A health policy analyst sees the closing of rural hospitals as part of a bigger trend in the U.S.


The Associated Press reports that rural hospitals are struggling to stay open amid changing medical practices and government policies. At least 50 hospitals in the rural U.S. have closed since 2010, and the pace has been accelerating with more closures in the past two years than in the previous 10 years combined. Meanwhile, nearly 300 rural hospitals in 39 states are vulnerable to shutting down, and 35 percent of rural hospitals are operating at a loss.

"Well, this is part of a bigger trend," says Hadley Heath Manning, director of health policy at the Independent Women's Forum. "What happens when government puts so much red tape on a sector like the healthcare sector is you do see a lot of consolidation – and we've seen that in health insurance, we've seen it in healthcare.

"And these small businesses, whether they're selling health insurance or they're private practice or if they're a small rural hospital, often are being bought up by bigger healthcare companies."

As a result, Manning says consumers get less choice. "And some of these stories [are just tragic] about people in rural areas left without a choice where to go for immediate and desperate healthcare situations …."

Manning adds that another aspect of this involves states and "certificate of need" laws that are aimed at reducing healthcare facility costs and allowing coordinated planning of new services and construction, providing a mechanism for state governments to reduce overall health and medical costs.

"People demand healthcare regardless of whether they live in a big city or a rural area," she explains, "but the state really has no business in saying whether or not the market can support another hospital or another private practice. I would suggest the states that do have trouble keeping rural hospitals open to get rid of those certificate of need laws."

Manning acknowledges changes are needed in the way healthcare is provided, such as through urgent care centers. Still, she believes nothing can really replace a hospital with an emergency department when people have a very immediate need.