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Corporations should not be running hospitals with shareholder profit as the primary goal. Hospitals should be owned and run by the communities, or more likely the state, with the goal of providing the best reasonable level of care.
Medical care should not be for profit.
Medical care, Pharmacy, Schools, Daycare, Elder care, End of life care, prisons.
These things should not generate revenue with the target of making rich people richer.
I'd suggest we add Insurance to the list, but I guess if the things you listed weren't for profit, we might not NEED insurance.
Insurance is an interesting case. You're paying into a loan you might never take out in case an unlikely event happens. The entire reason the companies stay in business is because people never take the money out.
Instead of "insurance", make it work like a mandatory 401k. You have to pay into it, it's yours for retirement, but you can draw against it. Qualifying life events happen you can draw against it up to a point. you can pay it back down.
Quorum Health shut down Martin County’s 43-bed hospital, citing “financial challenges related to declining population and utilization trends,”
We’ll make more money if we let you die.
Yes profit is killing our medical system
Yes profit is killing ~~our medical system~~
No hospital should be run for profit, period.
This issue is a bit more complex than just "hospitals shouldn't be for profit". Not to dismiss that's a big driver here, but there's a lot more going on.
Rural communities tend to have lower insurance coverage, that means for the people who do show up, their debt will eventually go into collections or be completely written off as a loss. Rural communities have vastly less access to better insurance and many just completely forgo insurance altogether.
Additionally, rural communities have a tendency to enter a death spiral between visits and costs. The number of people showing up at the hospital is low, but for the ones that do they show up with incredibly expensive conditions.
A lot of the financing and extended lines of revenue for rural hospitals is tied into the expanded Medicaid offerings under the Affordable Care Act (ACA). There's clear demonstration that states that have opted to not expand Medicaid are the ones overwhelmingly facing hospital closures. States that have expanded still face issues, but states that have not are facing worse outcomes for rural hospitals.
Finally, costs for healthcare have steadily increased at rates that outpace pretty much every program out there. Pharmaceutical companies are ever shifting costs of materials and medication making long term planning difficult. These companies cite new regulation requiring a remixing of their costs of products. Basically, if some state mandates $30 insulin, that makes cancer treatment go up some, massive percentage. So a requirement to reduce cost to consumer in one area induces an increase in cost somewhere else.
And no just telling hospitals they can't drive a profit won't fix the issue. The doctors, insurance, coverage, politics over the ACA, the education of those doctors, the supply chain of the hospitals, and the production of medical supplies all have played a role in this. There's just thousands of things that have to change or we're going to see more of this.
The entire thing is predicated on a completely unsustainable economic model. This system we have is completely unsustainable. It was never sustainable, it's just that the losses had to eventually add up enough to run the thing into the ground. And this isn't limited to just Red States, it's just that the Red States are the ones least prepared for this slowly building problem. This issue is coming for everywhere. There's no hospital that's going to survive this if we do not fundamentally change the system upon which our healthcare is built on.
There are just too many flaws to band-aid here. We have to have a massive overhaul of our system or people are literally going to die. The problem is, that we can't tell who is going to be at the steering wheel to direct those changes. There has to be a shared vision between the two major political parties that can endure for decades to ensure that whatever new systems is made, is actually built. If the two parties that run our government can never agree, hang it up folks, we're done here. I know some people are going to take that as an invite to bash the other party, but at the end of the day, we either all work together or we don't.
We have to have some sort of change to our system like yesterday. It needs to be a massive change that take effect at ALL of the layers within the healthcare system. We cannot keep making minor incremental changes, it's just plugging one hole in the dam only for another one to spring forth.
Biggest change we can make to the whole model is making it non-profit. Hospitals should be patient first in all instances. That is probably the biggest hurdle to clear and then a bunch of the other issues you mentioned will actually be easier to solve. Right now there is too much private equity involved with insurance, hospitals and medical care in general. The costs associated with medical care are outrageous and also need to be addressed.
The number of people showing up at the hospital is low, but for the ones that do they show up with incredibly expensive conditions.
Welp we've literally designed it that way so 🤷♂️
It's not just the financial part. There's still a huge shortage of qualified doctors. Even if you had infinite money to keep rural hospitals open, they couldn't all be staffed with enough doctors.
There's also a management issue. Most doctors are terrible at management, but it's common for doctors to make the bulk of hospital management. Professional managers have the opposite problem as they don't really understand patient care.
This leads to all sorts of odd problems, a notable one is the 12+ hour shift in most hospitals. This was done in part to reduce patient death, because transfer of care is the cause of most errors.
I would note, this is not just a problem for rural red states.
The only hospital in my home town of Eugene, Oregon has closed. It sat just a few blocks from the University of Oregon campus.
People in need of emergency services need to drive miles to the neighboring town of Springfield, 6 miles away, or Cottage Grove, 23 miles.
https://apnews.com/article/eugene-oregon-hospital-closure-a983f5ad1923a7e40e07583fc910cf0b
spoiler
sdfsaf
Yep, and after looking into this a little, affinity health providers is the culprit. They bought the hospital in 2021. ‘Streamlining’ is one of their key phrases on their website.
This is the best summary I could come up with:
When Quorum Health shut down Martin County’s 43-bed hospital, citing “financial challenges related to declining population and utilization trends,” residents here didn’t just lose a sense of security.
People like 73-year-old Bobby Woolard say they don’t believe any politicians – from the local county commissioners to the presidential candidates who will pass through this swing state with big campaign promises in the coming months – care enough to help them fix the problem.
The sentiment in this sharply polarized and segregated eastern North Carolina county could hint at trouble for President Joe Biden, who has made health care a key part of his reelection campaign against Republican rival Donald Trump.
And in North Carolina, the campaign is narrowly focused on promoting Democrats’ successful efforts to expand Medicaid, which will extend nearly-free government health insurance to thousands of people and reduce the indigent population for hospitals.
“Health care is on the ballot this year, and voters will remember that when they reject Donald Trump in November,” said Dory MacMillan, the Biden campaign’s North Carolina communications director.
But with that money spent, hospital closures might tick up again, said George Pink, the deputy director of the University of North Carolina’s Sheps Center’s Rural Health Research Program.
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