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My rural grandparents never spent a day in a hospital... all of their kids were born at home as they were that rural... some with midwife and some with only my grandfather... they had a small family diary farm...
Early to bed and early to rise with mostly what they produced for food... the best smoked hams... fresh unpasteurized milk, homemade cheese, etc...
My Grandfather was still helping around the farm in his 90's and one day he had to sit down as he felt a little dizzy... one of the Grand-kids insisted in taking him to the big hospital a couple of hours away...
Doc said he was fit as a fiddle... but his heartbeat was irregular... said a pace maker would due the trick... Grandfather thanked the Doc but refused saying when it was his time it was his time... he passed in his sleep at 96 the day after New Years and had commented just the day before what a blessed life he had... still sharp as a tack and standing tall.
I guess when you have that belief system there is a lot less to worry about... hard work, the simple life and little stress... never owned a car... drove the tractor to town when needed... listened to the farm report at night on the radio before turning in...
I was fortunate to spend an entire summer there a few times.. when I was 4, 11 and 17... and sometimes I would trade all the big city living for a my grandparents home, the one they built in a picture perfect pastoral setting...
My family, the pattern I've noticed is people either lived to the late 80's or into the 90's, even with hard lives, or they died early in their sixties or before. Mom's dad was into his 90's, his health still very good for one that age, when very quickly his body just started to fail. He was put in the hospital, and chose to go home. There was little they could do for someone 94 but keep him comfortable. So he died peacefully in his own bed with family there. His own father lived into his 90's too, and had a hard life long before any of the great advances in medicine had been known.
My other grandfather was barely into his sixties. Dad's father wasn't prone to illness, and pushed his way through a hard life, and then suddenly took ill and died in his early 60's. But my Grandmother was in her 90's. Mom's mother was 89, and had had a stroke, but before that has never been badly ill. For most of their lives, they didn't have access to medicine which wasn't known yet.
Part of it is medicine, and part of it is written from within. Mom had just turned 65. She'd had lots of health problems, but had an anurism burst in the heart. It was inoperable, and at the time if we'd known it would have been a slow and painful watch for when it went. But both parents also smoked like chimneys. Dad might have lived longer, but mom not likely.
Living on a farm, or many other occupations from before now, were not necessarily going to give you a long life, but they weren't living a life that was always in a hurry, always rushed to get there first. We wear ourselves out with worry that it won't be enough. More people survive longer with out level of health care, but we still help create the situation.
I do believe that if we could learn to pull back, calm down, and not keep ourselves in fight or flight most of the time it would vastly improve the general health and likely the life span of today's population. The thing about the farm wasn't that it was kindly, but that they accepted the way of life and didn't live in a constant state of stress over what was to come as we so often do now.
The flip side of life - when you start it - suffers greatly with lack of care in rural America.
I know a number of nurses who decry the lack of child health care services in their rural towns. It catapulted them to get their masters and become providers of primary care. Midwifery too.
The flip side of life - when you start it - suffers greatly with lack of care in rural America.
I know a number of nurses who decry the lack of child health care services in their rural towns. It catapulted them to get their masters and become providers of primary care. Midwifery too.
Everything is NOT roses in rural care.
No it is not...
But, working 26 years in Healthcare in an urban setting the same can be said here...
For decades our local community urban Hospital was really a part of the community... we sponsored wellness fairs, provided free screenings, provided space for support groups like diabetes, etc...
This year ownership changed and now our little facility is part of a 100,000 employee organization and within 30 days all of the above no longer exists...
But... the new ownership spends a bundle of commercials that come into my living room each night about how focused they are...
But, working 26 years in Healthcare in an urban setting the same can be said here...
For decades our local community urban Hospital was really a part of the community... we sponsored wellness fairs, provided free screenings, provided space for support groups like diabetes, etc...
This year ownership changed and now our little facility is part of a 100,000 employee organization and within 30 days all of the above no longer exists...
But... the new ownership spends a bundle of commercials that come into my living room each night about how focused they are...
Notice most of those commercials have the subliminal message ... eat macrobiotic, be an exercise addict, meditate hours per day, etc, etc ... so you can, by golly ... make sure you never get sick!!! It's like the health care industry is no longer inviting new customers and is encouraging existing ones to go away.
