The COVID-19 pandemic has revealed many of the weaknesses of the current American medical system. But even before this, health care in rural communities has been threatened.
Hundreds of rural communities are about to lose their local hospitals.
Since 2005, 166 rural hospitals have shuttered, with a third of rural hospitals in the danger zone. Bad debt for rural hospitals has gone up about 50% since 2010. The financial health of rural hospitals depends largely on the insurance status of patients: 83% of rural hospital closures occurred in states that did not expand Medicaid.
The math is simple – hospitals that treat uninsured patients must absorb the cost of uncompensated care. On top of that, administrative costs eat up about a quarter of rural hospitals’ budgets, largely due to the billing requirements of dozens of different insurers. But under single-payer Medicare for All, every patient who walks in the door would be covered for all medically necessary care. Even better, Medicare for All would end the archaic fee-for-service payment model, a system that punishes hospitals that don’t have a consistent flow of patients. Instead, we would fund hospitals through annual “global budgets” that are based on community health needs, not patient insurance status or corporate profits.
As a rural family physician, I am convinced that Medicare for All is the lifeline that rural Americans and our community hospitals need and deserve.