Hospital loss for smaller towns in America

[U201491]

.

http://mobile.wnd.com/2014/12/obamacare-blamed-for-killing-hospitals/

OBAMACARE BLAMED FOR KILLING HOSPITALS Closures by the multitude seen as danger to patients, harbinger of future Published: 1 hour ago

46

By Paul Bremmer

Eighteen acute-care hospitals across the United States shut their doors in 2013.

At least 12 more hospitals have closed this year in rural areas alone. More are getting out the plywood to nail over windows and barricades for doors.

Don't worry, it's just the new normal under Obamacare, says Lee Hieb, M.D.

"Events happening now give us some idea of what medicine will be reduced to in the future," Hieb writes in her forthcoming book, "Surviving the Medical Meltdown: Your Guide to Living Through the Disaster of Obamacare."

"Today, all over America, small and midsize hospitals as well as hospitals in inner-city, poor areas are closing," she said.

Hieb is an orthopedic surgeon and past president of the Association of American Physicians and Surgeons.

Read More

 

[albin25]

When laws are written by and for only those that live in the largest urban centers, they have no idea what they're doing to the towns and small cities that make up the largest part of the country. The Flyover States of America don't even enter into their thoughts or plans except as "stupid voters" to be manipulated and then discarded.

"Let them eat cake" has become " Let them live urban"

 

[lonegunman]

People who live in rural areas are more independent, educated, religious and conservative than the current socialist elite. The socialists have made it clear they want to end suburban and rural living and push people back into cities where they can force them to be more dependent on their federal overlords and party masters.
.
The sooner you die and turn your farm into a part of a government ran factory farm,,,,,,,,,,,,,,,,,,,,,,,,,,the faster we go into bondage.

 

[Martini_Up]

The sooner you die and turn your farm into a part of a government ran factory farm,,,,,,,,,,,,,,,,,,,,,,,,,,the faster we go into bondage.

Happy to be in a family of ranchers then, dats fer-sher.

 

[Oregonhunter5]

I am a guy that was raised in the burbs, but have lived in small towns for over 8 years. So I care.
But. Have you ever heard of critical access hospitals? Like in Coquille? And Many others. They get reimbursed way more than the standard in town place. Vendors charge list price at these places.

 

[Stomper]

It's all part of "nudging" everyone into urban city areas because it's easier to control people (and impose things like "street taxes" on them) when they're consolidated into a few areas and are dependent on outside sources for food.

 

[Redcap]

It's all part of "nudging" everyone into urban city areas because it's easier to control people (and impose things like "street taxes" on them) when they're consolidated into a few areas and are dependent on outside sources for food.

Yup. Never going to play that game.

 

[CoastRange57]

But. Have you ever heard of critical access hospitals? Like in Coquille? And Many others. They get reimbursed way more than the standard in town place. Vendors charge list price at these places.

There are very few rural or "local" area hospital care services available anymore. The economy of scale has forced most health care beyond very basic services to be located in regional centers such as Portland, Eugene, Medford, Redding Boise etc. Bend offer some advanced services, but a lot is still flown to Portland.

In areas such as Brookings, Crescent City, Coos Bay, hospitals provide stabilization services and take the patient to the airport so Cal OR Life Network can load them on fixed wing transports to Medford. I monitored a fall rescue on the Smith River in May and the patient with a compound leg fracture received basic scene care and was transported to Crescent City airport for a 20 minute flight to a trauma center in Medford. CVA'a, strokes, internal issues are all treated regionally since no specialists are located in these remote areas.

Follow up care is a 1.5 hour drive each way. Peopel living in these areas have to be willing to accept these situations since they are not changing and time soon.

 

[jvp]

sorry to inform you all this is something that has been going on for over fifty years. as the infrastructure and now the internet have expanded and with the rising cost of health care, malpractice insurance and getting the education to become a doctor the disappearance of small town medical practices and hospitals are the result. that anyone wants to blame it on the affordable care act is just another lunacy of politics at work. to say the government wants us all to live in the city is preposterous at best and uninformed at the least. in one breath i hear people say well that is just capitalism at work but when it hits home then the words are about how the government is doing this to us. capitalism is killing small town medicine. it makes no sense to continue a lose lose proposition when you look at small town american health care. when all the docs from the gunsmoke era are gone then there will no longer be small town medicine.

 

[PiratePast40]

jvp, I agree with you but please learn how to use the shift key on your phone. And by the way, punctuation is free!

 

[bolus]

For most things, you dont want to go to a rural hospital. Lets say you are having a heart attack. They are not going to have a state of the art angiogram suite and they are not going to be able to get you from the door to an open artery in 30 minutes like my hospital can.

for a simple pneumonia or other common admission problem they are going to be fine. But for the most part you want to be at a major hospital. But, its very difficult for small hospitals to stay profitable when all their high billing procedures go to the big hospitals.

I agree with JVP. The whole healthcare industry is like the titanic sinking. the affordable care act is just adding the band to play while it continues to sink.

