I remain fascinated at the fact that, so far in South Dakota, the biggest problem our hospitals have faced is not too many patients but too few. But sensible social distancing has led us all to skip our checkups and elective procedures, creating financial woes for every South Dakota hospital, big and small.
But the coronavirus recession only exacerbates a fundamental preëxisting condition of our rural hospitals: they can’t survive in the free market and must rely on government support to survive:
“Do I think rural health care is at risk? Absolutely,” said Thomas Worsley, president of Spearfish Hospital and Hills Markets for Monument Health, the largest medical system in West River with its flagship hospital in Rapid City and smaller facilities in Hot Springs, Custer, Sturgis, Lead-Deadwood, Wall and Buffalo, among others. “It’s always going to be at risk because it’s not a profitable endeavor or something that is going to attract big dollars, but it’s something that fills a real need in these rural communities” [Bart Pfankuch, “Pandemic Threatens Fragile Rural Health-Care System in South Dakota,” South Dakota News Watch, 2020.06.24].
Howard-based Horizon Health Care (perhaps the last major outfit based in Howard) saw half of its revenue dry up due to coronavirus and is weathering the recession with $3 million in CARES Act money, but even in good times, they stay afloat with federal help:
The aid and bounceback in procedures have been critical to Horizon, based in Howard, S.D., but especially to its patients in rural communities who are never turned away because of ability to pay, Erickson said. About a third of Horizon’s funding comes from the federal government, and about 20% of its patients are uninsured [Pfankuch, 2020.06.24].
So much for that Freedom™ Kristi Noem keeps talking about. As Pfankuch reports, in good times and bad, we get less access to health care and worse health outcomes, and what health care we do get subsists on federal subsidies for services we can’t collectively afford.