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Re: Hospitals closing

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Message 1 of 26

   While some will bicker back and forth and attempt to justify killing off of hospitals for any variety of reasons, the point may be that when a hospital closes, the city may often follow.     

 

    Now back to the cherry pickers attempting to justify whatever they want.    Are they impacted?  probably not, so that makes hating rural medical hospitals so convenient.   NIMBY.  

 

    Totally sideways, these are the people that are impacted and the donald supporters will be shocked, they are not minorities.  http://www.denverpost.com/2017/04/02/rural-americans-disability-jobs-disappear/    

 

      So driving to another slightly larger rural  town hospital will never be the problem, because hey, there are 1971 of them and only 1,332 are designated as Critical Access Hospitals by CMS.2 CAHs are rural hospitals with no more than 25 beds and are at least 35 miles (15 miles in areas with mountainous terrain or only secondary roads) away from another hospital.    

PRO-LIFE is Affordable Healthcare for ALL .
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Re: Hospitals closing

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Message 2 of 26

@GailL1 wrote:

While that is true, the Kaiser Family Foundation study which I linked gave a history of how we got so many small rural hospitals and how it is all coming tumbling down because of several reasons

Yes, these were for-profit hospitals but some are not and they face many of the same perils - not enough people to support the number of them in the same area, not enough physicians, rates being cut and modified for government programs of Medicare and Medicaid.  We now support moving them out of the hospital as soon as possible when it use to be otherwise - keep them until they were able to go home or they died.

 

Believe me, the Medicaid expansion choice is only one among many reasons why many small rural hospitals are closing their doors.  In fact, if I remember correctly, the KFF study included one example of a closed rural hospital which was in a state that expanded Medicaid.

 

it is not just profit either that is causing the problem - we may need a different type model because with many small rural hospitals not having even enough local people to support them - is not working.

 

I believe that the KFF article said the Mercy Hospital in Independence, Ks was only at 25% of its capacity in the years building up to the closure.  

 

 


Gail1

 

As you pointed out in an earlier comment (second or third chronolgical) this whole thread is about either an event that didn't even happen (a hospital closing in a non-existent place in Kansas) or a hospital closing shortly after a massive expansion in a real city in Kansas. As is typical, you and I can't tell because few people commenting here provide links to what they are talking about.

 

But one thing is for sure, in reference to the third paragraph in your comment that I quoted, no hospital is closing because its state legislature chose not to expand Medicaid under the Patient Protection and Affordable Care Act (PPACA). Two reasons:

1. Since the hospital never had that revenue in the first place, how could it have become dependent upon it?

2. A significant amount (if not most) of the expansion of Medicaid-patient enrollment nationwide under PPACA has been people who always qualified for Medicaid anyways (that is, they were under FPL or whatever the rule is). So the hospital should be getting that revenue irrespective of what the legislature did. That's unless people in its area who qualified chose not to sign up even though they were eligible, which you certainly can't blame the legislature for.

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Message 3 of 26

@GailL1 wrote:

@umbarch64 wrote:

No Gail....what I said was intended to apply to the topic about hospitals closing. Look just a bit further afield from isolated symptoms and you will find the real root cause.  Details are often used to confuse issues and deflect legitimate criticism...at least here on this forum.

 

Where you can't turn a profit, business goes away.  That's what commercial 'for profit' enterprise does and that is what the private approach to this thing called health care is....is it not?

 

 


While that is true, the Kaiser Family Foundation study which I linked gave a history of how we got so many small rural hospitals and how it is all coming tumbling down because of several reasons.

 

thank you for posting the link.  Agreed...there is a real, not make believe, problem. 

 

There are multiple reasons the problem exists.  Economics is one.  The private sector will NOT address this issue because of economic reality...they WILL lose money. 

 

So People and their well-being, no matter who they are or where they live, are the ONLY reason that Government exists.  'How to do that?'   That question IS rhetorical.  I think you know.

 

Yes, these were for-profit hospitals but some are not and they face many of the same perils - not enough people to support the number of them in the same area, not enough physicians, rates being cut and modified for government programs of Medicare and Medicaid.  We now support moving them out of the hospital as soon as possible when it use to be otherwise - keep them until they were able to go home or they died.

 

I'm not sure it is clear whether or not these hospitals and those like them were economically viable on a 'for profit' basis in the first place....always were subsidized or underwritten in one way or another.  That is beside the point, though....health benefits for people who live in locations like this very likely have to be treated differently than in New York City, say.  Again...'How to do that?'

 

Believe me, the Medicaid expansion choice is only one among many reasons why many small rural hospitals are closing their doors.  In fact, if I remember correctly, the KFF study included one example of a closed rural hospital which was in a state that expanded Medicaid.

 

Any time and any where politicians can 'tinker', they will.  It will always do it for 'advantage', whatever that might be....it is what they have always done and will always do, given an opportunity. There is a 'follow on' to that statement, probably more than one.  None will work without an agreed upon Concept as the base criteria

 

it is not just profit either that is causing the problem - we may need a different type model because with many small rural hospitals not having even enough local people to support them - is not working.

 

You are correct.  It would have to be a specific accommodation within a specific concept....Universal Health Care.  From there on it is simply a matter of working out "How to do that". 

 

I believe that the KFF article said the Mercy Hospital in Independence, Ks was only at 25% of its capacity in the years building up to the closure.  

 

 Frankly, I do not know how "branch hospitals" with full staff complements can BE economically feasible in such cases.  The answer may be, "under some circumstances, economics simply do not apply".

