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Growing health care inequality must be addressed

EDITORIAL

The Advocate-Messenger

We’re all familiar with the problem of skyrocketing wealth inequality in the U.S. But health care is another growing area of inequality that doesn’t get talked about as much, perhaps because those most affected by the change primarily live in rural areas of the country.

One in 20 rural hospitals in the U.S. have closed in less than a decade, and one in five of those still open are at high risk of closing in the near future, especially if the economy takes a turn for the worse, according to a new report from Navigant Consulting.

Almost two-thirds of those at-risk hospitals “are considered highly essential to the health and economic well-being of their communities,” according to Navigant.

Kentucky is one of the most at-risk states in the nation for losing health care availability in rural areas with 16 rural hospitals considered at “high financial risk” in the Bluegrass State, representing nearly one of every four, according to Navigant.

Only nine other states have higher at-risk percentages: Alabama (50 percent), Mississippi (48.4 percent), Georgia (41.3 percent), Maine (40 percent), Alaska (40 percent), Arkansas (36.7 percent), Oklahoma (29.3 percent), Kansas (28.7 percent) and Michigan (25.4 percent).

The Navigant study reveals low rural population growth, declining in-patient care and a lack of capital that would allow rural hospitals to take advantage of new technology are among the factors contributing to the problem.

The loss of rural health care centers is no small problem.

A recent University of Kentucky study showed ambulance runs for rural patients are 76 percent longer after a rural hospital closes.

The study also notes areas where rural hospitals close often have high percentages of poor and elderly residents, and the impact of losing a hospital is even worse for senior citizens: Their ambulance rides wind up 98 percent longer after a hospital closure.

Beyond emergency response, there are all kinds of negative effects to losing a local hospital.

People who should get preventative care can find it more difficult and more expensive to do so, leading to more long-term health problems.

Hospitals are often large employers, providing many local workers with good jobs and boosting the local economy.

As rural hospitals close, the communities they served can begin to spiral.

With fewer job options and a worse outlook for their quality of life, many residents are incentivized to move away to big cities.

A shrinking workforce leads to less revenue for local government and less interest from businesses.

We should not allow health care inequality to continue growing, especially since there are such far-reaching impacts beyond just the closure of some hospitals.

One possible solution pointed out by the Navigant study is the Rural Emergency Acute Care Hospital (REACH) Act, which would create a new Medicare classification that could keep some hospitals open as emergency and outpatient centers without in-patient beds.

The study also suggests building collaboration between academic institutions and hospitals, which could help hospitals capitalize on things such as electronic health records, physician training and tele-health services.

No one solution will fix such a complex problem, but every little step helps.

Our rural health care providers have taken care of us all our lives; now it’s time for us to take care of them.