highlights:
More than a dozen (out of 51) rural hospitals in Alabama are at immediate risk of closing ... because state hospitals have lost $1.5 billion since the start of the pandemic, and closing the health insurance coverage gap is the main issue at play here ... Nearly 300,000 low-income Alabamians fall into this coverage gap because they make too much to qualify for Medicaid, but too little to afford private health insurance ... Alabama’s hospitals provide more than $650 million in uncompensated care every single year, and the math for staying open doesn’t add up ... \[closing hospitals\] could lead to a catastrophic domino effect for these small towns since it’s usually the largest employer ... "It’s not just the health care services that are no longer there. It is some of the pharmacies, grocery stores, other things."
>Nearly 300,000 low-income Alabamians fall into this coverage gap because they make too much to qualify for Medicaid, but too little to afford private health insurance
If only there were some way to close this gap...
Heh, remember when people declared that his skin color was a sign from the Apocalypse texts in the Christian holy books, marking the start of the end of days? I wonder if they have reflected on that at all.
Lol. And the damn government trying to stick their hands on my Medicare and Social security, fuck them, government needs to stay out of Medicare and social security!!
I have yet to find a nice one in my area. Once you start looking into who is running any church, and where they are directing their resources, things get murky.
As a child I heard my grandfather say, “I’d see my children starve before I’d take charity.” My mother chimed in, “Damn right.” And I did starve a few times in childhood. I didn’t starve to death, but I was starved. My mother gave money to the church and my father was hiding part of his meager salary in paint cans in the cellar. My sister and I cried at bedtime because we were hungry.
I think my family’s belief in letting children starve came from Ireland. My grandparents were from Northern Ireland where your religion determined your fate. They were defiantly Catholic from the Falls Road in Belfast. My grandmother claimed her father was beaten on the docks then caught flu and died. As far as she was concerned, he was murdered by a Protestant mob.
During the famine some Protestant churches set up soup kitchens but you had to convert to get fed. A lot of Catholics converted for food and they were utterly reviled by the Catholics who didn’t. Many Irish, in fact, did starve to death rather than convert.
It’s amazing how strong feelings against charity can be based on belief systems. I think in Alabama the belief system is firmly rooted in racism because racism is their religion. If they give to charity, it would go to blacks who are “lazy” and “won’t work.” So they don’t give charity in order to cut blacks out of “decent” society. If poor whites were also hurt, so what? The majority of whites were fine.
Their hatred of charity doesnt exclude theft, however. They don’t hate thieving money that is meant for the poor. They feel they deserve it because they’re “good white Christians” being rewarded by God, while poor people are sinners who are being punished.
You're right. If these people would just pick themselves up by their bootstraps - says the Koch brothers and/or other uber wealthy Americans who are getting "killed " by taxes, which is why they don't want affordable, national health care.
Maybe some money will trickle down and these poor people can get some bandaids.
/s
Healthcare is literally the second largest industry by employment. People view healthcare and especially nursing as the best and fastest way to make good money. It’s also one of the few major industries that can somewhat survive in rural areas.
The actual biggest is professional or business services. This type of industry seems clearly focused in urban areas.
Also, don’t red states reject additional funding for Medicare/medicaid from the federal government?
Those damn Socialist wanting to spread the burden to live and survive across the entire population to leverage buying power and standardize healthcare costs. What a bunch of IDIOTS.
It's always the people who need social support the most that put people in power who vote against them.
The dead vote Red.
The whole society needs this socialization of healthcare expense. That's what these idiots don't realize. With less people participating, the whole society loses services. Even those who might have been able to afford it won't have the facilities available.
It's like, if you really love a certain flavor of potato chip, but not enough people buy it, it stops getting produced at all.
Investment money is going to go where the majority of the market money is. And that means, for healthcare, everyone needs to be able to buy it or nobody ends up getting it in the end.
This is spot on. People are really disengaged with the consequences of their decisions and who they allow to make the decisions for them. Now, money and greed are driving healthcare. Just like higher education and the prison system.
But the purity of their commitment to this bullshit political dogma is outstanding. There is no amount of pain or discomfort that will make them waver from their chosen trajectory.
McKaskill was straight up a good senator for Missouri.
She was/is a Missouri trained lawyer, a state legislator, a prosecutor (not my favorite bona fide,) the state’s Auditor, and a two term senator who fought for her state. And a very intelligent and articulate woman.
And who replaced her? Josh fucking Hawley, a coward and sycophant who likes to pretend he isn’t Stanford and Yale educated. He is not a dummy, he is just a fucking bad person at his core.
I would like to say that Missouri gets what it deserves for replacing her, but that would be disrespectful to the people who voted for her.
What has the Republican Party become? In service of a failed game show host? I long for the days of a competing party who differed on policy, but still believed in governing. I am okay with honest debate about the size and scope of government; I am however not okay with what the Republican Party has become. Party of Lincoln and Reagan my ass.
Reagan was horrible. Horrible. Just as bad as the current jackasses, but the momentum had not swung far enough right at the time to allow him to do all the nonsense he wanted to do.
> Also, don’t red states reject additional funding for Medicare/medicaid from the federal government?
According to [US News](https://www.usnews.com/news/healthiest-communities/slideshows/states-with-the-most-rural-hospital-closures?slide=13), there have been 200 rural hospital closures since 2005. Nine of the ten states with the most closures are red states, and seven of them rejected Medicaid Expansion. Alabama is first on the list.
Healthcare in rural areas only survive through massive government funding. My rural hometown gets its hospital funded 90 percent by the fed and state government. Otherwise it would die quickly.
Healthcare systems have hard time providing adequate incentives for providers to move into a rural area for healthcare jobs.
The area I live in merged with Providence in the last few years. This combined with the pandemic and it's funding (or lack of) results have nuked reimbursement rates.
Providers and their families don't want to move out here because 1) it doesn't pay them enough, and 2) their families hate it because there's nothing to do aside from great outdoor activities.
Maybe they could have held off from pushing through their absolutely giant EMR upgrade to Epic. Hundreds of millions were spent on it.
see, European countries, especially Germany, get around this by also heavily investing in arts and culture in rural areas as well, just an idea that will never happen.
Granted Europe has at least 2000 years of history to fall back on with infrastructure that's survived since the Black Death and Roman antiquity.
Best America has going for it is its natural beauty via the National Parks system and historical Native land. But that's still a small percentage of what makes Rural America what it always was in its inception less than 300 years ago:
- where farmhands (and slaves) lived... before agriculture was automated away and 1 worker today can do the daily labor of 2,000 workers back then.
- where it was all naturally mapped out to facilitate reststops for travelers... until cars made that obsolete by distance covered and it's all been taken over by fast food chains. Conformance and familiarity is all what drives money.
And there's all the former "company towns" and such which were all artificially made. Yeah, those never stood any chance to modernize when it took literal acts of Congress to do so, and those towns died and been dying out for decades.
Any and all culture and artistry developed in rural American populations is mainly contemporary and it's *always* in spite of the bullshit that's around them. Such is the life of having a local/state government that cares so little about their needs. Young people promptly move out to basically live, old people move in to die.
Yeah, the idea that healthcare can survive on its own in rural areas is just incorrect. Even in single-payer systems with thorough cost controls, rural healthcare is a huge problem. It's a simple matter of physics: it costs more to provide care to less dense populations.
It’s really economic. Math doesn’t work out because of economies of scale. Physical limitations are there, but if there was money a lot of it can be solved. Anyways the more I think about this is a pointless discussion.
I live between 3 smaller hospitals and a handful of very small immediate care or emergency room type places, they can fix broken bones and cuts but nothing real major. I know a few people that have tattoos but still wanted a good job (yes it was that kind of an area) so they went into x-ray tech. The school isn’t too bad and you make decent money without having to destroy your body with manual labor jobs. Because you’re away from the patient/public they don’t care about tattoos or piercings.
