May 24,2018

Wyden Statement at Finance Committee Hearing on Rural Health Care

As Prepared for Delivery

Every year I hold open-to-all town hall meetings in every rural Oregon county, and I meet with a lot of leaders from the rural health care community. There are a few potential health care calamities that have them afraid for what’s coming down the pike.

First, people in rural communities feel like there’s a wrecking ball headed their way because the Trump administration and half of Congress have spent the last 15 months desperately trying to make huge cuts to Medicaid. Now there are rumblings that another assault may be coming. The fact is, Medicaid is a lifeline for rural hospitals and patients. The experts will tell you that if you wanted to turn rural America into sacrifice zones where hospitals shut down and people cannot get the health care they need, the quickest way to do it is by slashing Medicaid.

Second, people in rural areas today feel like their local hospitals are already teetering on the brink of closing their doors. And if the local hospital goes under, that means no more emergency department open in a crisis.

This isn’t a far-off, theoretical problem. Decades ago, back when getting routine health care more often meant spending multiple nights in a hospital inpatient bed, rural hospitals were much more secure. They could afford to maintain the emergency department. But that service may be on the ropes, because rural hospitals today are under huge financial pressure. Offering a variety of inpatient services and keeping that emergency room open is enormously expensive, and at the same time, more and more Americans are turning to outpatient settings for chronic care, rehab and routine surgeries. Since 2010, 83 rural hospitals have closed services, and hundreds more are in dire straits.

Bottom line, when you live in a big city like Portland, Chicago or Los Angeles, you take it for granted that there’s always going to be an emergency department nearby. But rural Americans who fear their hospital will be the next to close are left wondering where they’d turn if their son or daughter breaks a leg in a high school basketball game. Where would they go if an older loved one suffers a stroke? Would they get to a hospital in time if dad suffers a heart attack?

Keeping these hospital emergency departments open is a key challenge when it comes to rural health care. In my view, it’s step one when you’re working to prevent rural America from turning into that sacrifice zone where people can’t get the care they need. In a country as wealthy as this one, where we spend $3.5 trillion a year on health care, it absolutely must be possible to guarantee rural Americans aren’t on the outside looking in.

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