 

[Sstrand]

They can use the old hospital buildings for the "Final Rites" as dictated by the death panels. . .

Sheldon

 

[Oregonhunter5]

For most things, you dont want to go to a rural hospital. Lets say you are having a heart attack. They are not going to have a state of the art angiogram suite and they are not going to be able to get you from the door to an open artery in 30 minutes like my hospital can.

for a simple pneumonia or other common admission problem they are going to be fine. But for the most part you want to be at a major hospital. But, its very difficult for small hospitals to stay profitable when all their high billing procedures go to the big hospitals.

I agree with JVP. The whole healthcare industry is like the titanic sinking. the affordable care act is just adding the band to play while it continues to sink.

They are profitable. They get more money if they are Critical Access hospitals.
They do a a lot of general cases. Lots of emergencies.
Some spine cases.

 

[CoastRange57]

I am not familiar with the term Critical Access, and I do not know what that covers. My background is in early emergency medicine back in the late 70"s to late 80's, a pretty heady time in field EMS. My wife was a floor nurse for a number of years, and my son is a paramedic.

I just know that my mother in law had to be flown from Crescent City to Medford for a broken hip and another time for a stroke. The hospital at Crescent City simply does not have an orthopedic specialist, or cardio doctor, a good internist, thorasic and neurological doctor. To be a trauma centers requires access to and in the hospital of several types of doctors and teams. This simply cannot exist in rural communities anymore.

Economies of scale and the management of health care systems for bottom dollar results will all ways result in sub standard health care.

 

[Just Jim]

The end will be single payer and the hospitals run like the VA hospitals with long waits and corruption.

 

[Oregonhunter5]

I thought kaiser was the end back in the day?
Critical access works like this. If a facility gets reimbursed by insurance at the rate if $30,000 for a whatever case. The CA hospital gets 60-90$. It's huge. They never talk price with implant reps like me. There's also a lot of hospitals in town, that aren't trauma centers. There has been an influx of specialist head for the smaller towns due to better pay.

 

[Caveman Jim]

Yup. Never going to play that game.

Me neither!!!! I have been raised all over the South and always in small towns and I'll be Danmed if I'll live in a town with more than 3k people...... It's just how I feel and big cities SUCK!!!!

Our Hospital district pulled a fast one on all of us. They got a levy to build a hospital (which didn't need to be built in our town) and after 2 years they were having a time paying for it. So the state said that if it turned into a public hospital that they would be able to "increase the reimbursements for Medicaid patients to match the higher reimbursement rates of Medicare patients. However, the law mandates that the hospital must be owned and operated by a public entity – a hospital district. "
How's that for pulling the wool over the sheeple?
Did I mention we voted 2 times to NOT BUILD THAT DANM HOSPITAL with a majority vote & they still crammed it down our throats!!!!!!

 

[Oregonhunter5]

Me neither!!!! I have been raised all over the South and always in small towns and I'll be Danmed if I'll live in a town with more than 3k people...... It's just how I feel and big cities SUCK!!!!

Our Hospital district pulled a fast one on all of us. They got a levy to build a hospital (which didn't need to be built in our town) and after 2 years they were having a time paying for it. So the state said that if it turned into a public hospital that they would be able to "increase the reimbursements for Medicaid patients to match the higher reimbursement rates of Medicare patients. However, the law mandates that the hospital must be owned and operated by a public entity – a hospital district. "
How's that for pulling the wool over the sheeple?
Did I mention we voted 2 times to NOT BUILD THAT DANM HOSPITAL with a majority vote & they still crammed it down our throats!!!!!!

That's bad news.
Kinda makes you want to go take a crap in the front lobby.

 

[Caveman Jim]

That's bad news.
Kinda makes you want to go take a crap in the front lobby.

And to top It off the parcel they used to build it on they cut down over 50 old growth Fir trees in town!!!

 

[Bazooka Joe]

Critical access works like this. If a facility gets reimbursed by insurance at the rate if $30,000 for a whatever case. The CA hospital gets 60-90$. It's huge.

That's sort of it. Critical Access applies to medicare and not to regular insurance as far as I know. So medicare might arbitrarily set the reimbursement for giving an MMR vaccine at $45 because that sounds like a nice number. But it may actually cost the hospital $75 to buy the vaccine plus another $75 in provider time and $30 in facilities costs. So they lose money if they give a vaccine. Many places now don't give vaccines because it's a money loser. The CA hospitals get reimbursed by medicare at the actual cost (providing that cost isn't unreasonable) -- so they get $180 in this example. Which is huge not in terms of making a profit, but in terms of not having to close down for losing money while being able to provide services to people who otherwise might have to travel an hour or more to get health care. A CA hospital has to be in a rural area more than 35 miles from any other hospital and a few other criteria. We have a CA hospital in our town and it's struggling in spite of that extra reimbursement.

eta: There are some CA hospitals that don't actually qualify under that 35 mile condition because they were grandfathered in under an old provision that allowed governors to add any small hospital that they wanted to the program.