They need more customers ...open the boarder ...
that will help
That and the demand for treatment that can’t be afforded by the economic base of the community
so, iow, urban hospitals absorb selected rural hospitals at distressed business cost(?)
One of Boston’s biggest,and most important,hospitals has recently been revealed to be in serious financial trouble.IIRC the Feds just announced that they’ve moved in to monitor and investigate.
Let’s de-populate the land and move everyone into enormous cities! Everything you need will just 15 minutes away! And don’t worry about transportation — you won’t be allowed to go anywhere.
Doctors have told me that when they are on call, have to go in to the hospital and there is a translator then they aren’t getting paid.
Obamacare.
Politicians suck.
Health Care in the USA is effectively socialized/marxist, with a heavy dose of crony-capitalism and 1000 carve-outs for corruption and political favorites
Its so bloated, it CAN NOT be reformed.
What is needed alongside the existing system is to permit medical “free trade zones” - perhaps on Indian Reservations or other “sovereign territory,” where business is done IN CASH, and Fed.gov / FDA rules do not apply.
Rural communities also tend to skew older.
Medicare and Medicaid payments don’t keep up.
Plus, I’m hearing from little birdies in my Upstate NY neck of the woods that utilization rates for just about everything discretionary are through the floor.
People are even postponing necessary treatments/procedures.
Number of reasons for that (including loss of trust, no money for copays and deductibles, foreign heathcare workers), but it all means far less money coming in while expenses for health systems are up big time.
Note to Big Med: You should have brought a longer spoon.
Zerocare is certainly part of it. Big fish eating little fish is another. Big city hospitals went out and bought regional/rural hospitals. Those hospitals were in the business of serving their communities with simple basic care. Not good enough for the megahospitals who want expensive treatments and glitzy medicine over the basics. Since rural folk can’t pay that, they will shut them down.
Anyway, once you are forced into the 15 minute cities, there will be no need for those pesky rural hospitals....
State issue to resolve
One of the things that happened with all of the Covid deaths is that....people are not going to the hospital. Because they are dead. A lot of those folks would have been filling the system for years to come because they were compromised to start.
The second thing that is happening is that people are not having babies. The number of labor and delivery services that are being closed is staggering. In one hospital that I am aware of, they went from 5-6 deliveries a week to 3 deliveries per MONTH. That number is too low for most practitioners to remain “certifiable” over time. The cost of maintaining that service—that hardly anyone is using—is huge.
Covid also brought about a loss in nursing staff. A lot of older, more experienced nurses just retired.
In addition, if you are young or unattached and don’t mind an adventure...the world of traveling nurses became very attractive. A 25 year old nurse with a couple years of general experience can make 3-4X the average “resident nurse” by moving from one contract to the next. Its tough work—but making deep into six figures is fairly common.
And of course, the bad debt in the hospital business is staggering. The current insurance model doesn’t work and people are simply walking away from their bills. Companies are shifting towards “gig” hiring and they won’t provide insurance. These gig employees either don’t buy insurance or they buy high deductible insurance. Then they simply walk away from the deductible.
Of course in cities with high medicaid populations, the hospitals don’t recoup anything. The same would be true with immigrant patients without insurance.
Finally, the state regulators are not willing to adjust to the markets. They force hospitals to retain services (see the Labor and Delivery note above) without any transactions. The State Regulators act like the mafia in the movie Goodfellows: “No babies coming in? Too bad. Staff it anyway.”
The demographics of America is leading to a tough few years. As the boomers pass and the use of services drops, the system is going to contract. The system will have to change to meet the new needs.
Changes in Healthcare in the US don’t move very fast. We are seeing that right now.
1. Limited customer base.
2. Small labor pool.
Item #2 is particularly challenging for health care facilities because they have a need for educated, specialized workers who aren’t easy to find in rural areas.
You can blame this on illegal immigration. The system where I am is good, but they demand payment/co-payment up front for outpatient services. Unless of course, you “No entiendo inglés.”
Who would ant that? ObamaCare Plan at Work...... tic tic...
People are better off without them.
STAY AWAY from hospitals as much as you can.
If you REALLY NEED a hospital, go to a big city hospital where they have the necessary equipment and expertise to be able to help you. Not some podunk hospital.
1. The medical profession is run like a business instead of a profession with business aspects.\
2. A hospital is like a fire department/house: you may not really need it until you really need it, like when disaster hits.
That’s not a bug, that’s a feature.