Heidi Heitkamp: America’s rural health care crisis must be addressed
CNBC | By Heidi Heitkamp | June 12, 2019

When it comes to health care, America’s political leaders have shown they are lousy at triage. Republicans and some Democrats continue to push policies that would either take health insurance away from millions or dismantle the private insurance system entirely – acting like two doctors bickering over the long-term treatment for a patient with a chronic condition. Meanwhile they are neglecting a patient in dire need of emergency care – the rural health system.

This crisis is years in the making and increasingly getting worse. A confluence of issues including rural hospital closures and a growing physician shortage, are wreaking havoc not only on rural patients’ access to quality health care, but the economic well-being of their communities.

For some politicians in Washington, Medicaid expansion and hospital infrastructure are not flashy enough topics to mention on cable news or in a rousing floor speech. But these are the issues that need to be talked about if we are going to address the fact that of surveyed adults living in rural areas, 26 percent lacked access to health care when they needed it.

Families in rural zip codes have a harder time accessing quality health care, with services in remote communities much more limited than in denser metro areas. A wave of rural hospital closures is now compounding the problem – putting rural communities at serious risk of becoming “health hazard zones.”

For some politicians in Washington, Medicaid expansion and hospital infrastructure are not flashy enough topics to mention on cable news or in a rousing floor speech.
Since 2010, 106 rural hospitals have closed or restricted care to outpatient or emergency services only. A further 430 rural hospitals – or one in five – are at high risk of closure due to their precarious financial situations. How are rural Americans to receive necessary treatment if there aren’t any hospitals left to care for them?

Reduced access to health care in rural America can be a life or death issue, especially for women. According to the Scientific American, the maternal mortality rate is 61 percent higher in rural areas than in urban ones. This is a crisis in and of itself. The rural maternal mortality epidemic deserves increased attention and a solution to remedy this devastating reality for expecting mothers.

The failing rural health care system is not only hurting patients, but it is threatening the sustainability of entire communities. The Washington Post and NPR have both recently noted that hospital closures can have a deep impact on the social and economic fabric of rural communities.

According to a study by the National Center for Rural Health Works, the average net loss in salaries, wages, and benefits to a community that loses a rural hospital amounts to a staggering $3.5 million. The loss of high-paying, high-skilled jobs created by hospitals is another blow to rural economies already suffering from the effects of President Trump’s trade war on farming and agriculture.

Our rural communities are being neglected by the current leadership in Washington. Hospitals will continue to close, local economies will continue to suffer, and rural mothers will continue to be at significantly higher risk than their urban counterparts if nothing changes.

I am a founding board member of the One Country Project, an organization promoting greater opportunities for rural Americans and ensuring our leaders in Washington and candidates for public office are earning their support from rural communities. Our work is shining a spotlight on this health crisis because rural Americans deserve access to high quality care and adequate funding for health care programs and infrastructure.

Washington needs to start taking action on the issues facing rural Americans. People’s lives and livelihoods are at stake.

Heidi Heitkamp, a CNBC contributor, served as the first female senator elected from North Dakota from 2013 until 2019.