Increasingly in NC we’re seeing a troubling new trend. Older hospitals built during the 1950s and 1960s hospital boom that brought modern medical care to many of the poorer and more rural regions of our state are starting to get so old they need replacement.
Surprise, surprise. Apparently, the best place to rebuild these hospitals isn’t in the rural, poorer areas where they are now, but to move them closer to the wealthier metropolitan regions of areas like Raleigh and Winston-Salem. Good Hope Hospital in small-town Harnett County wished to move closer to the wealthier suburbs of south Raleigh. Franklin Regional Medical Center in the center of largely rural Franklin County wishes to move south to the wealthier environs of North Raleigh and Wake Forest. You apparently just can’t make the profits our health care system demands if you insist on continuing to stay and provide critical medical care in those poorer and more rural areas of our state.
Enter Wake Forest University Baptist Medical Center. They manage Davie County Hospital (DCH) in rural Mocksville – a town that’s certainly small, rural, and a ways from Winston. DCH is getting old and Baptist wants to close it and build a new hospital much closer to Winston-Salem in the town of Advance which just happens to be next to the wealthy exclusive gated community of Bermuda Run.
In a previously confidential internal document entitled “Why Davie County”, WFU’s Baptist explains its reasoning for proposing the move:
The Advance region is the most affluent portion of Davie County and accounts for approximately 32% of the county’s total population. The region is characterized by a predominately white population, at 96%. Only 2.5% of the population is Black and 2% of the population reports having a Hispanic ethnicity. The Advance region is home to two large, upscale golf communities. Bermuda Run, incorporated in 1999, is a 300 acre gated residential community with a population of 1,470 and an average resident age of 60 years. Oak Valley is a 400 acre community with home prices ranging from $200,000 to $800,000.
The remaining 68% of the Davie population resides in the Mocksville and Cooleemee regions…This region is less affluent compared to Advance and has more racial diversity, with almost 13% of the population reporting a non-white ethnicity. The bulk of this minority population is Black, totaling 8.6% of the region’s population.
Note that the vast majority of the population of Davie County does not live in Advance. However, thanks to the tireless researchers at WFU-Baptist, we now know where lots of white people and rich people live in the county. After more discussion, on page nine of the document Baptist lays it out. They will close the hospital in rural Mocksville and:
Thus a decision was made to propose construction of the replacement hospital in Advance.
Rarely have I seen such a blatant display of the real reasons for these hospital moves put so clearly. The prominent consideration of race and wealth lays bare all that is wrong with our health care system. That a respected university medical center would stoop so low is a testament to how much the corruption of profit and abandonment of the 1.5 million people in North Carolina without health insurance has infected every facet of a medical system that was once the most respected in the world.
Were the race and class considerations the only reasons for Baptist to choose to move the hospital away from the more populous and poorer area of the county? No. But their extensive discussion in the document and the continuation of the pattern of other hospitals in NC moving from poor rural areas to wealthier metropolitan areas and suburbs leave little doubt. No one wants to spend money to build a new hospital in the poorer and more rural areas of NC – there just isn’t profit in it. Why isn’t there profit? Because there are more minorities, more low-income folks, more people without health insurance – in short, more people who can’t pay the full bill.
I am simply disgusted with the actions of WFU Baptist and, indeed, with all of us here in North Carolina who have let our responsibility to our fellow citizens come to this low point. Where institutional racism and fear of the costs of providing the most basic help to our fellows drown out the imperative that we afford every man, woman and child in our state the very best medical care we would wish for our own families, I am ashamed.
Compromise is possible. Build a smaller, more efficient facility where the current hospital exists while also building a new hospital next to the golf courses and gated homes of the wealthy. Profits may not be as high, but responsibility comes with a price. That is a price we should all be willing to pay.[Full disclosure: When I saw the above document, I was so disturbed that I agreed to testify – without any compensation of course – in an administrative hearing against WFU-Baptist’s application to the state to move Davie Hospital to the wealthy Advance region. Novant Health, a rival hospital system, wishes to build a hospital in the same area too – although they are not proposing to close a rural hospital to do it.]