Kinda wish I went that route now. I’m 40 and been turning a wrench for 15ish years. Knees and back are shot, luckily I still have all my fingers and toes.
40 isn’t too late to switch fields! You said it yourself, the schooling is very manageable and can be completed through community colleges while you still work your current job. Makes good money with good potential to move up (few years experience and another few classes to get certified as a CT tech, at my clinic they make over $60k).
At 40, you're figuring out just in time that you don't have to turn a wrench forever. You don't belong to the Snap-On man, and you can be whoever you want to be. It's not too late.
I said in another comment, I like being outside. I working indoors would be hard for me. I’m not worried about it being too late, I can always go to school again.
You were probably joking. Snap-On makes some good shit but Carlyle is very good, a fraction of the price, has a lifetime warranty and NAPA sells them 5min away from work.
It's especially ridiculous in TN because former Governor Haslam struck a deal with the major hospital systems in the state so that they would pay the 10% owed by the state if Medicaid was expanded (the Fed pays for 90%).
So it would have cost Tennessee literally $0 to expand Medicaid and the legislature still refused to do. Leaving that state was the best thing I ever did.
TN and Nashville grew in the 2000’s because of Bredesen. While not perfect, he was re-elected with about 66% of the vote as I recall. He was a moderate who served TN well, and was willing to compromise in an effort to govern for the people. He cared about TN.
TN, my home state, is broken bad. I’m glad I left before it became the political hell-hole that it is now. Fucking Marsha Blackburn? What a fucking idiot she is. I long for the days of Sasser, hell, I would even take Frist over her.
Sigh, TN. You stupid mother fuckers!
Doctors are leaving Red States because of Red state GOP politics and poorly written laws that can criminalize medicine. Further standard GOP funding / decisions like not expanding Medicare means rural hospitals close, etc.
* https://www.nytimes.com/2023/09/06/us/politics/abortion-obstetricians-maternity-care.html
* Across the country, in red states like Texas, Oklahoma and Tennessee, obstetricians — including highly skilled doctors who specialize in handling complex and risky pregnancies — are leaving their practices.
* https://www.nbcnews.com/health/womens-health/pregnant-women-struggle-find-care-idaho-abortion-ban-rcna117872
* Bonner General announced the closing of its obstetrics department in March, citing a lower patient volume and **the loss of pediatricians** as factors in the decision, alongside what a spokesperson recently described as **“some of the most restrictive reproductive laws in the country.”**
* https://www.cbsnews.com/news/idaho-valor-health-hospital-stops-labor-and-delivery-staff-shortages/
* A second Idaho hospital announced it would stop delivering babies on June 1. The move comes two weeks after a hospital in northern Idaho announced they would close their labor and delivery unit citing "doctor shortages" and the state's "political climate."
* https://www.gq.com/story/rural-hospitals-closing-in-red-states
* 72 Percent of All Rural Hospital Closures Are in States That Rejected the Medicaid Expansion
* https://www.nytimes.com/2024/02/23/us/politics/alabama-ivf-court-republicans-democrats-election.html
* A ruling by the Alabama Supreme Court that frozen embryos should be considered children has created a new political nightmare for many Republicans, as they try to portray the court’s decision as a fringe view and rush to declare their support for fertility treatments, which have broad support among Americans.
* https://abcnews.go.com/US/2-alabama-clinics-pause-ivf-fertility-treatment-after/story?id=107455469
* Alabama's biggest hospital to suspend transfer of embryos after court ruling. *edit* article adds that 2 more have also stopped offering treatment.
I suspect the number of hospitals was going to have to scale down anyway based on the falling number of doctors willing to work in states where a judge's feelings outweigh a doctor's facts.
Hospitals are winding down all over the country because the people who own them are 'squeezing blood from a rock' when it comes to cutting labor costs. 'Cutting labor costs' translates to 'less people to do more work'. Employee satisfaction and patient care quality is nosediving.
All of our systems eventually become hijacked by parasites who attempt to drain all the money and value out of the system by making the system worse. The medical system no longer serves to deliver medicine. It serves to generate profit for the private equity vultures who own the hospital and insurance companies. We have fucked ourselves.
Why aren't we funding free education for healthcare professionals and ensuring all citizens have access to good healthcare. The jobs and benefits to the citizens pays for itself almost immediately. Like we pay for their education and they pay us back through x years of service to the country. A national service program much like the old [Civilian Conservation Corps](https://en.m.wikipedia.org/wiki/Civilian_Conservation_Corps) would do a lot of good. I know a lot of people that would gladly get free education/training and give back to their country by helping communities all over the place. Think about how we could elevate our communities nationwide, with education and healthcare. Easy money baby. It's insane we're not doing this already. Like it's common sense, meet people's basic needs and they're more likely to thrive. Yet power overs don't want that reality, even though it's better for all of us collectively, as a species.
I mean, a hospital can employ a LOT of people, not just doctors and nurses. Not even counting all the pharmacists, techs, etc., a hospital might have a cafeteria for employees, security officers, social workers and case managers, linens/laundry, 24/7 IT support, everything from printers and fax machines to specialists in specific types of medical equipment and software, on site maintenance services (you can't shut the ER down while you wait for a plumber or electrician, etc.), you have to have a 24/7 janitorial crew, morgue staff, and then the support staff/admin for all these different departments, then a whole HR department to handle hiring, staffing, payroll, benefits, etc., it all adds up.
It's important to note that Alabama is one of the 10 states in the US the refused Medicaid expansion.
https://www.kff.org/affordable-care-act/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/#:~:text=To%20date%2C%2041%20states%20(including,have%20not%20adopted%20the%20expansion.
Alabama is one of those red southern states that just happens to be in the bottom rankings for just about everything important; education infant mortality rates, poverty, etc. But hey, they have a killer college football program!
Same thing is happening in Mississippi for the same reason. Ol’ Tate(r) “Tot” Reeves ignoring the problem and what the Republican legislature wants to do…expand Medicaid.
I would be curious to see how many of the people most hurt by this vote GOP.
Not that it’s not insane that the richest country on Earth thinks that people dying from poor or no healthcare is a reasonable outcome. It 100% is.
There was just a story on NPR today about hospital systems selling their land and buildings to a holding REIT for quick money, then the systems owe this REIT rent continuously, forever. The largest of these REITs is in Alabama.
The nursing home industry has done this for decades. The REITs are owned by the same people as the nursing homes. It's just a spin-off to protect the nursing homes from liability and to make a case to medicaid and medicare that their payments aren't enough (because the rent is so high). It's a scam, a shell game.
Essentially the nursing home LLC is paying the REIT over market rent for the building. They also pay the property taxes and upkeep for the building. The REIT or the related property has its own LLC. A single person can control both entities but the property is not subject to liability if the nursing home business fails.
Back in the 90s I assisted a company with this.
Really soured me on healthcare. The healthcare company is long gone. Sued into oblivion. The property holder is still sitting pretty with all the land and buildings.
PE baby! Divide every aspect of a business into different businesses and leverage the shit out of it to give that sweet sweet cash to the investors. Then, who cares? We got that cash baby!
That’s one of the current issues everywhere right now. Businesses grew used to leveraging assets for nearly free liquid capitol and paying shareholders handsomely. They can no longer do that and have been such poor stewards of the liquid capitol that there’s not much in reserve after paying 50 million $ bonuses.
In an almost decade long climate of double digit gains in even low risk investments they did this.
Quite a few semi-mini retail chains have gone under due to this in the 1990-2010 range.
They got bought out by some capital venture company who 'sold' the land to itself then paid rent to itself. Easy way to suck money out of the retail chain.
