Healthcare and Rural America

The 25-bed Cedar Vale Hospital that serves the residents of Cedar Vale, Kansas is the latest victim of the growing healthcare crisis in America. The doors will close at the end of the month unless further revenue streams are located. So far, all attempts to keep the doors open beyond August have failed. Cedar Vale sits in Chautauqua County, is less than a square mile in size and boasts less than a thousand residents, of whom roughly one-third are over the age of 65. The per capita income of the town is less than $15,000 per year.

Cedar Vale is just the latest rural hospital to face closure in the face of economic woes, and the crisis in healthcare in middle America is playing out according to script. It works like this: Healthcare providers take care of the poor and elderly and submit the bills to Medicare and/or Medicaid. The assignment paid be Medicare is inadequate, and the assignment paid by Medicaid is laughable. This formula guarantees that every year, the facility sinks deeper and deeper into a sea of red ink.

The question that keeps cropping up in my mind is this: If the federal government can insure pensions and insure against floods; why the hell can't they insure that rural hospitals that serve an aging and poor client base have enough capital to operate? It would be a worthwhile investment. I have worked in healthcare for 20-plus years. I have seen up close and in person what happens when a rural area loses it's hospital and the doctors move on. People stop receiving care and monitoring for chronic but manageable conditions, like type II diabetes, hypertension and the like. The conditions siilently take their toll, and in a short period of time, elderly people start showing up in the emergency room of the nearest metropolitan medical center - arriving by ambulance - and are treated for exacerbated and worsened conditions. A bug bite to a foot costs a diabetic a leg, and that headache that Aunt Minnie had for three days? It was a stroke in the making.

The lucky ones will end up in the ICU at Villa Christi in Wichita. The less fortunate will likely end up in the funeral parlor.

Remember how taxes are what we pay to live in a civilized society? Isn't it time, in the 21st century, to expand that definition of "civilized" to include the guarantee that anyone who is sick in the richest nation on earth has, as an inherent human right, access to healthcare when one needs it?