Washington Post Op-Ed on Take-Down of U.S. Hospitals

April 13, 2020 (EIRNS)—An op-ed in the Sunday edition of Washington Post by Andreas Flynn, the director of health equity at the Roosevelt Institute, and Ron Knox, a senior research at the Institute for Local Self-Reliance, points to the take-down of the country’s rural hospitals and the extensive hospital mergers during the last few decades as responsible for the serious predicament the country is in with the outbreak of the coronavirus.

“America’s now-disastrous lack of hospital capacity is no accident,” they admonish. “It is, in part, a result of consolidation over the past 30 years that concentrated our health-care system in wealthy cities and suburbs, where the prevalence of expensive insurance plans allowed big health systems to rake in profits. There have been more than 680 hospital mergers over the past decade, a trend that is likely to accelerate in the coming years. It involves mergers between hospital systems, as well as large hospital conglomerates’ takeovers of rural hospitals, physicians’ offices, ambulatory surgical centers and other outpatient clinics.”

The authors observe that there are about 15% fewer community hospitals in the U.S. than there were in the mid-1970s and 120 rural hospitals have been shuttered over the past decade. Mergers and closures have contributed to the reduction in hospital beds in the United States, from around 1.5 million in 1975 to just more than 900,000 in 2017. And the Affordable Care Act increased the pace of consolidations, they say.

“Recent studies have shown that even before COVID-19 began to strain rural health systems, 1 out of every 5 rural hospitals was at risk of closing because of financial pressure. Part of the pressure comes from sicker patient populations that are more likely to rely on Medicare and Medicaid, which have lower reimbursement rates than private insurance does. That has made for an underlying health crisis upon which the COVID-19 pandemic is now layered.”

The authors call for broad public investments in the hospital system, health being a public good. “Hospitals should not be run according to corporate-style efficiencies, operating at near-full capacity to satisfy investors. Rather, hospitals should ensure that they have the capacity to care for their communities should the worst occur.”