Sunday, March 10, 2019

Bill Crawford: Hospital Closings & Healthcare for Poor Become Campaign Issues

"Half of Mississippi’s rural hospitals at risk of closing, report says," read the startling headline in Mississippi Today.

"Thirty-one of Mississippi’s 64 rural hospitals, or 48%, are at 'high financial risk,' according to a national report of rural hospitals from independent consulting firm Navigant," read the article.


Perhaps even more startling was this from an article in News Mississippi: "Four hospitals have closed in the past five years and five more are threatening closure. Expanding Medicaid would ensure that Mississippians continue to have access to local trauma centers and proper healthcare, however, (Senate Medicaid Committee Chairman Senator Brice) Wiggins said the hospitals need to work it out on their own."

"Work it out on their own." Hmmm.

Public and private hospitals in Mississippi, excluding state and federally owned hospitals, employee over 50,000 people with average salaries of $46,700. Apparently, sustaining these high paying jobs in rural communities is not a state priority.

On the other hand, the state was willing to pony up $600 million in incentives to attract the Continental AG tire plant with 2,500 lower paying jobs.

Hmmm. At that rate 50,000 high paying hospital jobs should be worth $12 billion in state support.

The Continental plant will be a huge economic engine for the Hinds County urban area. Hospitals, on the other hand, are huge economic engines in rural communities, providing millions in economic impact over and above the salaries they pay. (A Mississippi Hospital Association study estimated Mississippi hospitals provide 119,908 direct and indirect jobs with over $15 billion in economic impact.)

Here's the real clinker in this story.

Over the past several years, hospital representatives have met with Wiggins and other state and legislative leaders to try and come up with a solution to keep rural hospitals viable AND provide better and more affordable healthcare to Mississippi's working poor.

One option discussed would, indeed, let hospitals work it out on their own. It would change Medicaid similar to what Vice President Mike Pence did while governor of Indiana plus revamp the Medicaid managed care model. In this option hospitals, not state taxpayers, would pick up the tab (hospitals already pay the state over $280 million in annual assessments to support Medicaid).

No option discussed, however, was acceptable to Mississippi Senate leadership and, apparently, remains that way with Lt. Gov. Tate Reeves in his campaign for governor. "I'm opposed to Obamacare expansion in Mississippi," he said, apparently seeing no difference between Pence's conservative "Healthy Indiana" plan and generic Obamacare.

Two opponents for governor, however, seem to think Republicans need a conservative "Healthy Mississippi" solution to the growing crises for rural hospitals and uninsured workers.

State Rep. Robert Foster of Hernando told the Clarion-Ledger he will look for "an innovative way of bringing health care that is affordable to the working class Mississippians that are left out right now."

Retired Supreme Court Chief Justice Bill Waller, Jr., told the Meridian Star, "I think we have a health crisis and we have to address it. Our hospitals have got to be viable and strong and citizens have got to have access."

Well, apparently there is a "Healthy Mississippi" way to work it out, but not with current leadership. That makes the issues of hospital closings and healthcare for the working poor significant campaign issues.

Crawford is a syndicate columnist from Meridian.

25 comments:

The Truth Hurts said...

Obamacare and Medicaid don't pay the bills, and neither do many of these patients. A business model or system that allows every Tom, Dick, Sheqwan, and all of the "frequent flyers" to go to an ER for a runny nose is not sustainable. Those ER docs usually don't work for the hospital as individuals, but rather as contractors. They don't discount their fees.

Someone has to pay for that "free stuff."

Anonymous said...

Medicare for all will doom healthcare as you expect it. Reliance on taxpayer dollars will not save these hospitals, the only possible 'cure' for this problem is employee insurance coverage which moves private money directly to the healthcare provider. The sad fact of business is that as we move to more 'universal' coverage, the funding required to provide the level of medical care desired is not available. England and Canada are the models touted as examples of healthcare for all,.....but inevitably these models must 'ration' services. If waiting six months for a cancer consultation is not acceptable then funding hospitals with government reimbursements is not the answer.

Anonymous said...

I am so looking forward to future Governor Waller's leadership on this important issue next year. Tater Tot wouldn't know the differences and similarities between Mike Pence's Medicaid initiative and Obamacare if you wrote it out for him with color crayons in 3" letters.

Anonymous said...

And on the other end of the spectrum from 9:32's Tate analysis, we find Jim Hood - The socialist who would prefer to see 83% of the population of this state on Medicare (if not Medicaid and disability). That fits his narrative perfectly.

Anonymous said...

You wouldn’t know they were losing money on frequent fliers with runny noses the way they tout their wait times on billboards all over the interstate.

Anonymous said...

I give you the VA Medical System as an example.

Anonymous said...

I ask this question not to be a jerk, but do we need to “save” all these rural hospitals? Or should they be saved but in different form of delivery? I know plenty of people all across this state that have hospitals and physician groups in their hometown, but choose to drive to places like Tupelo, Jackson and Hattiesburg because of the quality and complexity of care they desire.

Anonymous said...


The US ranks as the worst health care system in developed countries in every measure.

Yes , Canada is experiencing wait problems for some treatments ( not all cancer treatments by the way, it's shorter for some than here), but we are worse than they are overall and our costs per capita far exceed any country.


The bottom line is we are paying more for less no matter how you run the numbers.

How about using the models for countries that are succeeding like Sweden and Great Britain?

How about looking at how our system worked when we were the best? What changed? One thing was that we had government funded hospitals in the past that served the poor and before hospitals were supplied very differently.

And, have any of you bothered to understand how poor nutrition and inadequate health care affect the development of children? Or do you think humans, unlike other mammals, grow up normally without adequate care?

