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Hospitals – A False Choice

Yesterday I highlighted a troubling new trend in how we deliver medical care to rural and poorer areas of NC – the relocation of rural community hospitals to wealthier urban centers. Previously confidential documents resulting from WFU-Baptist Medical Center’s efforts to move rural Davie County Hospital closer to Winston-Salem provide embarrassing revelations of the race and class considerations integral to these deals.

State regulators, to their credit, have begun over the last few years to take a strong stand for lower-income and rural areas of the state when they are asked to approve these sorts of hospital moves. They even denied an earlier attempt to move Davie Hospital for just these reasons. Regulators have most recently moved to protect underserved residents in Franklin County where a for-profit hospital chain and UNC-Rex hospital are attempting to move a small-town hospital closer to Raleigh.

But so much money is at stake in our profit-driven health system that big hospital centers can bring enormous pressure to bear on these issues and the regulators. In the latest Davie County case, this is typified by a slick, full-color political campaign-style mailer. Basically it gives people in Davie a false choice – a common political campaign tactic. Here the message was either let us build a new fancy hospital in the richest part of the county while we close the current rural hospital OR we’ll close your rural hospital for good.

What about building a new hospital near the current one, even if the new hospital needs to be smaller and more efficient? And remember – while this mailer was what the public was seeing, in private the hospital was looking at documents highlighting the fact that the area where they want to build the new hospital has a “predominately white population, at 96%.”

Guess including the racial stats about the community where the new hospital would be built in the mailer was seen as counterproductive.

Is a deceptive PR political campaign really the best way to decide where we build hospitals in North Carolina? I don’t think anyone would agree. However, regulators are fighting a losing battle. Rival hospital systems disputing over where to build hospitals (which is why all this documentation is coming out through administrative and court disputes between WFU-Baptist and rival Novant Health) have enormous resources. Until we get every person in North Carolina on an affordable, quality health plan, hospitals will continue to fight tooth and nail over the ever-dwindling pool of North Carolinians with good health insurance.

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