People in America’s Deep South don’t blame hospitals for closing their maternity wards. They blame their ‘pro-family’ politicians. ‘It’s complete hypocrisy.’
I have been in healthcare for 40 years. the hospital cannot afford this service due to poor reimbursement. Also one bad outcome is a tremendous insurance liability hit. Liability insurance is not affordable for OB docs or the hospital unless the volume is significant.
Olivia, you twisted this story to fit your narrow view that this was about Alabama and Pro Lifers. Mediicaid’s reimbursement of $1,800 on a cost of $5,600 is a major problem. 80% of the patients on Medicaid, another problem. Offering a 3 million dollar annual bonus if you turn beds around within 24 hours is not my idea of quality healthcare. I would like to know the names of hospitals that actually get that. Walmart destroying small town businesses also a problem.
Much about your article was interesting and had me more focused on the reasons why small towns are suffering. To point out “Hipocrisy” was way out of line. You took a good story and turned it into garbage. This had nothing to do with Alabama or Pro Life. I’m thinking this scenario is true for small towns in every state. V.
RIDICULOUS! IF the Hospital loses $3,800 per baby this has nothing to do with the state or pro life. It has to do with economics but somehow you have managed to mangle it into some political Hypocrisy?
Olivia this is a bad take. You could have just as easily done Nebraska or Iowa or Wisconsin (moving bluer with each visit). I would have nodded and agreed with you as I don't have factual knowledge of the matter.
In the case of this area, I do. And what I see is a thinly veiled attack on the right to life movement, from a unique angle. You should be proud of your framing if that was your intended goal.
What you failed to mention was that 58 miles away is a much larger hospital (Wayne General) that has a much larger and well-staffed OB unit. Yes, it's in Mississippi. That means nada to the people of Grove Hill. Or Jackson. Or any of the small towns in that neck of the woods.
We all realize Bari runs around with her hair on fire, urging y'all to "publish, publish, publish."
But perhaps you might spend a little more time to develop a fuller picture than.... "Small shrinking town of religious anti- abortion people put babies at risk, and nobody does anything about it."
I have lived in several small rural Southern towns like Jackson and Grove Hill for 25 years at different times, and not all that far away from these towns. My wife bore three children in a hospital 90 minutes away over country roads. Two of them required additional hospitalization. So I know something about the funding and resource issues in the rurals, as well as the many other challenges people in these areas face, and why they choose to remain. A hellvua lot more than New York City Reingold who sweeps down looking for an angle to slam Alabama over its pro-life anti-abortion stance.
So she found individuals whose opinion is that it is "hypocritical" for a pro-life state not to do more for obstetric services. Why would that be a surprise? Does she ask any of these folks besides just the pastor what their views are on abortion and the pro-life legislation? Or most importantly, whether any of them believe there is a connection between the dearth of services in their area and their own pro-life values, as held by a distinct majority of people in the state? No, somehow she omits doing that, even though that is the whole point of her piece.
Reingold also doesn't bother to explore whether Alabama has the resources to backfill for Medicaid. Or to talk with the state representatives from the rural areas about the shortages affecting their constituents, issues they deal with every day. Apparently none of this is relevant.
But she does manage to fit in her own view about "especially a state government like Alabama that professes to be pro-life" that has "gone to extraordinary lengths" against abortion. "Especially", bad old Alabama. "Professes", as if the people aren't sincere. Small town health services shortages just must be connected to that, right? This is disgusting.
Just to be clear, I am not in the pro-life camp. But I do know the people of Alabama well, understand why they believe as they do, and I respect their sincerely-held viewpoint even though I don't agree. Which obviously Reingold does not.
This piece is cheap journalism and insulting to the people of Alabama.
Closing maternity wards is a nationwide issue. Nor is it new, as it has been a pattern over the past decade. It is especially worse in rural areas where a large percentage of the population is on MediCaid. It is worsened by many of these hospitals not meeting critical access hospital definition. MediCaid reimbursement is woefully inadequate and it is the driving force in maternity ward closures, especially when 80% of encounters are MediCaid. The solution is simple: increase MediCaid reimbursement rates. Tying reimbursement to less than 24 hour stays is bad medicine. To spin closure of maternity wards, a well known medical economic reality, into an abortion issue is a stretch.
