title: OBAMACARE TAKING DOWN MORE RURAL HOSPITALS
text: Let s face it Obamacare s been a disaster from Day 1. The closing if rural hospitals is the latest issue and it s a big one for those who ll need to travel farther to get medical help.The AP has noticed something. Rural hospitals seem to be closing. Now, what has happened to the American health care system in recent years that might help explain that? Hmmm .From The AP via ABC (with some honest commentary mixed in): Sac-Osage is one of a growing number of rural U.S. hospitals closing their doors, citing a complex combination of changing demographics, medical practices, management decisions and federal policies that have put more financial pressure on facilities that sometimes average only a few in-patients a day.  Most of the rural hospital closures so far have occurred in the South and Midwest. Of those at risk,nearly 70 percent are in states that have declined to expand Medicaid coverage under the federal Affordable Care Act, although some experts are hesitant to draw a cause-and-effect correlation.At first, the AP tries to blame the closures on the conservative states that decided not to expand medicaid coverage (in spite of Obamacare s explicit instructions), but then admits that this is likely correlation without causation. They don t expound on it, but the obvious reason for the 70% figure is that, generally speaking, the more rural a state is, the more conservative it is, and therefore, the more likely it is to have a governor who opposes Obamacare enough to refrain from expanding medicaid.After all, that was the point (Are you listening, SCOTUS?). Even the AP could see that one a mile a way.Big city hospitals have been closing at about the same rate as rural ones during the past five years, but an abundance of alternatives in most major metropolitan areas typically reduces the effect on patients. When a rural hospital closes, people may have to travel dozens of miles to reach the nearest hospital, an inconvenience that potentially is a matter of life or death.They (briefly) admit that rural hospitals are closing at roughly the same rate as urban hospitals. Isn t this strong evidence that there might be another reason for the closings? What do rural hospitals and urban hospitals have in common? (hint: Obamacare) Declining populations and stagnant economies make it hard on rural hospitals. Rural areas tend to  have older, poorer, sicker populations,  said Michael Topchik, senior vice president of iVantage.That means they often have a higher percentage of patients covered by Medicare and Medicaid, a pair of government health care programs that pay a lower reimbursement rate than private-sector insurers. Hospitals that rely heavily on those government programs have been particularly hard hit by federal budget cuts and provisions in the 2010 federal health care law that reduced charity care reimbursements and changed other payment criteria.Oh this section is pure gold (and, of course, it all appears on page 2). Not only does the AP admit that part of the problem is that the economy is stagnant, they admit that the closings are, in large part, specifically due to the low rates Medicare and Medicaid pay. And to make it worse, they note that the government is reducing the amount of charity care  reimbursements that go to these hospitals.Obamacare is a disaster REPEAL!Via: Poor Richard s