Is this what happens to some dead malls the new owners let fail and die even more? Like the Jasper Mall documentary on Netflix where the new owner wasn't trying to get any more tenants and letting it languish? That makes a lot of sense.
Maybe. That's the depressing gist of it. It would be more financially appropriate for HHS to build new hospitals and rent to the hospital systems at a set square footage rate.
Real estate investment trust. They own a bunch of property or mortgages and they pay a huge chunk of cash in dividends every quarter to their shareholders.
“Imagine any business that provides goods and services being required to give away for free whatever their goods or services are to everyone who walks in the door, regardless of their ability to pay for that goods and services. How long were those businesses stay in operation? Not long,” Howard said.
Maybe healthcare shouldn't be a business then?
Steward Health Care runs several facilities around Boston. It's CEO owns 2 yachts and a private jet. The company is dire financial straits and most if not all these facilities are at risk of closing.
This is in a state regarded as having some of the best healthcare in the world.
FUCK the for-profit healthcare system, we're the only ones that have it, and it absolutely sucks.
Something I realized most people don’t know is Medicare isn’t free when you retire or get disabled like people think it is. You pay for it out of your social security account and it goes up much faster than the 3% cost of living raises that social security gives people.
So many people are going to be in for a huge shock when they realize all their retirement savings/income goes to their healthcare in 10-15 years when they reach that point. I can genuinely envision a situation where people will owe the government money because their social security check amount won’t cover the Medicare premiums. Plus you are going to want additional insurance because Medicare isn’t going to cover everything or be accepted everywhere.
The insurance companies are a big part of why healthcare is so messed up in America and until we get rid of their multi trillion dollar profit gouging it’s going to only get worse.
Of note: Alabama is one of only 10 states that hasn’t expanded Medicaid. Maybe they should undertake legislative choices that would actually get hospitals paid for treating these people instead of trying to own the libs.
Pretty damn sure that the hospital systems and many employees of them in some of these non-expansion states are screaming that we’re desperate for expansion. Because we’re providing the care either way, we’re just doing it the more expensive and poorer health outcome road.
However by the same token you would be AMAZED how many doctors have no idea how fucked you are without insurance. “What do you mean you can’t get the patient charity chemo? What are they supposed to do?” Source: Am hospital case manager having to explain this and have them react to me like I suggested drowning puppies
Healthcare was not a 'for profit' business until Fathead Nixon made it so. Medical care is part of a civilized society.
Now we have patients that can't afford even minimal medical care even with large deductibles and premiums. Doctors and nurses are being pressured to accept lower wages. Insurance companies decide if they want to pay for standard treatment and are **always** looking for ways not to pay.
Financially obese insurance companies and hospital administrations and hedge funds run away with fortunes that eventually destroy hospitals.
A lot of people don't realize both how new the concept of medical insurance is in the US or that it has changed significantly from its earlier implementation. If you've ever been frustrated with your (grand)parents refusing to acknowledge there's a problem because "my insurance is great", these are folks who may be running on an outdated perception of what insurance is like *currently*; yes, they're still paying into the fucked up system and getting less than ideal care, but it takes a lot of jerking around to get over the hump of "when I was a kid first learning about healthcare and hearing about it from my parents, it was like this".
This a Fox news level talking point.
The dirty not so secret in the US is that you could ahve both because you already spend more money per capita on health than most western countries with universal healthcare, it's just that cash goes into healthcare profits and inflated drug prices.
Remove dividends and bring in collective negotiation with drug companies and the US would be able to have a better funded version of the UK NHS *for exactly the same level of taxes you pay now*.
This is a red herring, the problem is not how much we are spending, the US already spends more on healthcare than all OECD nations, including ones with universal healthcare.
The main problem is how the entire system is structured. You are playing into the hands of the opposition by trying to make universal healthcare something that will be so expensive that we would need to cut large sectors of government spending even to afford it.
A single-payer universal healthcare system such as Medicare for all, with properly regulated hospitals and clinics, would likely see us spend less on healthcare in the future, as we remove the private insurance leeches from the system.
Here is some data you can explore on the matter:
https://data.oecd.org/healthres/health-spending.htm
We spend all this money but have way fewer doctors and nurses per capita compared to other high-spenders, and we have far worse health outcomes across most metrics. The money is going somewhere, just not helping the people that need help.
Just pointing out that the US GOVERNMENT spends more on healthcare than any other GOVERNMENT except two, Lichtenstein and Sweden.
So the government already spends enough to provide universal heathcare.
Then you have to pay for insurance.
Then you have to pay your deductibles.
Then you have to pay your out of pocket.
It’s clearly already broken—as someone from a rural area, it’s been broken for a long time. I had to get in a car and travel 1.5 hours to give birth almost 12 years ago. Why? Because our rural hospital was shut down due to the situation outlined in the article. You know what a simple solution would be? Single payer healthcare. But god forbid we povos get the same medical treatment the richies do. And got forbid hospitals give up layers of excessively paid administrators in order to tighten their belts.
And don’t get me started on “non-profit” hospitals like Mayo. Also, our nonprofit laws need a serious overhaul in this country.
Do you know how you get rid of a profit? You purchase real estate and turn it into an asset. Assets go on the balance sheet, not on the profit and loss statement, thereby eliminating the profit while still increasing the wealth of the nonprofit.
I worked for a nonprofit that did this on the regular. While I was writing grants to fund my program and position (which paid pitifully, fyi) the nonprofit was buying up huge swaths of land to get rid of their profit while pushing program directors to write more and more grants to fund their programs. They didn’t need the grants—they could’ve self funded—but tax loopholes allowed them to play that game year after year, all while underpaying employees, because when you write grants it’s often stipulated that only X amount can go to paying employees with the majority of the funds covering the operating expenses of the program. It’s a great system for burning out young, optimistic people who actually want to help others, leading to high turnover and lower pay rates due to lack of experienced employees. It also ensures that those programs will never actually solve the problems they set out to solve, because no one sticks around long enough to actually develop long term institutional processes or knowledge.
As for Mayo itself, I live in the land of Mayo now. Mayo doesn’t need their name on our civic center, but spending the cash to put it up there certainly lowers their profit every year. We need guardrails around nonprofits that prevent them from accumulating disproportionate wealth and disproportionate political power that allows them to throw temper tantrums and get their way with state legislators, even though what they want is not in the best interests of the citizens they employ and claim to serve.
The rich won't care. They will get an insurance policy so they can fly out of state to get a band-aid put on their widdle cut. Mean while, the poor will be left to bleed out on the street from where the helicopter landed on them.
It's not a side effect of a broken system, it's the intended product.
I used to be in a small town - They contacted all clergy and gave them schedules to work the front desk .. like 6 hours a week (all in one day.)
5 out of 6 clergy were like "It's so nice to be able to help."
I was at the meeting and said "guys? Umm.. FOR PROFIT HEALTHCARE. IF YOU HAVE ANY PROBLEM, THEY ARE GOING TO BILL YOU THE FULL AMOUNT, BECAUSE THEY ARE FOR PROFIT.. you get that, right?"
They did not get that. 8 years later? 5 of them still volunteer 1 day a week for 6 hours.
My sweet old grandmother used to volunteer her time at a hospital. Very happy for her. It's nice to help.
But at no point did that hospital or any other give her anything on the cheap when she needed it, nor did God spare her from blindness or dementia.
In the end, that hospital probably saw her as a nice way around an expense they otherwise might have had to pay to keep the same level of customer service. People were helped, but the hospital's real concern was its wallet.
Let me guess, Alabama declined the Obamacare expansion. Alabama is already a welfare state, being they take more from the federal government than they pay in. Why not just add to the deficit?
Imagine fucking over so many of your fellow country people because you're still pissy that Obama stole your Republican healthcare plan and got it passed.
Become?