I agree except that it is one issue the entire democratic election cycles repeats as talking points that create tenuous associations to virtually every issue.
The real cause of this—government cost shifting— has been going on for almost fifty yeas. The government promises benefits—yet limits the reimbursements to below the actual costs. The hospitals and doctors then increase their rates to private payers to make up the difference—unless there aren't enough private payers—in which case the providers go broke. This cost-shifting is a significant portion of health insurance premiums.
The Affordable Care Act increased the number of people eligible for medicaid and the increased percentage has been devastating to smaller and rural hospitals since their private. pays were dimiinishing.
The cure is for the government to be responsible for paying the cost of the services it promises. I dare say—this won't happen.
There is a simple solution that I am sure the religious right, who are the primary pro-life supporters will approve of. At each major cross road in the state post signs indicating the location of the nearest manger. Good enough for God, good enough for anybody, hmmph.
Sarcasm, for those with two recessive copies of the sarcasm recognition gene.
We should have seen this coming. We have outsourced the financial success of everything to the central government. Then, when the central gov does not keep up with the local financial needs, you are screwed. The problem with depending on federal or insurance for that matter is that, at any time, they can turn off the spigot.
The real key to success will be to find a way for locals to pay for local issues. I know that sounds insurmountable, but that's because we are trained to think that way. We are trained to think that help can ONLY come from some benevolent 'biggie' somewhere who will grant us 'benefits.'
Insurance has become the biggest scam of all time. LOCAL is the key and always has been.
I am not an economist, nor do I have any particular business acumen. I am just a veterinary practice owner. We have never had the luxury of depending on federal money or insurance money. We have to make it work with the resources we have. WHY are we able to provide basically the same medical procedures in many instances for a fraction of the cost? I do a C-section for an average of $1,500 all in. And we deliver multiple infants at one time. I am the surgeon and the anesthesiologist and the neonatologist.....and, because I have not limited my desire for knowledge to one NARROW path, as is common in human medicine(the fact that you have to have a hand AND a foot doctor always blows my mind.....I see all feet and 'hands(the front feet)' and my patients have multiple variations of these structures....hooves, nails, number of toes, etc) has made human medicine incredibly complex and inefficient. Doctors no longer can do everything....not sure how much of that is the fault of tort law, but it's insane. Specialization has destroyed human medicine. Knowing about only one body system is not only expensive and inefficient, it's bad medicine. To say you ONLY look at the heart, without considering what role the rest of the body has in the function and health of the heart is EXACTLY where human medicine goes astray.
There is no good reason why a doctor could not learn to deliver babies and care for both mother and child following the delivery. Why do you have to have an obstetrician SPECIFICALLY???? Human medicine has become so compartmentalized that no one can see the big picture anymore. Oh, but the key is this.....specialists make much more money, so everyone wants to specialize. That doesn't mean they are better doctors. If anything......I suggest they may not be as good as a general practitioner, who looks at the whole picture.
Just my two cents worth.
If you could find a group of doctors actually dedicated to the care and well being of the patients instead of worrying about their specialty and collaborating as a group instead of different factions, then I believe the cost of medicine would be reduced DRAMATICALLY.....but that's just me and I'm just a dumb ole dog doctor.
This could have been a great story, but I agreed that tying this issue to pro-life vs pro abortion isn’t logical. It should have been about the Biden administration’s perverse $3 million incentive to bring the average hospital stay under 24 hours! That should have been the headline.
Angela - Great observation! The lede is buried here and the headline reflects a simplistic editorial bias rather than a complex analysis focused on financial incentives.
Calling people "pro-life" because they oppose abortion is simple Orwellian double-speak. They're not "pro-life," they're "anti-abortion." That's all. They oppose abortion even if it costs the mother her life -- how is that "pro-life"? The media should stop using that aphorism and call it what it is.
What is your source for bluntly saying those that oppose abortion generally oppose it even if the mother will die? I would bet less than 30% of them think that way.
