Discussion for article #234085
This is definitely the kind of thing that needs to be looked at very carefully. Depending on just where you are, 35 miles as the crow flies may be an awfully long way to travel. (Same thing with the transport costs – moving a patients safely by ambulance can cost several thousand dollars, which would eat quite a bit of potential savings.) In some cases you could definitely save money and do better for patients by moving to a skilled nursing facility instead of a hospital. But one of the problems with trying to slice budgets is that you’re also getting rid of the caseworkers and managers who can take the time to make these decisions properly.
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Another reason why healthcare policy is not easy.
Hopefully the coverage of this issue will be more nuanced than the typical gotcha! over the discovery of apparent over-spending for healthcare service.
Yes, there might be savings realized in having patients rehabilitated at non-hospital facilities at a lower rate. However, in isolated rural communities, there may be a relative lack of available facilities; for many of these small towns, it is the local hospital that provides the bulk of these services, and conditions might not exist to promote the development of additional facilities.
And in states that refused to expand Medicaid, safety-net hospitals already are facing enormous financial challenges.
The situation is similar for healthcare personnel. For many practitioners who might be interested in being a small-town country doctor, the sense of professional isolation, and a relative lack of a variety of modern and well-resourced practice settings and professional advancement opportunities, among other factors, outweigh the benefits of rural practice. For some, simply completing mandated continuing medical education courses entails shutting down your clinic and traveling to a hospital or medical school campus in a metropolitan area for several days.
And throwing money at the problem is not always enough. There have been programs implemented that provide partial tuition reimbursement to medical graduates that complete a few years of post-graduate service in medically underserved communities, but often, these young doctors leave soon after fulfilling their service requirements.
I don’t have any answer to this dilemma, but feel there is a role for the public sector to strengthen the safety net to support measures to recruit, train and retain healthcare providers in medically underserved rural and urban areas. Things like providing library resources and continuing medical education to isolated providers, exposing medical and other healthcare students to the challenges – as well as rewards – of rural practice, and promoting the affiliations and networking linkages between isolated primary care and rehabilitative centers and metropolitan county hospitals and government and non-profit agencies that coordinate care and referrals. Healthcare reform is already making some of this possible, but more needs to be done. For too many, the problem is simply obtaining access to care, not the level of quality of the care itself.
Government waste can’t just be viewed as x or y. There is a clear reason for the difference. The necessity of the rural hospital care is no different than that in a metropolitan area, it just isn’t as cost efficient. It is clear that all factors are also not being figured in.
OK, you can say that its cheaper if only the actual circumstances weren’t real but they are. So, in terms of government expense, this is 4 billion dollars over 6 years that goes to a real and important issue, that’s peanuts compared to military spending or really stupid shit like shutting down the government.
Instead of wasting money repealing Obamacare and inventing problems in order to damage it, we could build hospitals or design more efficient care in the rural hospitals that we already have.
This is a cost efficiency issue not a blatant waste issue. 60 useless, for show only, efforts to repeal Obamacare, that is 100% waste. The Iraq War, $4 trillion and counting, that is massive waste that has a giant negative feedback loop into our healthcare systems.
Lets prioritize!
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So dozens of rural hospitals have closed in the past five years, and nearly 300 others are on the brink. And?
Welcome to what happens when people vote for Conservatives.
HHS needs to shut this fraud down and go after the money that was pissed away on said fraud.
If they whine, HHS needs to tell them: Next time vote for Democrats who support Single Payer if they want a real healthcare system.