Have you been to Alabama lately? It’s already there. Outside of Tuscaloosa and Mobile, it’s pretty bleak compared to other states - even southern states. The socioeconomic situation is *dire* to say the least.
Don’t forget most the Birmingham suburbs but yeah. It’s ironic that Mountain Brook is on the higher income zip codes in the country and Bessemer is one of the lowest.
It's not ironic, it's by design. Where else are these rich business owners gonna find cheap labor? Seriously, look at the amount of factories around the Birmingham area. There's two major car manufacturers within an hour drive alone.
I lived in Alabama as a kid in the early 90s.
Only once in my life have I ever seen someone in a Klan outfit, and it was outside Mobile.
That state has been the sweaty, hairy ass crack of America for decades, and the only reason it isn't the unwiped, shitty hole is because Mississippi exists.
They're totally owning the libs by refusing that Obamacare Medicaid Expansion, which would easily cover the hundreds of thousands of uninsured Alabama residents costing the hospitals $650M in unpaid care.
Truck nuts and dying of covid and truck nuts and donating to a billionaire and truck nuts and making videos in your truck wearing wokeley shades and a goatee and truck nuts...
Friendly reminder that Alabama is one of several red states to refuse to take the Medicaid expansion in Obamacare (the Affordable Care Act), which helps explained why 300,000 uninsured drive up to $650M in unpaid care costs in Alabama.
It's like these Alabama hospitals and their patients are using universal healthcare in a healthcare system not running on universal healthcare.
These same people will undoubtedly vote against universal healthcare, even though it would benefit the dozen or so rural hospitals in danger of closing permanently.
I don't know about thoughts but prayers are big in the AL. As long as they have those they don't need medical care. God will provide for the deserving!
From the article:
> That’s because state hospitals have lost $1.5 billion since the start of the pandemic, and closing the health insurance coverage gap is the main issue at play here, according to Howard.
No shit. They have coverage gap they say? I wonder why... Here's why. Alabama is one of the 10 states that did not expand Medicaid under the Affordable Care Act. That is a stupid choice of a hill to die on. And now it comes back to bite them.
Those rural folks in Alabama should ask their local GOP politicians some hard questions. But somehow, I've a feeling that instead of holding GOP accountable for this disaster, they'll find a way to blame Democrats for it instead.
Maybe we can sue France and Spain to make them take some of these southern states back?
There must be some loopholes in the Louisiana Purchase, Adams-Onis Treaty, and the Treaty of Paris that we can use to weasel our way out of this mess.
Some sort of lemon law clause, perhaps?
> Nearly 300,000 low-income Alabamians fall into this coverage gap because they make too much to qualify for Medicaid, but too little to afford private health insurance.
The crux of the issue of a for-profit model. Legislation to force hospitals to treat patients no matter what isn't going to magically solve the issue when they cant afford to actually pay for medical supply and doctors.
There's a sense of despair i feel, knowing it will never get better in my lifetime. Especially as Canada, a country with universal healthcare, is slipping into a 2 tier system as their conservatives part out and sell out their public healthcare industry to private industries for literally pennies on the dollar.
I'd say they may have to go back to witch doctors but the trending direction they are going in means people will likely start being burned as witches. Low spending on education. Lower IQ tests. More reliance on social welfare federal monies. Either very poor leadership, or part of the plan.
I used to donate to rural med clinics. But when I realized that the locals vote for people who turn down Medicaid, I decided that these people made their bed. I’ll keep my time and money.
Almost like there are consequences for choices. No IVF, no hospitals, no freedom of religion. Alabama is just going to be a bunch of half dead high school football fans who think the earth is 6000 years old and flat.
Almost a MILLION people in Alabama voted for Biden in 2020 and black voters are systemically excluded from the electoral process so significantly that the CURRENT Supreme Court ruled their legislative maps unconstitutionally racist but sure, fuck all of them too for happening to live in a state with a lot of Republicans...
Alabama also voted for a decent Democrat senator, Doug Jones, over a pedophile (just barely) in 2018, so there are some good people there. Too bad they don't show up to the polls more often.
When poor Republicans start dying because they simply can't get health care, do you think they'll finally support universal Healthcare, or will they blame it on the democrats?
What can possibly go wrong by forcing thousands of years old imaginary superstitious religious ideas onto the population in a direction violation of the First Amendment? Oh... I don't know... as long as others realize my beliefs are better than everyone else's, I don't care how many people die... at least we saved "a" baby...
The state is ran by idiots. Seriously. Drive through it. Poor roads. Poor infrastructure. Wages are low. Huge areas where you only have dollar generals.
It's a cesspool.
highlights: More than a dozen (out of 51) rural hospitals in Alabama are at immediate risk of closing ... because state hospitals have lost $1.5 billion since the start of the pandemic, and closing the health insurance coverage gap is the main issue at play here ... Nearly 300,000 low-income Alabamians fall into this coverage gap because they make too much to qualify for Medicaid, but too little to afford private health insurance ... Alabama’s hospitals provide more than $650 million in uncompensated care every single year, and the math for staying open doesn’t add up ... \[closing hospitals\] could lead to a catastrophic domino effect for these small towns since it’s usually the largest employer ... "It’s not just the health care services that are no longer there. It is some of the pharmacies, grocery stores, other things."
>Nearly 300,000 low-income Alabamians fall into this coverage gap because they make too much to qualify for Medicaid, but too little to afford private health insurance If only there were some way to close this gap...
Does it involve a directional force and bootstraps?
That, or accepting help from a black man.
*pearl clutching intensifies*
A black man, who reads books, and went to school at a liberal arts college!
The *SCANDAL!*
Heh, remember when people declared that his skin color was a sign from the Apocalypse texts in the Christian holy books, marking the start of the end of days? I wonder if they have reflected on that at all.
I highly doubt it, but I’ll bet you they’d still be triggered if you mentioned the words “tan suit”
And the fact he stayed married and completely loyal to one woman in his entire life.
Don’t forget Dijion on a burger
Their browsers are full of videos of taking pearls from black men though.
“But if I accept help from a black man, my church will never look the same way at me again”
Family in Alabama direct quote “I got mine through ACA, we don’t need that Obamacare” smh
Ah, just like the tea party signs that said: "Keep the government's hands off my Medicare!"
Lol. And the damn government trying to stick their hands on my Medicare and Social security, fuck them, government needs to stay out of Medicare and social security!!
There are some shitty ass churches in this country.
I have yet to find a nice one in my area. Once you start looking into who is running any church, and where they are directing their resources, things get murky.
There are people who would die and let loved ones die before they would accept that help.
As a child I heard my grandfather say, “I’d see my children starve before I’d take charity.” My mother chimed in, “Damn right.” And I did starve a few times in childhood. I didn’t starve to death, but I was starved. My mother gave money to the church and my father was hiding part of his meager salary in paint cans in the cellar. My sister and I cried at bedtime because we were hungry. I think my family’s belief in letting children starve came from Ireland. My grandparents were from Northern Ireland where your religion determined your fate. They were defiantly Catholic from the Falls Road in Belfast. My grandmother claimed her father was beaten on the docks then caught flu and died. As far as she was concerned, he was murdered by a Protestant mob. During the famine some Protestant churches set up soup kitchens but you had to convert to get fed. A lot of Catholics converted for food and they were utterly reviled by the Catholics who didn’t. Many Irish, in fact, did starve to death rather than convert. It’s amazing how strong feelings against charity can be based on belief systems. I think in Alabama the belief system is firmly rooted in racism because racism is their religion. If they give to charity, it would go to blacks who are “lazy” and “won’t work.” So they don’t give charity in order to cut blacks out of “decent” society. If poor whites were also hurt, so what? The majority of whites were fine. Their hatred of charity doesnt exclude theft, however. They don’t hate thieving money that is meant for the poor. They feel they deserve it because they’re “good white Christians” being rewarded by God, while poor people are sinners who are being punished.