What about reproductive freedom? Shouldn’t it be called anti-reproductive freedom? I simply want to point out that both terms so not reflect the philosophy behind them. I m for freedom to reproduce or not, whatever women want.
The US system is not cost effective. WE don't need one doctor per patient. (I was the first member of my family born in a hospital. Both my parents and their siblings were born at home.) Most births can be safely handled by a midwife. In Israel, midwives run the show. Prenatal care is handled by doctors, who don't the deliver the babies. Delivery is in hospitals with one doctor available to multiple midwives. Doctors handle anesthesia and emergencies.
I don't think the $5600 price tag was from the doctor reimbursement. It's the whole hospital bill: from meds to nurses to linens to anesthesia, malpractice and insurance.
Oh boy, not even going to attempt tonipack the complete lack of logic in this article - but it’s those evil pro-life people (the standard excuse now for all complex issues?). Olivia- do better.
Maternity wards are closing because they aren't profitable. If labor and delivery cost the hospital more than 3 times what Medicaid pays, and the majority of patients are on Medicaid, then the maternity wards can't stay open. The first step is to get the government entirely out of healthcare and let a free market deal with the matter. Second, we are not our brother's keepers and it is not taxpayers' obligation to pay for the cost of delivering other people's children. To the woman who says, “This is my body and I should be able—with God’s will—to carry as many children as I and God would like," who does she think will pay the bills? Women have a right to have as many children as they wish, as long as they, or someone other than taxpayers are prepared to pay the bills.
Well said. I feel the same way about childcare. My husband worked and I gave up working full time to stay home and raise our children. I worked on a part-time basis that accommodated our schedules. If one chooses to have children make sure they fit into "your" budget.
I have been in healthcare for 40 years. the hospital cannot afford this service due to poor reimbursement. Also one bad outcome is a tremendous insurance liability hit. Liability insurance is not affordable for OB docs or the hospital unless the volume is significant.
Olivia, you twisted this story to fit your narrow view that this was about Alabama and Pro Lifers. Mediicaid’s reimbursement of $1,800 on a cost of $5,600 is a major problem. 80% of the patients on Medicaid, another problem. Offering a 3 million dollar annual bonus if you turn beds around within 24 hours is not my idea of quality healthcare. I would like to know the names of hospitals that actually get that. Walmart destroying small town businesses also a problem.
Much about your article was interesting and had me more focused on the reasons why small towns are suffering. To point out “Hipocrisy” was way out of line. You took a good story and turned it into garbage. This had nothing to do with Alabama or Pro Life. I’m thinking this scenario is true for small towns in every state. V.
Abortion! Yay!
That's all women want!
More dead babies!
Yay! Yay! Yay!
Isn't this the writer who wants us all to lose control to alcohol?
Abortion! Yay!
RIDICULOUS! IF the Hospital loses $3,800 per baby this has nothing to do with the state or pro life. It has to do with economics but somehow you have managed to mangle it into some political Hypocrisy?
Olivia this is a bad take. You could have just as easily done Nebraska or Iowa or Wisconsin (moving bluer with each visit). I would have nodded and agreed with you as I don't have factual knowledge of the matter.
In the case of this area, I do. And what I see is a thinly veiled attack on the right to life movement, from a unique angle. You should be proud of your framing if that was your intended goal.
What you failed to mention was that 58 miles away is a much larger hospital (Wayne General) that has a much larger and well-staffed OB unit. Yes, it's in Mississippi. That means nada to the people of Grove Hill. Or Jackson. Or any of the small towns in that neck of the woods.
What you should have said when you were critiquing "State Leaders" , you could have then balanced their obvious (smh) inaction by researching the "ACES" programs to stimulate Doctors and other medical professionals to serve in underserved areas. These programs are both State and Federally supported (Here's a link to a previous year, I'm sure you could find the most current one. https://evidence.alabama.gov/wp-content/uploads/2021/07/ACES_Policy-Spotlight_Addressing-Provider-Shortages-in-Rural-Underserved-Alabama_ACES-2021_FINAL.pdf)
We all realize Bari runs around with her hair on fire, urging y'all to "publish, publish, publish."
