Kentucky Hospitals Likely To Close And Counties Without A Hospital In That Event!

Over the last few weeks, we have all heard a lot in the news media about how TRAITOR Trump's "Big, Vicious, Ugly Bill" will do myriad kinds of harm to America, especially to rural America, the lower and middle classes, hospitals, education, health care in general, vaccines and vaccine production, Medicaid, Medicare, WIC, SNAP or Food Stamps, agriculture, food safety, airline safety, the arts and sciences, and several other critical aspects of life in America. It will also add about 4 TRILLION DOLLARS to the budget deficit, and all of this damage is being done to provide vast unnecessary tax cuts to the rich, super rich, and corporations. Every word you have heard about the upcoming damage is true! The damage is intentional, purposeful, and will cost thousands of lives across this country in addition to the vast economic damage it will do. But in this blog post, I just want to address one aspect of that damage, the damage to hospitals and health care in Kentucky. Every legitimate news agency and policy analysis corporation is telling us the same thing. If the proposed cuts to Medicaid are approved (and it appears they almost certainly will be approved) thousands of hospitals, especially rural hospitals will be forced to close due to lack of income. Hundreds of thousands of the poorest, and often sickest Americans will lose their access to health care, and thousands of those people will die along with the hospitals which have been serving them. According to the Kentucky Center For Economic Policy, there are 35 hospitals in Kentucky which are likely to close on that list of hospitals. Since I first heard that dire forecast, I have been studying the issue both on my own and in consulations with others who understand the issues and politics involved. Two of the people I have discussed this with in depth are a retired attorney who spent her career in Eastern Kentucky and comes from a very politically centered family, and a retired nurse who spent her career working in one of the poorest counties in the state which does not have a hospital at this time to lose. We all agree that there are a vast number of issues that would arise for Kentucky and the nation if this Big, Vicious, Ugly Bill" becomes law. My reading of the article which I supplied the link to above shows me that the majority of the 35 hospitals in Kentucky which can be expected to be starved out if Medicaid is cut are in Eastern Kentucky. Although I generally think of I-65 as being the border line between Eastern Kentucky and Western Kentucky, that is not absolutely accurate. We can also take the position that I-75 is the border between the two. But for the sake of somewhat original thinking on that issue, let's say that the border is an extension of the line created by the border between Ohio and Indiana. If we go to that point on the Kentucky border with Indiana and Ohio and draw a straight line from there due south to the Tennessee border, it is as good a candidate for the border between Eastern Kentucky and Western Kentucky as any other. The image below is of that map showing the locations of the endangered hospitals in Kentucky from the linked story by the Kentucky Center For Economic Policy. If you use that imaginary line from the KY/IN/OH intersection, you will find that only 12 of the endangered hospitals are west of that line. East of the line are the 23 remaining hospitals which are most likely to close due to the loss of Medicaid funding created by the "Big, Vicious, Ugly Bill". God Help Us In Eastern Kentucky If That Happens!

The counties in this list will all be without a hospital in the event Medicaid funding is cut as designed in the "Big Ugly, Vicious Bill" They are Letcher, Knott, Floyd, Martin, Lawrence, Elliott, Carter, Rowan, Greenup, Lewis, Breathitt, Jackson, Lee, Owsley, Rowan, Rockcastle, Montgomery, Powell, Clark, Clay Fleming, These counties are contiguous and constitute a vast block of real estate in Eastern Kentucky which would have no local hospital. Patients in these counties would have no readily available emergency rooms, ICU's, maternity wards, or other services which require a hospital setting. To illustrate just how bizarre this possibility is let's look at some geographic possibilities which would be created. It would be possible to travel by car from Jenkins on the Virginia border to Vanceburg on the Ohio border without ever driving through a county with a hospital. It would also be possible to drive by car from Mount Vernon in Rockcastle County to Greenup in Greenup County without passing through a county with a local hospital. In addition to the loss of these hospitals, the job losses would be catastrophic in a region which is already economically distressed. Nearly all the prescribing professionals (M.D.'s, APRN's, PA's) would be highly likely to leave the region, perhaps even the state. Additionally, thousands of licensed providers such as imaging professionals, Registered Nurses, Licensed Practical Nurses, Certified Nursing Assistants, and a few other professions would be forced to leave the region in order to find work. There would also be hundreds to several thousand unemployed food service workers, housekeeping workers, maintenance workers, clerks, bookkeepers, and security professionals. Yes, there are a couple of hospitals which might survive such as those in Pike and Perry Counties but those two counties are on the Virginia and West Virginia borders and the drive for many patients would be just too far, too expensive, too time consuming, and thousands of low income patients would be likely to not receive regular ongoing health care. One hospital not on the list in Johnson County would suddenly be the primary source of care for Lawrence, Martin, Floyd, Magoffin, and Elliott counties due to the closure of the one hospital in Lawrence County and all three in Floyd County. In legitimate emergencies and accidents, the concept of The Golden Hour for transport to an emergency room would no longer exist. Distances would be too great in many cases for an ambulance crew to assess, transport, and facilitate admission to a hospital for many critical patients in a timely, life saving manner. EMT's and other emergency responders would suddenly be traveling far from their primary service area and their numbers would, at present levels, be too small to provide both the added transport and provide the current level of services in their primary area of responsibility.

The Big, Vicious, Ugly Bill is a disaster in the making for Kentucky and many other states where multiple hospitals will be lost. The damage of this bill is deliberately designed to minimize the poor of this region and several others, to deny them medical services as are customary in a real Democracy. It is intentional! It is criminal! It must not be allowed to take place. This bill must not be approved.