Right up there with death and taxes, every American is more than likely to visit a hospital during their lifetime; most of us, multiple times. There was a point in our nation’s history when, whether you lived in a large metropolitan area or the tiniest of rural hamlets, emergency, prenatal, and preventive care was no more than a short drive away.
For a multitude of reasons explained in the new documentary “Flatline: America’s Hospital Crisis” (“Flatline”), basic hospital services are no longer available in parts of rural America. According to “Flatline,” there have been 200 small-town hospitals closed “in the last few years,” and according to Brock Slabach, CFO of the National Rural Health Association, another 453 are likely to suffer the same fate in the (nonspecified) future.
Sincere Intent
Given what has happened since 2018 to the three now-shuttered hospitals profiled in “Flatline,” much of the conjecture presented in the film is, if not entirely on the nose, certainly sincere in intent. And there is certainly enough content to raise our collective concerns.The first and most jarring factoid is delivered by Paul Seegert, managing partner of PCS Advisers, a company that specializes in reducing hospital operations and billing costs, something that should not be confused with any possible suggestion that hospitals should reduce or compromise services.
Cash Is King
It is here where Mr. Seegert agrees and points out that the cost of respective procedures or drugs will depend mostly on who is footing the bill. If Medicare or Medicaid is paying: top price. If a patient is paying with credit: lower. If a patient is paying with cash: up to an 85 percent discount.
The graphic immediately following Mr. Seegert’s first segment reads: “Medical debt is the top reason for bankruptcy in the U.S.”
This passage alone should make it clear that the principal goal of the current health care system is profit and not patient care. If the government, with few if any checks and balances, will approve any price, then why not jack it up into the stratosphere, and if Joe Lunchbox will pay cash, why not mess with the prices?
Capitalism is one thing; I’m all for capitalism, even in health care. Health care is a business and should not be prohibited from making a profit, but basing price structures on the ability to pay sounds decidedly un-American and smacks of organized price gouging.
Boomtowns in the Rust Belt
The three currently defunct hospitals profiled in “Flatline” are located in Massillon, Ohio; Kennett, Missouri; and Ducktown, Tennessee. These are all fitting locales, since all at one time or another were dependent on mining industries, which fit the textbook description of “boomtowns” usually confined to the U.S. Rust Belt.Once it becomes clear that these hospitals become unprofitable, they are sold off for pennies on the dollar to large corporations that cherry-pick employees and hardware. The new owners mostly leave behind shells of buildings that will be stripped of copper wiring and are then places of illegal housing for vagrants, squatters, and drug dealers. This then leads to a ripple or domino effect of local businesses and services disappearing that thrive only with the presence of a hospital.
It doesn’t take an economics major to determine that this business model will quickly lead to huge fiscal disparity, if not total collapse.
The main points of “Flatline” are that the partial loss or the altogether elimination of a small town’s principal (or only) health care outlet will result in risking not only the life expectancy of its residents but also the commercial, financial, and bonding components of entire communities.
Remedies to these issues are not only few but also unappetizing, at least from an everyman perspective.
“Flatline” does an excellent job of breaking down what’s wrong with a single component of our unnecessarily complex health care system, and would have been even better had it presented something resembling alternatives or solutions.