But perhaps you might spend a little more time to develop a fuller picture than.... "Small shrinking town of religious anti- abortion people put babies at risk, and nobody does anything about it."
I have lived in several small rural Southern towns like Jackson and Grove Hill for 25 years at different times, and not all that far away from these towns. My wife bore three children in a hospital 90 minutes away over country roads. Two of them required additional hospitalization. So I know something about the funding and resource issues in the rurals, as well as the many other challenges people in these areas face, and why they choose to remain. A hellvua lot more than New York City Reingold who sweeps down looking for an angle to slam Alabama over its pro-life anti-abortion stance.
So she found individuals whose opinion is that it is "hypocritical" for a pro-life state not to do more for obstetric services. Why would that be a surprise? Does she ask any of these folks besides just the pastor what their views are on abortion and the pro-life legislation? Or most importantly, whether any of them believe there is a connection between the dearth of services in their area and their own pro-life values, as held by a distinct majority of people in the state? No, somehow she omits doing that, even though that is the whole point of her piece.
Reingold also doesn't bother to explore whether Alabama has the resources to backfill for Medicaid. Or to talk with the state representatives from the rural areas about the shortages affecting their constituents, issues they deal with every day. Apparently none of this is relevant.
But she does manage to fit in her own view about "especially a state government like Alabama that professes to be pro-life" that has "gone to extraordinary lengths" against abortion. "Especially", bad old Alabama. "Professes", as if the people aren't sincere. Small town health services shortages just must be connected to that, right? This is disgusting.
Just to be clear, I am not in the pro-life camp. But I do know the people of Alabama well, understand why they believe as they do, and I respect their sincerely-held viewpoint even though I don't agree. Which obviously Reingold does not.
This piece is cheap journalism and insulting to the people of Alabama.
Closing maternity wards is a nationwide issue. Nor is it new, as it has been a pattern over the past decade. It is especially worse in rural areas where a large percentage of the population is on MediCaid. It is worsened by many of these hospitals not meeting critical access hospital definition. MediCaid reimbursement is woefully inadequate and it is the driving force in maternity ward closures, especially when 80% of encounters are MediCaid. The solution is simple: increase MediCaid reimbursement rates. Tying reimbursement to less than 24 hour stays is bad medicine. To spin closure of maternity wards, a well known medical economic reality, into an abortion issue is a stretch.
I don't understand still what this has to do with abortion
I agree except that it is one issue the entire democratic election cycles repeats as talking points that create tenuous associations to virtually every issue.
I ran hospitals in Illinois, the criteria for decisions there was no different than in Alabama.
The real cause of this—government cost shifting— has been going on for almost fifty yeas. The government promises benefits—yet limits the reimbursements to below the actual costs. The hospitals and doctors then increase their rates to private payers to make up the difference—unless there aren't enough private payers—in which case the providers go broke. This cost-shifting is a significant portion of health insurance premiums.
The Affordable Care Act increased the number of people eligible for medicaid and the increased percentage has been devastating to smaller and rural hospitals since their private. pays were dimiinishing.
The cure is for the government to be responsible for paying the cost of the services it promises. I dare say—this won't happen.
There is a simple solution that I am sure the religious right, who are the primary pro-life supporters will approve of. At each major cross road in the state post signs indicating the location of the nearest manger. Good enough for God, good enough for anybody, hmmph.
Sarcasm, for those with two recessive copies of the sarcasm recognition gene.
I'm about to say something very unpopular.
We should have seen this coming. We have outsourced the financial success of everything to the central government. Then, when the central gov does not keep up with the local financial needs, you are screwed. The problem with depending on federal or insurance for that matter is that, at any time, they can turn off the spigot.
The real key to success will be to find a way for locals to pay for local issues. I know that sounds insurmountable, but that's because we are trained to think that way. We are trained to think that help can ONLY come from some benevolent 'biggie' somewhere who will grant us 'benefits.'
Insurance has become the biggest scam of all time. LOCAL is the key and always has been.
