents well and cosponsor and actively support HR 3421, the vastly improved Medicare for All Act.”
Resources
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
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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