Hard Times in the Country

 The AP recently reported on the disappearance of maternity wards in rural areas: 

Alisha Alderson placed her folded clothes and everything she needed for the last month of her pregnancy in various suitcases. She never imagined she would have to leave the comfort of her home in rural eastern Oregon just weeks before her due date. But following the abrupt closure in August of the only maternity ward within 40 miles, she decided to stay at her brother’s house near Boise, Idaho — a two-hour drive through a mountain pass — to be closer to a hospital. . . .

A growing number of rural hospitals have been shuttering their labor and delivery units, forcing pregnant women to travel longer distances for care or face giving birth in an emergency room. Fewer than half of rural hospitals now have maternity units, prompting government officials and families to scramble for answers. One solution gaining ground across the U.S. is freestanding midwife-led birth centers, but those also often rely on nearby hospitals when serious complications arise.

 

In fact, although this AP story doesn't mention it, emergency departments in rural areas have also been closing, and in many places hospitals are disappearing entirely. Medical services -- or health care, if you will -- are a commodity in the U.S., increasingly provided by enormous corporate conglomerates that are not in business for their health, so to speak. They're in business for the money and rural hospitals just aren't profitable. There isn't enough population and what there is has too many people on Medicaid, which doesn't pay well, or in states that haven't expanded Medicaid, no insurance at all. There are fixed costs to maintaining a labor and delivery service or an emergency department -- there has to be a certified emergency physician on the premises 24/7 -- and they aren't making enough sales to pay for it.

 

Where I am, we're close enough to population centers that there are hospitals within reasonable distance, but we can't pay for our schools, roads, or public safety. Now, to be sure, the Republicans aren't doing anything for us but on the other hand, neither are the Democrats. I can understand why people feel alienated from government and politicians, and fall for scammers who stoke their grievances, create scapegoats, and promise some vague radical change. I'm hoping our governor will come here and find ways to work with us to save our town, but if he doesn't, I can understand why people won't vote for him in 2024. I'll keep you posted.