I am not an economist, nor do I have any particular business acumen. I am just a veterinary practice owner. We have never had the luxury of depending on federal money or insurance money. We have to make it work with the resources we have. WHY are we able to provide basically the same medical procedures in many instances for a fraction of the cost? I do a C-section for an average of $1,500 all in. And we deliver multiple infants at one time. I am the surgeon and the anesthesiologist and the neonatologist.....and, because I have not limited my desire for knowledge to one NARROW path, as is common in human medicine(the fact that you have to have a hand AND a foot doctor always blows my mind.....I see all feet and 'hands(the front feet)' and my patients have multiple variations of these structures....hooves, nails, number of toes, etc) has made human medicine incredibly complex and inefficient. Doctors no longer can do everything....not sure how much of that is the fault of tort law, but it's insane. Specialization has destroyed human medicine. Knowing about only one body system is not only expensive and inefficient, it's bad medicine. To say you ONLY look at the heart, without considering what role the rest of the body has in the function and health of the heart is EXACTLY where human medicine goes astray.
There is no good reason why a doctor could not learn to deliver babies and care for both mother and child following the delivery. Why do you have to have an obstetrician SPECIFICALLY???? Human medicine has become so compartmentalized that no one can see the big picture anymore. Oh, but the key is this.....specialists make much more money, so everyone wants to specialize. That doesn't mean they are better doctors. If anything......I suggest they may not be as good as a general practitioner, who looks at the whole picture.
Just my two cents worth.
If you could find a group of doctors actually dedicated to the care and well being of the patients instead of worrying about their specialty and collaborating as a group instead of different factions, then I believe the cost of medicine would be reduced DRAMATICALLY.....but that's just me and I'm just a dumb ole dog doctor.
This could have been a great story, but I agreed that tying this issue to pro-life vs pro abortion isn’t logical. It should have been about the Biden administration’s perverse $3 million incentive to bring the average hospital stay under 24 hours! That should have been the headline.
Angela - Great observation! The lede is buried here and the headline reflects a simplistic editorial bias rather than a complex analysis focused on financial incentives.
Calling people "pro-life" because they oppose abortion is simple Orwellian double-speak. They're not "pro-life," they're "anti-abortion." That's all. They oppose abortion even if it costs the mother her life -- how is that "pro-life"? The media should stop using that aphorism and call it what it is.
What is your source for bluntly saying those that oppose abortion generally oppose it even if the mother will die? I would bet less than 30% of them think that way.
What about reproductive freedom? Shouldn’t it be called anti-reproductive freedom? I simply want to point out that both terms so not reflect the philosophy behind them. I m for freedom to reproduce or not, whatever women want.
The US system is not cost effective. WE don't need one doctor per patient. (I was the first member of my family born in a hospital. Both my parents and their siblings were born at home.) Most births can be safely handled by a midwife. In Israel, midwives run the show. Prenatal care is handled by doctors, who don't the deliver the babies. Delivery is in hospitals with one doctor available to multiple midwives. Doctors handle anesthesia and emergencies.
I don't think the $5600 price tag was from the doctor reimbursement. It's the whole hospital bill: from meds to nurses to linens to anesthesia, malpractice and insurance.
Oh boy, not even going to attempt tonipack the complete lack of logic in this article - but it’s those evil pro-life people (the standard excuse now for all complex issues?). Olivia- do better.
Maternity wards are closing because they aren't profitable. If labor and delivery cost the hospital more than 3 times what Medicaid pays, and the majority of patients are on Medicaid, then the maternity wards can't stay open. The first step is to get the government entirely out of healthcare and let a free market deal with the matter. Second, we are not our brother's keepers and it is not taxpayers' obligation to pay for the cost of delivering other people's children. To the woman who says, “This is my body and I should be able—with God’s will—to carry as many children as I and God would like," who does she think will pay the bills? Women have a right to have as many children as they wish, as long as they, or someone other than taxpayers are prepared to pay the bills.
Well said. I feel the same way about childcare. My husband worked and I gave up working full time to stay home and raise our children. I worked on a part-time basis that accommodated our schedules. If one chooses to have children make sure they fit into "your" budget.