Spokane7
61°
December 20, 2011 in Opinion
Editorial: Lifeline for rural hospitals not place to save
The survival of many rural Washington hospitals – the survival of their patients – rides on a proposed $27.2 million cut in state funding for facilities more than 35 miles from urban medical centers.
If approved, matching federal Medicare dollars would also be lost, resulting in a total whack of almost $55 million spread among 38 hospitals, most of them in Eastern Washington. Hospital administrators say their institutions cannot afford those losses, and neither can the communities they serve.
Strip away the state and federal assistance, and patients end up at urban hospitals with conditions worsened because they could not get treatment closer to home. Patients and their families must spend money for travel and accommodations, simultaneously losing wages for time away from work.
The hospitals are also major employers in communities like Republic, just as they are in Spokane. And what new employer would consider a community without one?
And what doctor would open or take over a practice without resources other than those in her or his own office? Although the Inland Northwest benefits from a fine telemedicine network, doctors want to offer their patients the best possible treatment, not just diagnosis.
As one rural hospital administrator put it, “In health care, you can’t offer a low-ball-quality product.”
The cutbacks would be especially problematic for the budding University of Washington School of Medicine program in Spokane. The lack of opportunities for clerkships that put students side-by-side with local doctors has been a concern as the curriculum extends to four years. If fewer rural hospitals translates into fewer rural doctors and fewer clerkships, the school may not be able to increase enrollment despite the pressing need for physicians willing to practice in small towns.
Potential closures could also negate the benefits of a bill introduced last week by Rep. Cathy McMorris Rodgers that would rebalance the allocation of federal dollars for graduate medical education. The Graduate Medical Education program funds 10 residency slots per 100,000 people in Eastern Washington, compared with 250 for the same population in Western Washington. The distribution cheats a region with bigger doctor recruiting challenges than the Puget Sound area.
From school bus service to postal delivery to health care, rural communities have become the go-to piggy bank for government and quasi-government officials who have tapped out other resources, including imagination. They don’t lose many votes when a hospital in Coulee City, for a hypothetical example, closes its doors, particularly if they can argue the result is greater efficiency.
Washington already has one of the most efficient health care systems in the country. And among the best, certainly among the lowest-cost, medical school programs dedicated to rural health care for all the Northwest states except Oregon.
Washington legislators made the easy budget cuts in the just-completed special session. Tougher choices await as they look for at least another $1 billion in cuts next month. But too much in human and community health would be put at risk for $27.2 million.
Trudy Rubin: Egyptians say no to Islamists 
Raising_Hell on December 20 at 8:55 a.m.
I live in the 7th LD, where a lot of hospitals would be closed. Our two state reps and state senator (all GOP) are up in arms about the closures, as are our predominantly GOP county commissioners. But do they admit their anti-government message over the past thirty years, their obstructionism on closing tax loopholes and raising revenue from those who can afford it (which has frozen in pace the most regressive state tax sysytem in America), and their support for Eyman’s anti-government (not anti-tax) initiatives is a big part of the problem? Of course not. But should our governor and legislature find a way to save the hospital funding, rest assured Morton, Kretz, and Short will be at the head of the line claiming credit.
The bigger question is: “why is such a formerly productive area unable to afford the most basic trappings of civilization?” It will be people in Seattle who pay for the hospitals if they are saved. The GOP rants about environmentalists and environmental regulations. The real reason is the fact that our corporate economy is designed to extract wealth from the periphery and concentrate it at the center, and the tight control of rural economies by a very small minority who serve that system. The regulations that hurt are not the ones the GOP complains about, necessary environmental regulations, which have slowed, but not stopped, the corporate destruction of land, forests, water and other resources. The real culprits are:
• the “food safety” regulations, enforced at the behest of corporate agriculture that prevent rural NE Washington (and the rest of rural America) from taking the first steps toward rebuilding our local Main Street economies.
• the complete lack of financial regulation that causes profits and capital to be sucked out of rural areas and invested elsewhere, often overseas.
Our worthless GOP reps are an integral part of the wealth extraction and concentration process. They are working to keep rural Washington poor and dependent, despite their rhetoric to the contrary.