Since 2010, more than 125 hospitals have closed across rural America, victims of a lack of investment by both government agencies and private health corporations.
Now, about 60 million people who live in these regions — that’s about 1 in 5 Americans — are at risk not just from the advance of the virulent coronavirus pandemic, but also from a health-care system that may not be able to meet their needs.
The American South is disproportionately affected by these closures, according to a 2018 General Accounting Office report.
Most of the closures were among hospitals dependent on Medicare, and also for-profit hospitals.
Alabama, for example, has some of the lowest Medicare reimbursement rates in the country, and a 2016 report found that 88 percent of rural hospitals in the state were operating in the red.
The cost of efficiency?
In 2019, rural hospital closures hit a record high, with 18 such facilities shutting down.
Alan Morgan, the CEO of the National Rural Health Association, told U.S. News & World Report that “[as] a country over the last decade, we’ve focused on the issue of efficiency, and we’ve prioritized efficiency over access. So, now we’re going to see what the results are during a national crisis.”
To their credit, rural regions are not completely unprepared.
Rural clinics and hospitals that have survived the shutdowns have instituted pandemic-preparedness training programs in recent years.
And the residents of rural areas themselves are accustomed to collaborative efforts to overcome hardship, raising the prospect that mutual-aid networks could help fulfill some basic, non-intensive needs.
Additional research and writing by Mark A. Bonta.