Our EMTs and health workers deserve support, not budget cuts

I stand beside Todd Patterson, CEO of Washington County Hospital and Clinics, who put it plainly: “When policymakers in Washington or state capitals slash Medicaid funding or narrow eligibility, they are not making abstract budgetary decisions — they are turning off the oxygen for rural health care.”

Regardless of your political views, we can all agree that strong hospitals, prompt emergency services, and access to care for working families are worth protecting.

Right now in Iowa County, we’re facing a slow-motion emergency. Over the past few years, there have been repeated proposals to reduce funding for our county’s public health department, even as local needs have grown and serious health threats like measles have reemerged. This same department just spent a long weekend tracking down hundreds of residents exposed to measles — yes, measles, back and spreading in southeast Iowa.

Let me be clear: this shouldn’t be about politics. It’s about protecting our families, our economy, and our way of life.

Our local elected officials cheer the scaling back of Medicaid, even though nearly 800 working-class people here in Iowa County rely on it for basic health coverage. That’s one in five of our Medicaid users who may lose insurance. Some say Medicaid is wasteful. But for hundreds of Iowa County residents — working parents, seniors, and kids — it’s the only insurance they have. Without it, they’re one illness away from financial ruin, and our local hospital is one step closer to collapse.

Worse, one of our supervisors proposed shifting the cost of our ambulance service onto Compass Memorial Healthcare, our county’s largest employer. Our EMTs deserve better than threats to their livelihood. If we start balancing the county budget by off-loading essential services onto the hospital, we’re not saving money — we’re just passing the bill and risking more.

Let’s talk about what public health actually does. It prevents diseases from spreading. It provides vaccines to those who can’t afford them. It helps people with diabetes or heart disease stay out of the ER. Our home health team visits 25 to 35 of our most vulnerable residents every week. Despite what our supervisor may say, most of these residents couldn’t get care anywhere else. These services keep people in their homes and out of the hospital or nursing home. Cutting them is not just cruel — it’s expensive.

When you gut public health and cut off Medicaid, Compass Memorial gets hit from both sides: more uninsured patients walking into the ER and fewer dollars coming in to keep the lights on. Add ambulance expenses, and the pressure could become unbearable.

Some say, “If it’s not legally required, the county shouldn’t do it.” That sounds tidy until you realize what’s at stake: slower ambulance response times, more unpaid hospital bills, and fewer health care workers staying in rural Iowa. It’s a combination of creative accounting and corner-cutting.

Defunding what isn’t mandated won’t save money. It’ll cost much, much more in hospital closures, emergency failures, and community decline. There is nothing great about that.

Our rural hospitals already run on thin margins. If we keep stripping away the supports they rely on, some will fold. I don’t want Iowa County’s hospital to be one of them.

This is a time for common sense, not campaign slogans. I’m asking our supervisors to protect what works and fund what matters. Health care isn’t just a service. Out here, it’s survival.

Dr. Steven Rippentrop is a physician and chair of the Iowa County Board of Health.