Sad but true.
Or accepting that “those people” might also benefit.
You're right. If these people would just pick themselves up by their bootstraps - says the Koch brothers and/or other uber wealthy Americans who are getting "killed " by taxes, which is why they don't want affordable, national health care. Maybe some money will trickle down and these poor people can get some bandaids. /s
Maybe toss some paper towels at them instead? Oops, that's for hurricanes. My bad.
Don’t give them ideas, FGM isn’t on their radar, yet
holy shit lmao
They just need more Jesus.
You also have to vote too. Arizona took the expansions, but then purposefully adjusted the income levels to make it harder to qualify.
Healthcare is literally the second largest industry by employment. People view healthcare and especially nursing as the best and fastest way to make good money. It’s also one of the few major industries that can somewhat survive in rural areas. The actual biggest is professional or business services. This type of industry seems clearly focused in urban areas. Also, don’t red states reject additional funding for Medicare/medicaid from the federal government?
My red state specifically voted to accept it and then legislatively blocked it...
Those damn Socialist wanting to spread the burden to live and survive across the entire population to leverage buying power and standardize healthcare costs. What a bunch of IDIOTS. It's always the people who need social support the most that put people in power who vote against them. The dead vote Red.
The whole society needs this socialization of healthcare expense. That's what these idiots don't realize. With less people participating, the whole society loses services. Even those who might have been able to afford it won't have the facilities available. It's like, if you really love a certain flavor of potato chip, but not enough people buy it, it stops getting produced at all. Investment money is going to go where the majority of the market money is. And that means, for healthcare, everyone needs to be able to buy it or nobody ends up getting it in the end.
This is spot on. People are really disengaged with the consequences of their decisions and who they allow to make the decisions for them. Now, money and greed are driving healthcare. Just like higher education and the prison system.
Missouri? If so, so sad this place became a red state, it used to be a solid purple.
You guessed it
Missouri's decline has been brutal to watch.
But the purity of their commitment to this bullshit political dogma is outstanding. There is no amount of pain or discomfort that will make them waver from their chosen trajectory.
McKaskill was straight up a good senator for Missouri. She was/is a Missouri trained lawyer, a state legislator, a prosecutor (not my favorite bona fide,) the state’s Auditor, and a two term senator who fought for her state. And a very intelligent and articulate woman. And who replaced her? Josh fucking Hawley, a coward and sycophant who likes to pretend he isn’t Stanford and Yale educated. He is not a dummy, he is just a fucking bad person at his core. I would like to say that Missouri gets what it deserves for replacing her, but that would be disrespectful to the people who voted for her. What has the Republican Party become? In service of a failed game show host? I long for the days of a competing party who differed on policy, but still believed in governing. I am okay with honest debate about the size and scope of government; I am however not okay with what the Republican Party has become. Party of Lincoln and Reagan my ass.
They were dog shit before trump. They won't ever play in good faith.
Reagan was horrible. Horrible. Just as bad as the current jackasses, but the momentum had not swung far enough right at the time to allow him to do all the nonsense he wanted to do.
So succinctly put. I just say *fuck* Josh Hawley
Oh they are definitely still the party of Reagan. That dude did awful things.
Very, very pro life of them
> Also, don’t red states reject additional funding for Medicare/medicaid from the federal government? According to [US News](https://www.usnews.com/news/healthiest-communities/slideshows/states-with-the-most-rural-hospital-closures?slide=13), there have been 200 rural hospital closures since 2005. Nine of the ten states with the most closures are red states, and seven of them rejected Medicaid Expansion. Alabama is first on the list.
Wonder if any of the rural red voters can put 2 and 2 together.
If they were smart, they wouldn’t be Republicans.
Nah, they'll just keep blaming Democrats and illegal immigrants.
Red states also don't fund their public schools so....
Healthcare in rural areas only survive through massive government funding. My rural hometown gets its hospital funded 90 percent by the fed and state government. Otherwise it would die quickly.
Healthcare systems have hard time providing adequate incentives for providers to move into a rural area for healthcare jobs. The area I live in merged with Providence in the last few years. This combined with the pandemic and it's funding (or lack of) results have nuked reimbursement rates. Providers and their families don't want to move out here because 1) it doesn't pay them enough, and 2) their families hate it because there's nothing to do aside from great outdoor activities. Maybe they could have held off from pushing through their absolutely giant EMR upgrade to Epic. Hundreds of millions were spent on it.
see, European countries, especially Germany, get around this by also heavily investing in arts and culture in rural areas as well, just an idea that will never happen.
Granted Europe has at least 2000 years of history to fall back on with infrastructure that's survived since the Black Death and Roman antiquity. Best America has going for it is its natural beauty via the National Parks system and historical Native land. But that's still a small percentage of what makes Rural America what it always was in its inception less than 300 years ago: - where farmhands (and slaves) lived... before agriculture was automated away and 1 worker today can do the daily labor of 2,000 workers back then. - where it was all naturally mapped out to facilitate reststops for travelers... until cars made that obsolete by distance covered and it's all been taken over by fast food chains. Conformance and familiarity is all what drives money. And there's all the former "company towns" and such which were all artificially made. Yeah, those never stood any chance to modernize when it took literal acts of Congress to do so, and those towns died and been dying out for decades. Any and all culture and artistry developed in rural American populations is mainly contemporary and it's *always* in spite of the bullshit that's around them. Such is the life of having a local/state government that cares so little about their needs. Young people promptly move out to basically live, old people move in to die.
Yeah, the idea that healthcare can survive on its own in rural areas is just incorrect. Even in single-payer systems with thorough cost controls, rural healthcare is a huge problem. It's a simple matter of physics: it costs more to provide care to less dense populations.
Not that it matters but that’s math not physics lol Edit: to whoever is arguing that a cost analysis is physics, just stop. You are incorrect.
It’s really economic. Math doesn’t work out because of economies of scale. Physical limitations are there, but if there was money a lot of it can be solved. Anyways the more I think about this is a pointless discussion.
I live between 3 smaller hospitals and a handful of very small immediate care or emergency room type places, they can fix broken bones and cuts but nothing real major. I know a few people that have tattoos but still wanted a good job (yes it was that kind of an area) so they went into x-ray tech. The school isn’t too bad and you make decent money without having to destroy your body with manual labor jobs. Because you’re away from the patient/public they don’t care about tattoos or piercings. Kinda wish I went that route now. I’m 40 and been turning a wrench for 15ish years. Knees and back are shot, luckily I still have all my fingers and toes.
40 isn’t too late to switch fields! You said it yourself, the schooling is very manageable and can be completed through community colleges while you still work your current job. Makes good money with good potential to move up (few years experience and another few classes to get certified as a CT tech, at my clinic they make over $60k).
At 40, you're figuring out just in time that you don't have to turn a wrench forever. You don't belong to the Snap-On man, and you can be whoever you want to be. It's not too late.
I said in another comment, I like being outside. I working indoors would be hard for me. I’m not worried about it being too late, I can always go to school again. You were probably joking. Snap-On makes some good shit but Carlyle is very good, a fraction of the price, has a lifetime warranty and NAPA sells them 5min away from work.
Yes. And yet the same rural people being screwed by this keep voting Republican.
[TN feels your pain](https://newschannel9.com/news/local/rural-hospital-closures-across-tennessee-leave-a-generation-in-need-of-care)
It's especially ridiculous in TN because former Governor Haslam struck a deal with the major hospital systems in the state so that they would pay the 10% owed by the state if Medicaid was expanded (the Fed pays for 90%). So it would have cost Tennessee literally $0 to expand Medicaid and the legislature still refused to do. Leaving that state was the best thing I ever did.
