On a daily basis I scour the national and international news to read about and learn about the economic impact on health care across the country and around the world. I wrote about my concerns on this topic a few weeks ago. At that time, the articles that I was finding were about significant nurse staffing cuts and hospital closures internationally. Great Britain, India, Canada, and China are all facing significant financial impacts on their health care systems and over the last week or so stories have now started popping in the news in the US regarding hospitals closing clinics, units, and laying off staff.
The state of our economy, the changes to medicare and Medicaid reimbursement, and the ever-increasing costs of health care are very real and very legitimate concerns that hospitals face. The economy and the jobs picture in the U.S. impacts taxes, payments to social security, and a patient’s ability to pay. I expect we will continue to hear about staffing realignment as well as lay-offs at hospitals and health care organizations across the country impacting jobs and hiring in the health care sector.
In Bangor Maine, Eastern Maine Medical Center has announced this week that they will be cutting jobs as a cost saving measure over the next few weeks. The job cuts they have announced are across the board; administration, nurses, and clerical workers and all of their open positions will be eliminated. The hospital stated that they hope to avoid layoffs and have all of the affected workers are reassigned to other positions throughout the organization. The hospital cited directly in the news report a decrease in income, an increase in charity provided health care and a decrease in payments and reimbursements from Medicare/Medicaid as the reasons for the cutbacks in staffing.
In East Cleveland, the Cleveland Clinic is closing Huron Hospital and will end operations within the next 90 days. A plethora of reasons have been given as to why the organization’s final decision was to close this hospital: a decline in admissions, a decline in population, changing community health needs, aging facilities, and continued financial losses. Each of them a legitimate reason for building closure. At this point, Cleveland Clinic is moving and recruiting employees within the organization without any discussion of layoffs. It is a risky move for a city already greatly affected by the economic challenges and job losses facing the nation. By taking emergency services out of reach of an established population, an additional and greater stress is placed on the people who seek care in that building. The closing of a hospital can have long-term impacts on a community. The potential exists to perpetuate the health care disparities that are already rampant in cities like East Cleveland, which makes seeking health care and emergency services a greater challenge within a population that already doesn’t have the means to do so.
In Monroe Washington, a small town an hour outside of Seattle, the birthing center at Valley General Hospital will close June 24th. While driving an hour to Seattle or 40 minutes to Everett really isn’t that far, but for health care services such as child-birth, it is. The hospital is also closing its 14 bed in-patient psychiatric unit. Cost and financial losses are the reasons given by the hospital for their need to close these beds. 15 full-time employee positions will be lost between the closing of these 2 units. While the hospital seems to be working to get a buyer or a financial partnership with larger organizations in the area, these units reopening once they are closed seems unlikely. It is a great loss of vital services for a small community such as Monroe.
And in May, Westerly Hospital in Westerly Rhode Island announced a complete shake up to their nurse staffing. They eliminated their LPN positions and are going to a complete RN workforce. Work shifts for nursing staff are going from 8 hours to 12 hours. 29 employees were laid off, 59 had their hours reduced, and 20 vacant positions were eliminated. Below is a direct quote from the news article about the changes at the hospital:
Fewer patients mean reduced revenue. Nick Stahl, hospital spokesman, said the hospital’s total expense budget for the current fiscal year is $93 million and that inpatient admissions through March ran below this year’s budget by 11 percent and were 9 percent below 2010 admissions to date.
The above quotation is a clear depiction that hospitals, in the end, are businesses.
While I was reading all these articles, it really strikes a note how widespread these impacts are across our country. In many cities, health care organizations and hospitals are building new buildings, remodeling, expanding care, and treatment services; and now just as commonly hospitals are underfunded, bankrupt, losing money, and closing. This fluctuation leaves health care provider and health coverage disparities. In certain areas of the country it contributes to further job loss and unemployment. While I don’t have any ideas on how to fix this in the short-term. What is important, is for all of us to pay attention and educate ourselves about how health care and our access to it is changing. These hospitals all face the same economic and financial struggles and they are scattered throughout the country.
The loss of health care experienced by people thousands of miles away affects us even if we don’t see and experience it directly. Together we are citizens of this great land and we are in this together and together is the only chance we have of fixing it.