How to get a healthy health system?

There’s an article in MinnPost that has me more confused than usual: Greater Minnesota cities seek funding for EMS delivery, infrastructure in ’24 session . Here’s the part that makes me wonder:

“Over the last two years, our communities have been literally ringing alarm bells about the fragility of the system,” Bradley Peterson, CGMC’s executive director, said during a Zoom call about the organization’s legislative priorities. “Reimbursements from Medicare and Medicaid and private insurance are simply not keeping up with the services provided. The fee-for-service model is, frankly, in many of our communities, not sustainable.”

If the real issue is the reimbursement rate, wouldn’t metro area cities be facing the same issues? The article fails to mention that aspect.

EMS are far from the only rural health service facing cost and sustainability pressures. As noted in an article in The Daily Yonder: Seeking a Cure: The Quest to Save Rural Hospitals:

Across-the-board cuts in Medicare payments and reductions in reimbursements for uncollected patient debt disproportionately have impacted rural hospitals, whose patients are more likely to be enrolled in government health programs.

Rural hospitals must support fixed costs with fewer patients. They frequently struggle to comply with regulations that are not designed for small facilities, or maintain aging buildings that date back to an era when hospital stays were longer and inpatient care was more common.

Are you ready to vote?

Photo by J. Harrington

But wait! he wrote, there’s more. Right here in the Twin Cities metropolitan area, Fairview, Sanford call off health systems merger . This, after a prior merger between Fairview and the UM Medical Center hospital. Even the “big guys” are having real problems. Is it time to consider nationalizing our health care system? Are we getting what our insurance companies are paying for?

US spends most on health care but has worst health outcomes among high-income countries, new report finds

US comes in last in health care rankings of high-income countries 

Things are so bad you’d think the Republicans were in charge.

Hope 2020

Ashanti Files

I tried to write about hope
But wasn’t sure I had the audacity
The pandemic took a toll
And our last president was a fascist
He
Said he did more for Christianity
Than Jesus
And between the BLM protest and right wing hatred we just
Stayed inside and tried to live
Contemplating if loans would be forgiven
To provide a little relief
We were safe at home but had to march in the streets
To beats
Of Black Lives Matter
See I was flattered
To be part of the Healthcare Hero’s
Until I start telling the truth and the death toll added zeros
And zeros
Until the number reached 100000
And still people believed it was a hoax
And wouldn’t wear masks in public places
The deck was stacked against us and the government held
Aces
But they underbid as the death toll continued to rise
But as the number grew there were fewer tears from eyes 
Of the privileged
Because big business needed that money
Propaganda had normal people acting funny
Yet still I dared to hope
Until I couldn't breathe as
George Floyd choked and his killer walked the streets free
See
We're going back into summer
But instead of George Floyd the name we will march to is
Daunte Wright
And we again will wear our masks as we continue to fight
Systems of oppression
The National Guards were called and wore bullet proof vest
When we said Black Lives Matter
But were nowhere to be seen when the right wing
Unhinged the government’s seat of power
And the hours
Continued to tick on
525600 deaths but rent wasn’t on
But Nurses were on
The verge of a mental break down every day
Saving lives of the people who claimed don’t tread on me
And yet I say I’m going to write about hope
As a black woman in America it’s impossible not to choke
On the repetitious contradictions
Vaccines vs quarantine things while the seams are bursting
On the national debt
“Make 600 dollars enough” because it’s all you gone get
As you try to survive this crisis
Going hungry while giving the nation its slice is
Your patriotic duty
I’m a poet and I know it sounds looney
That I can’t write about hope
2020 had me riding a high worse than dope
And when I came down it was comparative to death
Knowing that nothing would change
So I inhale and deep breath
And continue to think about hope

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