[oaktrout]

The article is arguing that private payers don't reimburse rural hospitals enough, not that lack of medicaid or obamacare is an issue. Perhaps your premise is correct but it is at odds with the article, I would be interested in hearing more about why you disagree with the article.

From the article "The biggest problem facing small rural hospitals is inadequate payments from private health plans. Most “solutions” for rural hospitals have focused on increasing Medicare or Medicaid payments or expanding Medicaid eligibility due to a mistaken belief that most rural patients are insured by Medicare and Medicaid or are uninsured. In reality, about half of the services at the average rural hospital are delivered to patients with private insurance (both employer-sponsored insurance and Medicare Advantage plans). In most cases, the amounts these private plans pay, not Medicare or Medicaid payments, determine whether a rural hospital will have to close".

[nradov]

That part of the article makes no sense at all and appears to be pushing a biased political narrative. Private commercial insurers already pay more than Medicare / Medicaid for the same treatments. Patients with private insurance are effectively already subsidizing those on public plans.

Why should the burden of keeping small rural hospitals open fall entirely on private health plans? Perhaps hospitals should advocate for higher Medicare reimbursement rates.

[hotpotamus]

> Why should the burden of keeping small rural hospitals open fall entirely on private health plans?

Because that's how the majority of Americans get their healthcare? I assume that's the case, but I don't actually know - as mentioned there are multiple single-payer health plans (lol) that cover those we have deemed worthy of them. The paper linked says that rural hospitals need to bill higher because their unit costs to deliver healthcare are higher (which makes basic economic sense). Therefore it would seem like the market solution would be to charge people who live in rural areas more for healthcare/insurance.

I can never tell whether the US is a nation or an economy.

[oaktrout]

I found it odd also, I was under the impression that hospitals made their money on private insurance and lost on medicare/Medicaid. I do recall hearing that rural hospitals are reimbursed at a higher rate from the government, perhaps that explains the discrepancy.

[judge2020]

> In reality, about half of the services at the average rural hospital are delivered to patients with private insurance (both employer-sponsored insurance and Medicare Advantage plans). In most cases, the amounts these private plans pay, not Medicare or Medicaid payments, determine whether a rural hospital will have to close

If 50% are private insurance, what are the other 50%? Wouldn't that other half influence whether the hospital has to close?

[oaktrout]

Presumably, but if half your customers pay you just above your costs and the other half pays half that, which half is responsible for your business going bankrupt? Probably both, but one half is clearly more of an issue than the other.

[jorblumesea]

Yeah and guess who keeps voting against single payer healthcare solutions or any kind of healthcare reform?

Representatives from these red rural areas. It's a different big cat that's eating your face, if that makes you feel better.