The rural hospital closings will likely diminish when Obamacare has been repealed. The mandatory cuts to Medicare payments for hospital services will, we may hope, be reversed.
Nothing I said had anything to do with the closing of rural hospitals. But, since your response raised the issue with the intent of indicting the ACA, here are the facts from Kaiser on the issue of rural hospitals. The causes are multiple. What follows are the SIX identified by Kaiser in excerpt form - read the lengthy report for all the details:
Quote:
Key Findings
What factors contribute to rural hospital closures?
Rural areas face challenging demographic, social, and economic pressures. Respondents in all three communities pointed to similar economic and demographic trends that contributed to the closures. They cited high poverty and uninsured rates in rural communities, high rates of Medicare and Medicaid coverage, and declining populations. In each community, poverty rates were higher than state and national averages and median incomes were lower, and the population was shrinking.
Privately insured patients often went elsewhere for care, hurting the local hospital’s revenue base and contributing to perceived low quality of the local hospital. In all three case studies, respondents reported that, prior to the hospital closure, community residents with private insurance or other resources typically travelled to bigger, newer hospital systems outside the community
Rural hospitals built in neighboring communities under Hill-Burton now compete for limited patients, federal dollars, and health care resources. All three case study hospitals were located in close proximity to larger hospitals in nearby communities.
Corporate business decisions, rather than assessments of local needs or planning, drove the hospital closures. In all three sites, the large health systems that owned and managed the hospitals made the decision to close them based not on community needs, but on corporate business considerations that favored other hospitals in their system over the ones they closed.
Changes in Medicare and Medicaid payment over the past few years have had an adverse effect on rural hospitals. Decreases in Medicare reimbursement rates have exacerbated financial pressure on already struggling rural hospitals, especially those with an older patient population. In recent years, Medicare cuts arising from budget sequestration and other federal policies14 have led to lower reimbursement rates overall, while specific provisions of the ACA, such as the Readmissions Reduction Program, under which CMS reduces PPS payments to inpatient hospitals with high readmission rates, have also resulted in lower Medicare reimbursements for many hospitals.15
Rural hospitals have not adapted to new models of payment and service delivery that emphasize preventive and primary care provided in outpatient settings. Increasingly, Medicare, Medicaid, and large private payers are implementing payment and delivery system reforms that move “from volume to value” and shift investment away from inpatient care and toward preventive and primary care and greater access to care in outpatient settings.
'Cut's to Medicare' (which are complicated) play a small part in this picture. The real issues are poverty, demographics, competition, corporate decisions, budget sequestration, and failure to adapt.
Also, states which had not expanded Medicaid under the ACA, were more apt to experience rural hospital closings.
Local destination Hospitals were closing due to 70 and 80% of the patients having inadequate or no insurance.
In San Leandro CA the outrage resulted in the not for profit giving the hospital to the county and now the county is struggling for the same reason as the not for profit chain.
In Hayward the Catholic Hospital there provided a tremendous amount of free and low cost care... it was modeled and operated on the thinnest of margins... changes in Family Planning mandates forced the sisters hand...
Don't kid yourself... sometimes it is pure politics when it comes to Health Care... no matter how many poor are served and no matter how great the services... it did not matter because providing family planning services trumped all...
Last edited by Ultrarunner; 04-27-2017 at 01:14 PM..
I'm not worried. Metro Boston has more percapita health care providers than you can shake a stick at.
At least in Boston the Midwives are master's prepared RNs.
In Wyoming they're few and far between. No one wants to live there.
MUCH safer in Boston.
I was being facetious. I had no idea that urban women in this country couldn't find physicians trained in childbirth. They're very common here as well as in the Salt Lake City market, They're called obstetricians. They have a bit more training and education than nurses.
I was being facetious. I had no idea that urban women in this country couldn't find physicians trained in childbirth. They're very common here as well as in the Salt Lake City market, They're called obstetricians. They have a bit more training and education than nurses.
Many women prefer NOT to have obstetricians.... rural or urban.
Your less likely to have a C-section with a midwife. OB-GYNs are notorious for being overbooked and unable to be available when moms give birth..... or they're out on the golf course so much that they insist on doing their work on their schedule rather than the moms and babies.
I'd take a good master's prepared midwife over many of the OBs I've come in contact iwth over the years - in a heartbeat.
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