Alabama's rural hospitals fear "immediate" closure

Originally published at: https://boingboing.net/2024/02/24/alabamas-rural-hospitals-fear-immediate-closure.html

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Alabama is so pro-life that their state policies are driving out anyone who actually has expertise in preserving life.

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If God wanted these people to be healthy, why did He make them ill?

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Well the free market thought hospitals there wouldn’t make any money soooo…

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But this article neglects to point out that if people in Alabama want free healthcare, all they have to do is drive to the emergency room of a neighboring state. (Checks neighboring states) Ok, maybe two or three states over.

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Driving to another state just to utilize (shudder) medical science? Bah! Just pray harder!

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the assholes that implement these healthc are denying policies never seem to lose their own health care access.

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Given the closure of rural hospitals nation-wide, I’m surprised there are any in Alabama to still close. Although I guess “rural” has no real fixed definition, so there’s progressive closures of hospitals in more and more populous areas…

My grandmother lived in a town of 7000 people in Northern California - it had a hospital when the town was much smaller, but in recent decades it didn’t even have doctors, except a few days a week. If you needed any sort of urgent medical care, you’d have to travel to a town with a population of around 100,000 to find a hospital, all of which were at least 40 miles away. I imagine things are even worse in Alabama. I don’t know how people live like that. My grandmother had to have supplemental insurance to cover helicopter rides, because that was the only way to get emergency attention. When you have people with no insurance at all…

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What else can Alabama do? Health care costs are literally out of control; expanding Medicaid would just bankrupt the whole state without doing anything to fix insurance, or health care, or costs, or Medicaid.

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The reason for that is left as an exercise for the reader. < cough>private insurance</ cough>

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spongebob squarepants bullshit GIF

There are LOTS of things they CAN do here, including creating sane tax base to provide services for the population. Not to mention that the medicaid expansion comes with federal dollars. And as @teknocholer, the problem here is private insurance.

You can’t solve all problems with tax cuts and hate. And the sooner conservatives figure that out and start demanding better from our state (and the federal) government, the better we can actually start solving problems that other countries have successfully tackled.

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It’s true, health care costs are literally out of control – which is to say that nobody is controlling them. Because America lets these things runs things for profit, even though it costs them dramatically more than every other country that has public health care.

There’s an easy fix if only people would stop blocking it on the specious grounds that there isn’t the money for the cheaper, better option.

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Eh. Medicaid rates are set as a percentage of Medicare rates. Medicare rates are dictated by the Federal government, not private insurance.

Medicare rates have also been out of control for ages as well because every time cost controls are put in place, Congress kills them at behest of the health care lobby (e.g.: the “doc-fix” bills from 1997-2015). They’re still lower than private insurance rates of course, but doctors and hospitals will tell you they’ll die in a ditch if they were forced to universally accept them, despite being quite a bit higher than neighboring Canada’s Medicare rates (or any country in Western Europe besides Switzerland).

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Healthcare costs are out of control? Maybe. But some how other countries manage to provide better outcomes than the United States.

For example, Costa Rica, with a GNI of $64.1 Billion manages to provide universal healthcare for its population, and ranks 36 on the 2000 WHO index, while the United States ranks 37.

But Costa Rica had no military, you might say, and so can allocate those funds to healthcare. Silly Costa Rica! Wait ‘til the Isla Nublar velociraptors make it to the mainland. They’ll wish they had a military then!

Okay, let’s look at Japan, which does have military spending. They spend 1/4 on healthcare compared to the US, and rank 10th.

How is it that Costa Rica, Japan, and every developed nation, really, can provide better healthcare for far less than the USA? Well, it’s because those countries view healthcare as either a human right or a precondition to a functioning society and levy taxes to pay for it, especially on the rich and corporations.

If Lichtenstein and Monaco which have about twenty people between them can provide universal healthcare, then so can the USA.

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teknocholer’s point is that private, for profit insurance is what’s driving up the cost of healthcare overall in this country, not that it’s increasing Medicaid costs specifically (although it is, just indirectly), which, I think, is a point you’d agree with.

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You missed the real culprit there. The whole system is supporting a trillion-$ unnecessary middleman: health insurers.

worm leech GIF

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I don’t see how health insurers have any impact here. We’re talking about the State’s cost for Medicare expansion which is 10% of the reimbursement rate.

The reimbursement rate has nothing to do with private insurers. They aren’t involved directly or indirectly. The rates are set by the Federal government.

And health insurers certainly aren’t earning trillions of dollars. Last I checked, health insurance represents about 5% of healthcare spending - which of course is still a lot of money, but not trillions. They’re a convenient scapegoat because no one likes them and no one, not politicians and not citizens, wants to attack doctors and hospitals - despite the healthcare provider lobby having been responsible for the vast majority of lobbying against universal healthcare for nearly a century.

Personally, I’d happily get rid of private insurers, or turn them into complimentary plans like countries like France have or ban price discrimination so all payers pay the same rate, but we’d still be screwed without strict price controls that kept Medicare-4-All rates under control.

How does this even track? That would imply the vast majority is debt.

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States with less financial resources than AL have made it work. If the best you can do is “what the hell, if they die, they die,” you really need to reassess your priorities.

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This is a horribly naive take on how the US healthcare system works. It’s also, very specifically, incorrect. Rates are set by medicare intermediaries regionally. Those medicare intermediaries are health insurers like BC/BS, Humana, etc.

Nope. Just under 30%, which is in fact trillions.

How has U.S. spending on healthcare changed over time? - Peterson-KFF Health System Tracker).

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