You hate those humans who are a burden on society, but you want to make sure they have lots of babies.


No, as usual, politics is driving a superficial and overly simplistic discussion where hypocrisy abounds.

Anonymous said...

11:05, hold my beer.

Never mind do the hospitals need to be saved. Is it the responsibility of the taxpayers to save them, or the communities they are in, or even the people who go to them for medical care? When did health care become the holy grail of government provided services?

People are starving every day, succumbing to the ravages of sleeping outside, and trying to survive without transportation, but try showing up a the Whole Foods, La Quinta, or Gray Daniels without any money and see what happens. Yet all hell breaks loose when someone with a routine problem is turned away from a hospital or doctor's office because he can't pay.

Taxpayers should help poor people afford what they need and be done with it. To paraphrase ol' Drago, if they die, they die. People die every day who would live if the government would intervene, and some of them die even when the government intervenes and tries to help them, so let's not make such a big deal out of it.

Anonymous said...

I am in a related industry. I am a life long Mississippian and truly do sympathize with our small communities and health care facilities. I think 11:05 hit on what will (or is) happening.Those that make it will establish a viable, limited mission. It might still require them to be a part of a larger health care system. They then have increased value to the larger system as a "feeder" facility. This is not attractive to some, but a reality I believe.

Anonymous said...

Population
United States - 325M
United Kingdom - 66M
Canada - 36M
~~~~~~~~~~~~~~~~~~~~
California - over 39M
Texas - 28M
Louisiana - 4.6M
Mississippi - Just under 3M
Alabama - 4.8M
Florida - Almost 21M

Number of States in The United States - 50
each with their own medical board, pharmacy board, insurance commissioner, CMS Medicaid $s each one utilizes differently. Telehealh. Where is the state on that? Hmmm. Multiple payors (private, public, for profit, non-profit, DOD, VA, etc.). Oh, and not a national patient ID. HHS initiatives..... drive $ and compliance....VBC, ACOs, HIPAA, HITECH, ACA, 2015 CERHT, on and on.

It it's a state's rights issue. No. Joke. Unless we decide to give up our say in insuarance, how we manage physician licensing, nurse licensing, prescription drug management and just turn it all over to the "Feds" to run for us. It is up to our communities to figure this out. Might be a good start to bring the governing boards for a lot of these community facilities into the 21st century. Might also help if we had broad band access throughout the state. Just sayin... maybe we figure out how to provide solid care across the board. Like getting rid of the fax machine and DVDs/CDs as a way to manage patient records? Facilities play nice with each other. Share patient data and care. Leverage each other's strengths. Everyone should have access to quality care close to home. Period. It's not up to the "government" to provide this. It truly is a community issue. However, we are dependent on "the government" for many things including healthcare whether we like it or not. City, county, state and federal. Hub and spoke healthcare models are working all across the U.S., but like everything else in this state... healthcare sucks. It's on us.

I choose go out of state for healthcare because I can and because I know what standard of care should be.

Anonymous said...

The US ranks as the worst health care system in developed countries in every measure.

Link?

... our costs per capita far exceed any country.

Link?

Anonymous said...

Maybe UMMC should purchase all the dying rural hospitals. The University is an expert on D quality rated care. It can even provide ellipticals for rural fitness centers.

Anonymous said...

7:44 nailed it. They could put one cardio machine in every county hospital and each would be used as much as it has been since UMC bought the local gyms.

Anonymous said...

Get rid of the CON and get the counties out of the hospital business. If the state wants to get involved, have a network of copters for under served communities.

Seriously, I can't imagine going to one of these little county hospitals for a major cardiac event or cancer. They only exist for treating sore throats for those without a regular doctor.

Anonymous said...

I don't get why people move out into BF Egypt and then wonder why they don't have gigabit speed internet and world class healthcare. You should look into such things before you put down roots.

Anonymous said...

@6:49 PM

Here is a link for you
www.google.com

Anonymous said...

Louisiana created 19,000 medical jobs after Bobby Jindal defeated.

Anonymous said...

At some point, the "leadership" of this worst ranked state will treat the causes instead of the symptoms. But until our goofball Gov. and Lt. Gov. acknowledge there are even problems, the MS Titanic sinks lower and lower...

Anonymous said...

8:51 - I fell for your link only to find that it's a link to the Google Search Engine - as if it becomes MY responsibility to prove an absurdity posted by someone else.

In proper debate circles, the one making a claim of fact is responsible for proving it....not those in the audience. That is, if the one making the assertion wants to be taken seriously. If not, though....he can do what you just did.

Anonymous said...

March 10, 2019 at 6:49 PM

Here's a link about U.S. Health care among developed countries......

"The US ranks as the worst health care system in developed countries in every measure"....and "our costs per capita far exceed any country".

Apparently so.

https://www.internationalinsurance.com/news/ranking-top-eleven-healthcare-systems-country.php


Anonymous said...

Socialism for the rich and capitalism for the poor is going to continue until the working peoples of the state seize the means of production.

Anonymous said...

Crawford certainly is entitled to his opinions, and can write whatever he believes. However, you would think he would feel some sense of obligation at the very least to inform his readers that he is a member of a hospital board of directors; a “non-profit” regional hospital which, in fact, owns and operates several “rural” satellite hospitals. Wouldn’t you think that some shred of journalistic integrity would mandate some disclosure to his readership?

http://www.andersonregional.org/AndersonLeadership.aspx

Anonymous said...

"Socialism for the rich and capitalism for the poor is going to continue until the working peoples of the state seize the means of production. "

How, um, quaint ;-)

Feel The Bern said...

Did you mean 'socialism for the poor' and 'capitalism for the rich'? Isn't that where we are or are headed?

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If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

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