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I think the key words here are "failure to adapt". The hospitals aren't the key issue here it's rural living as a whole falling out of fashion and functionality.
The same thing can be seen in rural places in Europe. In northern Sweden a lot of people living in rural villages etc are wondering why supermarkets, post offices and pharmacies etc are disappearing.
The simple answer is that when enough people and businesses move into the cities and leave the little towns behind as unproductive husks of former industries, these little towns lose their relevance.
The old welders, iron workers lumberjacks and whatnot need to re-saddle as something else, somewhere else. Industries die and new ones arise that's just the way economy works, and unlike the american automotive industry there is no bailout for failures.
Something goes for industries moving abroad, or taken over by low-wage foreign workers. it sucks for truck drivers that a polish driver will do the same job for a third of the pay, but all they can do is adapt.
Or that production of things move to low-wage countires like china, all the former factory workers can do is adapt and learn new professions.
Great post and very true.
But offered a lifeline, like ACA and Medicaid expansion and a strong social safety net and even TPP, many rural US communities are choosing to slit their own throats.
There is a war in America against rural and agricultural enclaves and they waging it upon themselves!
Last edited by shaker281; 05-27-2017 at 05:47 AM..
More rural hospitals are built? Obamacare moved money from the middle class to the poor. If you work in a non-urban area, you were paying for new hospitals and hospital expansions in urban areas while watching your local hospital close.
Obamacare has been a disaster for the middle class.
Can you explain and provide data to support your contention?
Lower mortality at Teaching hospitals in large urban areas. Lots of care is turning to Evidence Based Medicine--insurance coverage, too--and Teaching hospitals, larger hospitals know which care works and which doesn't. Makes sense for Insurance to only pay for those things, which promote better outcomes. Rural places can't keep up w/ the competition and power of knowledge based medicine institutions.
The "war on drugs" is hurting rural hospitals too. Here in Missouri, because of cold meds being used to make meth, they are prescription only. It costs $150 to see a doctor at local clinics, so those with no insurance are going to the ER to get a prescription. Just more added expense for the hospitals with no additional revenue.
Lower mortality at Teaching hospitals in large urban areas. Lots of care is turning to Evidence Based Medicine--insurance coverage, too--and Teaching hospitals, larger hospitals know which care works and which doesn't. Makes sense for Insurance to only pay for those things, which promote better outcomes. Rural places can't keep up w/ the competition and power of knowledge based medicine institutions.
Am sorry but that is just flat out wrong.
You are saying that only hospitals connected to a medical school and or have post graduate programs "know which care works and which doesn't"? You obviously know very little about how medicine is practiced much less how healthcare is delivered/that system works beyond what you've read.
By the way your link is to a *press release* from Harvard. What would you expect them to say?
There simply are far too many variables to issue a blanket statement that overall teaching hospitals have better patient outcomes than other facilities. Going by your statement unless one is admitted to a teaching hospital a patient will die or receive poor care, which is just not true.
But offered a lifeline, like ACA and Medicaid expansion and a strong social safety net and even TPP, many rural US communities are choosing to slit their own throats.
There is a war in America against rural and agricultural enclaves and they waging it upon themselves!
Key thing to this whole post is that the states where rural hospitals are failing fastest are in *Red* states that also failed to expand Medicaid.
So what you have is more of the same by GOP and their supporters. On the one hand they are claiming ACA is a "failure" and don't want any part of the thing. On the other side most of these are "donor" states; that is they are poor or at least not as wealthy compared to New York or California; thus they receive inflows of federal dollars rather than paying more than they get back.
Obamacare helped hospitals in ACHA states tremendously. States that refused continued to see bankruptcies because they are forced to care for patients who go to the ER with no coverage (which is a terrible way to address health issues). With Trump destroying Medicaid, it's going to get worse very quickly and rural areas will just have to deal with it. They voted for Trump so they should be happy to live the results of their vote.
You are saying that only hospitals connected to a medical school and or have post graduate programs "know which care works and which doesn't"? You obviously know very little about how medicine is practiced much less how healthcare is delivered/that system works beyond what you've read.
By the way your link is to a *press release* from Harvard. What would you expect them to say?
There simply are far too many variables to issue a blanket statement that overall teaching hospitals have better patient outcomes than other facilities. Going by your statement unless one is admitted to a teaching hospital a patient will die or receive poor care, which is just not true.
I think teaching hospitals or larger private even (don't have to be teaching per say) are, generally speaking, much better than small rural hospitals or local community hospitals. Catholic hospitals have excellent outcomes, too. And, US news is far from an expert on Health Care. I don't see people rushing into small rural or community hospitals to have major surgeries or care for complex problems.
I think teaching hospitals or larger private even (don't have to be teaching per say) are, generally speaking, much better than small rural hospitals or local community hospitals. Catholic hospitals have excellent outcomes, too. And, US news is far from an expert on Health Care. I don't see people rushing into small rural or community hospitals to have major surgeries or care for complex problems.
No they aren't, but why would anyone leave a major urban area to seek care at a rural hospital? That argument just does not make sense.
As for the whole "magnet hospitals' and "better patient care due to a more educated nursing staff", again you need to do some homework. That study and others like it have been debunked and or debated by the professional nursing community for some time. There were no controls regarding previous experience and a few other variables to simply say all BSN nurse care equals better outcomes.
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