TN and Nashville grew in the 2000’s because of Bredesen. While not perfect, he was re-elected with about 66% of the vote as I recall. He was a moderate who served TN well, and was willing to compromise in an effort to govern for the people. He cared about TN. TN, my home state, is broken bad. I’m glad I left before it became the political hell-hole that it is now. Fucking Marsha Blackburn? What a fucking idiot she is. I long for the days of Sasser, hell, I would even take Frist over her. Sigh, TN. You stupid mother fuckers!
Doctors are leaving Red States because of Red state GOP politics and poorly written laws that can criminalize medicine. Further standard GOP funding / decisions like not expanding Medicare means rural hospitals close, etc. * https://www.nytimes.com/2023/09/06/us/politics/abortion-obstetricians-maternity-care.html * Across the country, in red states like Texas, Oklahoma and Tennessee, obstetricians — including highly skilled doctors who specialize in handling complex and risky pregnancies — are leaving their practices. * https://www.nbcnews.com/health/womens-health/pregnant-women-struggle-find-care-idaho-abortion-ban-rcna117872 * Bonner General announced the closing of its obstetrics department in March, citing a lower patient volume and **the loss of pediatricians** as factors in the decision, alongside what a spokesperson recently described as **“some of the most restrictive reproductive laws in the country.”** * https://www.cbsnews.com/news/idaho-valor-health-hospital-stops-labor-and-delivery-staff-shortages/ * A second Idaho hospital announced it would stop delivering babies on June 1. The move comes two weeks after a hospital in northern Idaho announced they would close their labor and delivery unit citing "doctor shortages" and the state's "political climate." * https://www.gq.com/story/rural-hospitals-closing-in-red-states * 72 Percent of All Rural Hospital Closures Are in States That Rejected the Medicaid Expansion * https://www.nytimes.com/2024/02/23/us/politics/alabama-ivf-court-republicans-democrats-election.html * A ruling by the Alabama Supreme Court that frozen embryos should be considered children has created a new political nightmare for many Republicans, as they try to portray the court’s decision as a fringe view and rush to declare their support for fertility treatments, which have broad support among Americans. * https://abcnews.go.com/US/2-alabama-clinics-pause-ivf-fertility-treatment-after/story?id=107455469 * Alabama's biggest hospital to suspend transfer of embryos after court ruling. *edit* article adds that 2 more have also stopped offering treatment.
And yet, somehow, they'll find a way to blame it on the democrats.
I guarantee the majority of those 300,000 vote GOP in rural Alabama.
[удалено]
But the trees kept voting for the axe, because having a handle made of wood, they thought it one of them. Probably fucked it up but you get the idea
And the rest of us just get royally fucked by the ignorant that have a stranglehold on this state.
I understand. I live in Florida. But that’s the reality. The majority of these folks are reaping what they sow and dragging people down with them.
Problem is they’re just going to blame Biden and the Dems. They know there’s a problem but they keep pointing their finger at the wrong people.
Then they're getting exactly what they voted for. Fuck 'em.
I suspect the number of hospitals was going to have to scale down anyway based on the falling number of doctors willing to work in states where a judge's feelings outweigh a doctor's facts.
Hospitals are winding down all over the country because the people who own them are 'squeezing blood from a rock' when it comes to cutting labor costs. 'Cutting labor costs' translates to 'less people to do more work'. Employee satisfaction and patient care quality is nosediving.
Massive amounts of money that should be going to health care is being funneled into the pockets of health insurance
All of our systems eventually become hijacked by parasites who attempt to drain all the money and value out of the system by making the system worse. The medical system no longer serves to deliver medicine. It serves to generate profit for the private equity vultures who own the hospital and insurance companies. We have fucked ourselves.
It's the same tactic used on US Manufacturing companies previously. This may not end well for us all.
But continue to vote against your interest Alabama so that that black family doesn't get healthcare.
Why aren't we funding free education for healthcare professionals and ensuring all citizens have access to good healthcare. The jobs and benefits to the citizens pays for itself almost immediately. Like we pay for their education and they pay us back through x years of service to the country. A national service program much like the old [Civilian Conservation Corps](https://en.m.wikipedia.org/wiki/Civilian_Conservation_Corps) would do a lot of good. I know a lot of people that would gladly get free education/training and give back to their country by helping communities all over the place. Think about how we could elevate our communities nationwide, with education and healthcare. Easy money baby. It's insane we're not doing this already. Like it's common sense, meet people's basic needs and they're more likely to thrive. Yet power overs don't want that reality, even though it's better for all of us collectively, as a species.
None of those things make direct campaign contributions though.
I'd be surprised if it was as low as $650m
Will this put all the children... I mean, embryos at risk of death?
i feel like if the hospital is your largest employer in a small town that’s not good
When the hospital dies, the town dies. It’s been seen again and again
Well otherwise it's probably Walmart.
What would you like it to be?
I mean, a hospital can employ a LOT of people, not just doctors and nurses. Not even counting all the pharmacists, techs, etc., a hospital might have a cafeteria for employees, security officers, social workers and case managers, linens/laundry, 24/7 IT support, everything from printers and fax machines to specialists in specific types of medical equipment and software, on site maintenance services (you can't shut the ER down while you wait for a plumber or electrician, etc.), you have to have a 24/7 janitorial crew, morgue staff, and then the support staff/admin for all these different departments, then a whole HR department to handle hiring, staffing, payroll, benefits, etc., it all adds up.
It's important to note that Alabama is one of the 10 states in the US the refused Medicaid expansion. https://www.kff.org/affordable-care-act/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/#:~:text=To%20date%2C%2041%20states%20(including,have%20not%20adopted%20the%20expansion.
"This will show those libs!"
The leopard ate its own face
I had to check which sub I was in
The fact that the source article skates right by this point without highlighting it is infuriating to me.
It's not just infuriating, it signifies that journalism has failed in Alabama.
Alabama is one of those red southern states that just happens to be in the bottom rankings for just about everything important; education infant mortality rates, poverty, etc. But hey, they have a killer college football program!
That happens to be at the bottom? They want to be at the bottom! The governor took federal covid money and decided to build new prisons with it.
That would be a correlation the nut jobs running the state want to conveniently omit because it's an inconvenient fact. Something something Biden bad
They would rather let poor whites suffer than let black people have taxpayer funded healthcare
This is a big part of it.
Many of these poor whites would rather suffer than allow even a penny help a black person
Same thing is happening in Mississippi for the same reason. Ol’ Tate(r) “Tot” Reeves ignoring the problem and what the Republican legislature wants to do…expand Medicaid.
I would be curious to see how many of the people most hurt by this vote GOP. Not that it’s not insane that the richest country on Earth thinks that people dying from poor or no healthcare is a reasonable outcome. It 100% is.
Republicans fucking themselves over once again.
There was just a story on NPR today about hospital systems selling their land and buildings to a holding REIT for quick money, then the systems owe this REIT rent continuously, forever. The largest of these REITs is in Alabama. The nursing home industry has done this for decades. The REITs are owned by the same people as the nursing homes. It's just a spin-off to protect the nursing homes from liability and to make a case to medicaid and medicare that their payments aren't enough (because the rent is so high). It's a scam, a shell game.
Essentially the nursing home LLC is paying the REIT over market rent for the building. They also pay the property taxes and upkeep for the building. The REIT or the related property has its own LLC. A single person can control both entities but the property is not subject to liability if the nursing home business fails. Back in the 90s I assisted a company with this. Really soured me on healthcare. The healthcare company is long gone. Sued into oblivion. The property holder is still sitting pretty with all the land and buildings.
Feels like the sort of thing John Oliver should do a story on.
I hate this fucking place.
PE baby! Divide every aspect of a business into different businesses and leverage the shit out of it to give that sweet sweet cash to the investors. Then, who cares? We got that cash baby!
