Walkers Fight Rural Hospital Closures

Rural health advocates start a multi-state walk to Washington, D.C., today (Monday, June1) to raise awareness of the threat of rural hospital closures. Walkers will cover 283 miles – one mile for every at-risk rural hospital.

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Cecil G. Sheps Center at the University of North Carolina. The 21 hospitals that closed completely were located farther from other hospitals and served a higher proportion on non-white patients. 

 O’Neal says that one reason so many hospitals are closing the failure of state legislatures to expand Medicaid under the Affordable Care Act (ACA). Twenty-two states, including North Carolina, have not expanded their Medicaid coverage for low-income residents using ACA funding. 

“Indigent care reimbursements [for uninsured patients] within the Affordable Care Act are being lowered,” O’Neal said. “Medicaid expansion was supposed to offset those declining revenues. But when states don’t accept Medicaid expansion, there’s not any money to replace those falling revenues.”

Zellner says another reason is corporate greed. The nonprofit corporation that owns the hospital in Belhaven had ample earnings overall and a reserve fund to support the facility, Zellner said. “They’ve got plenty of money, they just wanted to make more money.”

A representative of Vidant Health said the issue is bigger than what is happening in Belhaven. “The changing landscape of health care in eastern North Carolina is part of a larger national trend due to changes in both how care is delivered and how it is financed,” wrote Christine Mackey with Vidant’s corporate communications in an email to the Daily Yonder.

She said Vidant Health has expanded the hours at a Belhaven family clinic to 24 hours a day to help fill the gap and is building a new facility that will offer around-the-clock care. But critics say these clinics do not offer adequate emergency care.

O’Neal  is quick to point out that this year’s walk is not about “pointing fingers,” but rather about drawing attention to the plight of rural hospitals and the impact of their closures.

Besides affecting the availability of health care and emergency services, hospital closures affect rural economies.  The 283 endangered hospitals employ 36,000 healthcare workers and contributed an estimated $10.6 billion to local economies.  Communities without hospitals also have a harder time attracting new businesses and residents. 

 “People don’t really move to areas that don’t have hospitals,” O’Neal said. “We have a lot of people from up North that retire here because we have a lot of waterfront, and that’s starting to slow down.  We have people moving away from the area because there’s no hospital.”

O’Neal has been walking for six weeks to prepare for this year’s walk.  “It’s a tough walk,” he says.  “You’re basically almost walking a marathon every day for 14 days.”

 Zellner, who is 76 years old, says he’s in better shape than last year and hopes to walk all of the 283 miles.

After two weeks of walking, they’ll reach Washington, D.C., and along the way, they’ll have a lot of company. They anticipate 20 walkers on the road at any given time.  On the morning of June 15, they’ll arrive at the Capitol, where they’ll hold a rally and speak with legislators.  Their aim, says Zellner, is to “get some legislation that says no critical access hospital can be closed in a rural area without notice given and some provision provided for those people to be taken care of.”

The men hope people will take notice.  Zellner believes they will.

“I think it was just the example of a very courageous white Republican mayor from a little town in North Carolina joining together with the civil rights movement… and walking with a civil rights organizer captures the imagination of the American public, and that’s why they’re coming out and supporting us in big numbers this year.”

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