My Point of View: Access to health care is a right, even in rural area
Published 8:59 pm Monday, October 15, 2018
My Point of View by Jennifer Vogt-Erickson
Health care is a “top of mind” issue for many people of all ages. How will we pay for it, and will it be there when we need it?
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We are in a city with a hospital that gained a Ferrari name only to be slowly scrapped. The ICU and inpatient surgery are gone. Fountain Centers, which used to be a thriving drug treatment center and was on the cusp of building a new facility just eight years ago, has lost its youth, women’s and detox beds since Mayo took over. The psychiatric services unit moving here from Austin will bring 16 beds this fall, which is something, but keep in mind that it’s less than half of what Fountain Centers has lost in the past few years.
When Mayo closes Albert Lea’s obstetrics unit in 2020 (projected), it will be the largest rural OB ward, by far, to close in Minnesota in recent history. Last year, there were over 300 births in Albert Lea’s hospital.
Going back to 2000, rural OB units that have closed in Minnesota have all had well under 100 births per year for numerous years before they shut down. Some had births in the low dozens or single digits for their last period of operation.
Albert Lea’s impending loss of OB services is not normal and not part of rural health care trends.
The usual rule of thumb is that 250 births a year is the minimum for financial viability and good birth outcomes. Nonetheless, dozens of rural Minnesota hospitals are currently keeping their OB doors open with fewer births per year than that because it’s a community service, and distance is a risk factor for negative maternal health outcomes.
So why can’t Mayo keep our OB open?
Maybe Mayo can’t, but perhaps Albert Lea can find another way. When you live in a rural community, you don’t expect to have the luxury of everything, but you make the best of everything you have, and you figure out how to make it work. Resourcefulness is a resource in itself.
Mayo wants us to believe its oft-repeated reasons and then nicely acquiesce to its hub-and-spoke consolidation model. But who will keep standing up for our seniors, our chronically ill, our acutely sick and our mothers-to-be? These are our community members who most need the protection of our community.
The Freeborn County commissioners have asked tough questions of Mayo’s leadership, and they haven’t accepted generalizations that don’t fit our situation. The recently updated Government Accountability Office report on rural hospital closures that our congressman, Tim Walz, signed onto at constituent request (it was initiated by Missouri Sen. Claire McCaskill) reinforces that Albert Lea’s hospital closure is atypical. The greatest risk factors for rural hospital closure are: being in the South, being in a state that didn’t accept Medicaid expansion and being a for-profit hospital.
None of these fit Albert Lea, but apparently it’s the best excuse a nonprofit health care system with a $700 million operating margin could muster.
This is a key takeaway in any case: Medicaid expansion protects rural hospitals. It’s possible that our state could lose Medicaid expansion, which has insured 150,000 more Minnesotans and reduced hospitals’ unpaid medical bills since the Affordable Care Act passed, if Republicans gain control of the state, or the U.S. House and Senate are able to repeal Obamacare. Our DFL candidates for state representative, governor, Congress and Senate are firmly in support of keeping Medicaid expansion. Every single one of their opponents is either against it or on the fence.
Democrats Tim Walz, Amy Klobuchar, Tina Smith, Dan Feehan and Terry Gjersvik are all in favor of offering people some kind of public health insurance option as well. This part of the original Affordable Care Act didn’t pass, and it’s an essential addition for keeping costs down and for giving consumers a choice when they live in rural areas where there are fewer private insurance options.
Health care shouldn’t be so expensive. We need to be able to drive down the prices, especially in our region where it’s the highest in the state. A public option gives the government more leverage to drive down costs. The people who profit from the health care system the way it is don’t like that idea; their profit motives do not align with the pocketbook interests of consumers who have bodies vulnerable to disease or accidents that can strike at any time.
We need leaders who will speak truth to power and fight for rural health care, not throw our health care back to the free market where only healthy people, stockholders and big cities benefit. Health care is a right, and we have a right to be rural — with access to health care.
Jennifer Vogt-Erickson is a member of the Freeborn County DFL Party.