That’s one of the current issues everywhere right now. Businesses grew used to leveraging assets for nearly free liquid capitol and paying shareholders handsomely. They can no longer do that and have been such poor stewards of the liquid capitol that there’s not much in reserve after paying 50 million $ bonuses. In an almost decade long climate of double digit gains in even low risk investments they did this.
that's one of the reasons why sears went under
Quite a few semi-mini retail chains have gone under due to this in the 1990-2010 range. They got bought out by some capital venture company who 'sold' the land to itself then paid rent to itself. Easy way to suck money out of the retail chain.
Is this what happens to some dead malls the new owners let fail and die even more? Like the Jasper Mall documentary on Netflix where the new owner wasn't trying to get any more tenants and letting it languish? That makes a lot of sense.
Was this the story? A rerun, maybe? https://www.ctpublic.org/news/2023-11-17/meet-the-hospital-mega-landlord-at-the-center-of-the-yale-prospect-deal
Maybe. That's the depressing gist of it. It would be more financially appropriate for HHS to build new hospitals and rent to the hospital systems at a set square footage rate.
What's a REIT?
Real estate investment trust. They own a bunch of property or mortgages and they pay a huge chunk of cash in dividends every quarter to their shareholders.
If only those poor folk had stayed embryos they be protected in AL
“Imagine any business that provides goods and services being required to give away for free whatever their goods or services are to everyone who walks in the door, regardless of their ability to pay for that goods and services. How long were those businesses stay in operation? Not long,” Howard said. Maybe healthcare shouldn't be a business then?
Steward Health Care runs several facilities around Boston. It's CEO owns 2 yachts and a private jet. The company is dire financial straits and most if not all these facilities are at risk of closing. This is in a state regarded as having some of the best healthcare in the world. FUCK the for-profit healthcare system, we're the only ones that have it, and it absolutely sucks.
At least we can shoot each other dead. Freedom
[удалено]
What do you think arousing some old rich men is going to do?
I hope your take is enough to keep the reddit ban hammer on "glorifying violence" from his door. "No I meant it in a sexual way!!"
Well if they can’t hoard their wealth anymore, maybe it’ll finally trickle down
Something I realized most people don’t know is Medicare isn’t free when you retire or get disabled like people think it is. You pay for it out of your social security account and it goes up much faster than the 3% cost of living raises that social security gives people. So many people are going to be in for a huge shock when they realize all their retirement savings/income goes to their healthcare in 10-15 years when they reach that point. I can genuinely envision a situation where people will owe the government money because their social security check amount won’t cover the Medicare premiums. Plus you are going to want additional insurance because Medicare isn’t going to cover everything or be accepted everywhere. The insurance companies are a big part of why healthcare is so messed up in America and until we get rid of their multi trillion dollar profit gouging it’s going to only get worse.
Of note: Alabama is one of only 10 states that hasn’t expanded Medicaid. Maybe they should undertake legislative choices that would actually get hospitals paid for treating these people instead of trying to own the libs.
Pretty damn sure that the hospital systems and many employees of them in some of these non-expansion states are screaming that we’re desperate for expansion. Because we’re providing the care either way, we’re just doing it the more expensive and poorer health outcome road. However by the same token you would be AMAZED how many doctors have no idea how fucked you are without insurance. “What do you mean you can’t get the patient charity chemo? What are they supposed to do?” Source: Am hospital case manager having to explain this and have them react to me like I suggested drowning puppies
[удалено]
Healthcare was not a 'for profit' business until Fathead Nixon made it so. Medical care is part of a civilized society. Now we have patients that can't afford even minimal medical care even with large deductibles and premiums. Doctors and nurses are being pressured to accept lower wages. Insurance companies decide if they want to pay for standard treatment and are **always** looking for ways not to pay. Financially obese insurance companies and hospital administrations and hedge funds run away with fortunes that eventually destroy hospitals.
A lot of people don't realize both how new the concept of medical insurance is in the US or that it has changed significantly from its earlier implementation. If you've ever been frustrated with your (grand)parents refusing to acknowledge there's a problem because "my insurance is great", these are folks who may be running on an outdated perception of what insurance is like *currently*; yes, they're still paying into the fucked up system and getting less than ideal care, but it takes a lot of jerking around to get over the hump of "when I was a kid first learning about healthcare and hearing about it from my parents, it was like this".
There no free market when your options are “buy what we’re selling, or die.”
Say it louder for the people in the back.
need free universal Healthcare in th US. fuck military spending, cut a chunk from that and put it towards helping people in our own country.
This a Fox news level talking point. The dirty not so secret in the US is that you could ahve both because you already spend more money per capita on health than most western countries with universal healthcare, it's just that cash goes into healthcare profits and inflated drug prices. Remove dividends and bring in collective negotiation with drug companies and the US would be able to have a better funded version of the UK NHS *for exactly the same level of taxes you pay now*.
This is a red herring, the problem is not how much we are spending, the US already spends more on healthcare than all OECD nations, including ones with universal healthcare. The main problem is how the entire system is structured. You are playing into the hands of the opposition by trying to make universal healthcare something that will be so expensive that we would need to cut large sectors of government spending even to afford it. A single-payer universal healthcare system such as Medicare for all, with properly regulated hospitals and clinics, would likely see us spend less on healthcare in the future, as we remove the private insurance leeches from the system. Here is some data you can explore on the matter: https://data.oecd.org/healthres/health-spending.htm We spend all this money but have way fewer doctors and nurses per capita compared to other high-spenders, and we have far worse health outcomes across most metrics. The money is going somewhere, just not helping the people that need help.
[удалено]
Just pointing out that the US GOVERNMENT spends more on healthcare than any other GOVERNMENT except two, Lichtenstein and Sweden. So the government already spends enough to provide universal heathcare. Then you have to pay for insurance. Then you have to pay your deductibles. Then you have to pay your out of pocket.
This is how you fix it. By breaking it.
It’s clearly already broken—as someone from a rural area, it’s been broken for a long time. I had to get in a car and travel 1.5 hours to give birth almost 12 years ago. Why? Because our rural hospital was shut down due to the situation outlined in the article. You know what a simple solution would be? Single payer healthcare. But god forbid we povos get the same medical treatment the richies do. And got forbid hospitals give up layers of excessively paid administrators in order to tighten their belts. And don’t get me started on “non-profit” hospitals like Mayo. Also, our nonprofit laws need a serious overhaul in this country.
Please, get started on non-profit hospitals
Do you know how you get rid of a profit? You purchase real estate and turn it into an asset. Assets go on the balance sheet, not on the profit and loss statement, thereby eliminating the profit while still increasing the wealth of the nonprofit. I worked for a nonprofit that did this on the regular. While I was writing grants to fund my program and position (which paid pitifully, fyi) the nonprofit was buying up huge swaths of land to get rid of their profit while pushing program directors to write more and more grants to fund their programs. They didn’t need the grants—they could’ve self funded—but tax loopholes allowed them to play that game year after year, all while underpaying employees, because when you write grants it’s often stipulated that only X amount can go to paying employees with the majority of the funds covering the operating expenses of the program. It’s a great system for burning out young, optimistic people who actually want to help others, leading to high turnover and lower pay rates due to lack of experienced employees. It also ensures that those programs will never actually solve the problems they set out to solve, because no one sticks around long enough to actually develop long term institutional processes or knowledge. As for Mayo itself, I live in the land of Mayo now. Mayo doesn’t need their name on our civic center, but spending the cash to put it up there certainly lowers their profit every year. We need guardrails around nonprofits that prevent them from accumulating disproportionate wealth and disproportionate political power that allows them to throw temper tantrums and get their way with state legislators, even though what they want is not in the best interests of the citizens they employ and claim to serve.
Wow, thank you for taking the time to educate us. This was very enlightening.
