Guest Columnist

Rural hospitals save lives and communities; they need saving now

Many of Iowa's hospitals were on life-support before COVID-19. Without federal action, the pandemic will kill them.

An appointment at Washington County Hospital and Clinics in Washington on Thursday, Sept. 26, 2019. (Jim Slosiarek/The G
An appointment at Washington County Hospital and Clinics in Washington on Thursday, Sept. 26, 2019. (Jim Slosiarek/The Gazette)

To Sens. Grassley and Ernst, and Reps. Finkenauer, Loebsack, Axne and King: When was the last time you were a patient in rural Iowa hospital?

Do you know how many are in the red? Are you willing to stand together and pledge to keep every single rural hospital in Iowa and America whole and healthy, with clarity and certainty, as a precondition and priority of any more federal stimulus?

My Dad just came out of a rural hospital – alive. My wife (and hero, especially these days!) works in the same hospital, providing ob-gyn services as a certified nurse midwife, including possible COVID-19 patients. My youngest daughter was born there. My grandmother recovered from illness there multiple times, before dying well-cared-for at 97. I myself was saved from life-threatening asthma attacks more than once as a child, in this same rural hospital.

If we’re in a war against COVID-19, it is not only the health care providers that are our front-line defense. It is our hospitals. They are the saviors of life, and in thousands of rural counties, they are the savior of community as well.

Rural hospitals were on life-support before COVID-19. Without much stronger federal action, the pandemic will kill many, and push many more hospitals and their communities into irreversible decline.

Since 2010, 128 rural hospitals have closed. Over half of all Iowa rural hospitals have a negative operating margin, and many are part of the over 400 nationally that are near collapse. It is often a piecemeal decline before death, such as the 32 Iowa rural hospitals that have closed their labor and delivery units in the last decade.

Rural hospitals are now hemorrhaging money thanks to the shutdown of nonessential services, and many have only weeks of cash flow. Stimulus efforts to date fail to provide financial clarity, resulting in cutbacks and even layoffs of providers. Hospitals and communities that lose providers will likely never get them back.

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Congress recently debated adding a quarter trillion to the Paycheck Protection Program for small business. Let’s start with a minimum 12 months of paycheck and operations protection for every rural hospital in America, including every employee.

Beyond this, the National Rural Health Association has defined many steps that would ensure the health of the hospitals that ensure the health of the rest of us.

Iowa’s Congressional delegation should stand together – every single one – and pledge that no more federal stimulus shall pass without absolute clarity that every single rural hospital in America will be alive and healthy and whole through and well beyond this pandemic.

Andy Johnson leads clean energy nonprofits and farms, together with his wife and three daughters, in Winneshiek County.

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