In natural disasters, economics is not an admitted critera...both have to do with saving life....how is this so much of a different ethic.  Me?  I don't think ii is and I don't think it should be.


 

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Message 4 of 26

@umbarch64 wrote:

No Gail....what I said was intended to apply to the topic about hospitals closing. Look just a bit further afield from isolated symptoms and you will find the real root cause.  Details are often used to confuse issues and deflect legitimate criticism...at least here on this forum.

 

Where you can't turn a profit, business goes away.  That's what commercial 'for profit' enterprise does and that is what the private approach to this thing called health care is....is it not?

 

 


While that is true, the Kaiser Family Foundation study which I linked gave a history of how we got so many small rural hospitals and how it is all coming tumbling down because of several reasons.

 

Yes, these were for-profit hospitals but some are not and they face many of the same perils - not enough people to support the number of them in the same area, not enough physicians, rates being cut and modified for government programs of Medicare and Medicaid.  We now support moving them out of the hospital as soon as possible when it use to be otherwise - keep them until they were able to go home or they died.

 

Believe me, the Medicaid expansion choice is only one among many reasons why many small rural hospitals are closing their doors.  In fact, if I remember correctly, the KFF study included one example of a closed rural hospital which was in a state that expanded Medicaid.

 

it is not just profit either that is causing the problem - we may need a different type model because with many small rural hospitals not having even enough local people to support them - is not working.

 

I believe that the KFF article said the Mercy Hospital in Independence, Ks was only at 25% of its capacity in the years building up to the closure.  

 

 


* * * * It's Always Something . . . Roseanne Roseannadanna
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Message 5 of 26

No Gail....what I said was intended to apply to the topic about hospitals closing. Look just a bit further afield from isolated symptoms and you will find the real root cause.  Details are often used to confuse issues and deflect legitimate criticism...at least here on this forum.

 

Where you can't turn a profit, business goes away.  That's what commercial 'for profit' enterprise does and that is what the private approach to this thing called health care is....is it not?

 

 

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Message 6 of 26

@umbarch64

 

Are you replying to this "Hospital Closing" thread?

Just having problems understanding where it fits in.

I also read another post by somebody last night that seemed way off subject

so I'm just wondering if there is something technical going on.


* * * * It's Always Something . . . Roseanne Roseannadanna
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Message 7 of 26

Can anyone else see the priority issues here?  How did a medium of exchange get to be more important than the people who use it?  Who did it?  How come?  Why did we let them get by with it?

 

Not rhetorical, folks.  Real questions that deserve real answers.  "the donald" immortalized the classic words of con men everywhere.  "Trust Me", he said.  I'd say he has lots of disciples running around out there, spreading the 'gospel'.

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Message 8 of 26

In July 2016, Kaiser Family Foundation did a study about the closures of rural hospitals.  They analyzed (3) examples, of which, Mercy Hospital in Independence, Kansas was one of the three.

 

Kaiser Family Foundation 07/2016 - A Look at Rural Hospital Closures and Implications formAccess to ...

 

Might be informative if we read this study and discuss what happened and how it is affecting the community or communities, since there were (3) in the study.

 

 


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Message 9 of 26

 Afisher-- yes!! Urgent care is almost a literal Band-Aid --break a bone, get sent to the hospital; have severe pain that can't be diagnosed without x-rays, MRI, CT scan, go to the hospital; need surgery go to the hospital-- that's all it is-a band aid!

 That golden hour-- if one should have a heart attack, medical science people tell us we have one hour from inception to end to resolve the  issue,  so the patient can live.

so go to urgent care-- we think you're having a heart attack--go to the hospital-- go to the hospital--possibly wait for ambulances-- pending where your hospital is, or where your urgent care, is you may be dead before you ever get to the hospital.

 By the way the argument that  people would know they're having a heart attack is false-many times people do not know they are having a heart attack,  when they are indeed experiencing one.  In my area,  we stand to lose four rural community hospitals,  which very well could be the difference between life or death,  and remember WE ARE  the population most prone to have heart attacks or to other emergencies.

 Using flimsy, ignorant excuses that Urgi-care will solve the problems of fully functioning hospitals is just another denial. 

Gee, I miss having a real President!!
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Message 10 of 26

    Urgent care is nothing but a bandaid and is not a replacement for a hospital, because of the lack of admission and actually nursing.     Then of course there is billing and Medicare does have different billing - which makes it a cost burden  to UC.  

 

  Consider what another person wrote - but a hospital is available 25 miles away.     Well okey doke then.   Assuming one survives that trip....another of the rules and goals of ACA is to reduce the readmission rate of patients.    That may include an extra day to assure that they patient is stable and can be safely transferred to a step-down facility or nursing home...except of course that most of those are now associated with smaller hospitals that are now closing and can't afford to have an adequately trained staff to meet safety guidelines.  

    How many physicians are going to travel to a small town for follow-up, or is the patient now expected to hire an ambulance to take them back and forth to meet their surgeon...who pays for that cost and it will be cut from most Insurance healthcare policies.  

    That may mean that people are sent home to fend for themselves, because the hospital can cut stays because the incentive to not re-admit is gone.  

 

     The supposed rational ideas of some, seem to want to dismiss the reality, because it is convenient to do so.    That is the GOP dream, get sick, die quickly and quietly.     

PRO-LIFE is Affordable Healthcare for ALL .
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