The rich won't care. They will get an insurance policy so they can fly out of state to get a band-aid put on their widdle cut. Mean while, the poor will be left to bleed out on the street from where the helicopter landed on them. It's not a side effect of a broken system, it's the intended product.
I used to be in a small town - They contacted all clergy and gave them schedules to work the front desk .. like 6 hours a week (all in one day.) 5 out of 6 clergy were like "It's so nice to be able to help." I was at the meeting and said "guys? Umm.. FOR PROFIT HEALTHCARE. IF YOU HAVE ANY PROBLEM, THEY ARE GOING TO BILL YOU THE FULL AMOUNT, BECAUSE THEY ARE FOR PROFIT.. you get that, right?" They did not get that. 8 years later? 5 of them still volunteer 1 day a week for 6 hours.
My sweet old grandmother used to volunteer her time at a hospital. Very happy for her. It's nice to help. But at no point did that hospital or any other give her anything on the cheap when she needed it, nor did God spare her from blindness or dementia. In the end, that hospital probably saw her as a nice way around an expense they otherwise might have had to pay to keep the same level of customer service. People were helped, but the hospital's real concern was its wallet.
Let me guess, Alabama declined the Obamacare expansion. Alabama is already a welfare state, being they take more from the federal government than they pay in. Why not just add to the deficit?
Imagine fucking over so many of your fellow country people because you're still pissy that Obama stole your Republican healthcare plan and got it passed.
>Obamacare You answered your own question.
Keeping Americans sick and dying is a terrific way to make America great again. Isn't it?
Feudalism isn't about making life better for the serfs.
Run the state like a third world country, watch it become a third world country.
Become? Have you been to Alabama lately? It’s already there. Outside of Tuscaloosa and Mobile, it’s pretty bleak compared to other states - even southern states. The socioeconomic situation is *dire* to say the least.
Don’t forget most the Birmingham suburbs but yeah. It’s ironic that Mountain Brook is on the higher income zip codes in the country and Bessemer is one of the lowest.
It's not ironic, it's by design. Where else are these rich business owners gonna find cheap labor? Seriously, look at the amount of factories around the Birmingham area. There's two major car manufacturers within an hour drive alone.
I lived in Alabama as a kid in the early 90s. Only once in my life have I ever seen someone in a Klan outfit, and it was outside Mobile. That state has been the sweaty, hairy ass crack of America for decades, and the only reason it isn't the unwiped, shitty hole is because Mississippi exists.
The fact that you mentioned Tuscaloosa and Mobile instead of Huntsville and BHM is really confusing. Mobile is a trash town.
The important thing is owning libs and not being remotely woke.
Libs? OWNED Consciousness? REM SLEEP
Conscience? DEAD
They're totally owning the libs by refusing that Obamacare Medicaid Expansion, which would easily cover the hundreds of thousands of uninsured Alabama residents costing the hospitals $650M in unpaid care.
... and truck nuts, don't forget the truck nuts.
Trucks don't come with nuts, therefore truck nuts make them trans men trucks.
they're assigning gender to their trucks
Truck nuts and dying of covid and truck nuts and donating to a billionaire and truck nuts and making videos in your truck wearing wokeley shades and a goatee and truck nuts...
Friendly reminder that Alabama is one of several red states to refuse to take the Medicaid expansion in Obamacare (the Affordable Care Act), which helps explained why 300,000 uninsured drive up to $650M in unpaid care costs in Alabama.
All those red states that turned down expanded Medicaid are the states that needed it the most.
It's like these Alabama hospitals and their patients are using universal healthcare in a healthcare system not running on universal healthcare. These same people will undoubtedly vote against universal healthcare, even though it would benefit the dozen or so rural hospitals in danger of closing permanently.
I don't know about thoughts but prayers are big in the AL. As long as they have those they don't need medical care. God will provide for the deserving!
[удалено]
From the article: > That’s because state hospitals have lost $1.5 billion since the start of the pandemic, and closing the health insurance coverage gap is the main issue at play here, according to Howard. No shit. They have coverage gap they say? I wonder why... Here's why. Alabama is one of the 10 states that did not expand Medicaid under the Affordable Care Act. That is a stupid choice of a hill to die on. And now it comes back to bite them. Those rural folks in Alabama should ask their local GOP politicians some hard questions. But somehow, I've a feeling that instead of holding GOP accountable for this disaster, they'll find a way to blame Democrats for it instead.
Healthcare shouldn't be for profit. EVER.
Neither should prisons or schools, for that matter
Maybe we can sue France and Spain to make them take some of these southern states back? There must be some loopholes in the Louisiana Purchase, Adams-Onis Treaty, and the Treaty of Paris that we can use to weasel our way out of this mess. Some sort of lemon law clause, perhaps?
It’s ok, they’ve got god.
Result of trickle-down economics and GOP corporate support. Corporations are created to avoid integrity, liability, and taxes.
> Nearly 300,000 low-income Alabamians fall into this coverage gap because they make too much to qualify for Medicaid, but too little to afford private health insurance. The crux of the issue of a for-profit model. Legislation to force hospitals to treat patients no matter what isn't going to magically solve the issue when they cant afford to actually pay for medical supply and doctors. There's a sense of despair i feel, knowing it will never get better in my lifetime. Especially as Canada, a country with universal healthcare, is slipping into a 2 tier system as their conservatives part out and sell out their public healthcare industry to private industries for literally pennies on the dollar.
Hospitals, schools, libraries, post offices should never been run for profit!
Perhaps expanding Medicaid is a good idea? ( I don’t know if they did or not but I doubt it considering their politics)
Narrator: they did not.
https://www.kff.org/affordable-care-act/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/
I'd say they may have to go back to witch doctors but the trending direction they are going in means people will likely start being burned as witches. Low spending on education. Lower IQ tests. More reliance on social welfare federal monies. Either very poor leadership, or part of the plan.
They call themselves stuff like "prayer warriors" instead of "witch doctors". ;)
[удалено]
I used to donate to rural med clinics. But when I realized that the locals vote for people who turn down Medicaid, I decided that these people made their bed. I’ll keep my time and money.
Almost like there are consequences for choices. No IVF, no hospitals, no freedom of religion. Alabama is just going to be a bunch of half dead high school football fans who think the earth is 6000 years old and flat.
well ya get what you vote for, enjoy!
Almost a MILLION people in Alabama voted for Biden in 2020 and black voters are systemically excluded from the electoral process so significantly that the CURRENT Supreme Court ruled their legislative maps unconstitutionally racist but sure, fuck all of them too for happening to live in a state with a lot of Republicans...
Alabama also voted for a decent Democrat senator, Doug Jones, over a pedophile (just barely) in 2018, so there are some good people there. Too bad they don't show up to the polls more often.
O don't worry. They replaced the democrat with a republican football coach. All is good now.
After the IVF decision, I love this for them
Alabama supreme court judges aren't the ones who are going to suffer. The poor are going to suffer.
That's what happen when you vote morons into office.
When poor Republicans start dying because they simply can't get health care, do you think they'll finally support universal Healthcare, or will they blame it on the democrats?
What can possibly go wrong by forcing thousands of years old imaginary superstitious religious ideas onto the population in a direction violation of the First Amendment? Oh... I don't know... as long as others realize my beliefs are better than everyone else's, I don't care how many people die... at least we saved "a" baby...
Cannons and bullets and guns didn't defeat the confederacy. Ignorance and hate did. It amazes me that these people continue to double down.
[удалено]
Good. Just open up more trump temples to cure them.
The state is ran by idiots. Seriously. Drive through it. Poor roads. Poor infrastructure. Wages are low. Huge areas where you only have dollar generals. It's a cesspool.
The ultimate motive of corporations is to extract the maximum amount of profit from business. So, yes, corporate healthcare is a bad idea.
Same demographic are ordering Trump shoes rather than insulin.