
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, July 11, 1990                   TAG: 9007110399
SECTION: EDITORIAL                    PAGE: A-7   EDITION: METRO 
SOURCE: KEN WOODLEY
DATELINE:                                 LENGTH: Medium

VIRGINIA'S RURAL HOSPITALS NEED EMERGENCY CARE

THE LATEST example that redwood trees are alive and well and living between the ears of our nation's bureaucracy is a plan that could render some rural hospitals comatose and then remove them from life support systems. Rural hospitals already get 18 percent less from Medicare than their urban and suburban counterparts - 18 percent less for providing identical health care to Medicare patients. That's bad enough, but the federal government is involved, so the story has to get worse. It does. Unless something is done to prune some of the dead wood within Washington's cranium, the Medicare reimbursement disparity will rise to 25 percent this fall.

Medicare reimbursements are based on supposed wage scales - what Medicare thinks rural and urban hospitals pay their medical staff. Urban hospitals pay their doctors and nurses more, thinks Medicare, so they should get more money for treating Medicare patients than rural hospitals do.

Perhaps if Medicare experimented with a concoction using an eye of newt, toe of frog, and wing of bat a more realistic and fairer formula would be found. Southside Community Hospital (SCH) in Farmville, for instance, competes with hospitals in Lynchburg, Charlottesville and Richmond for doctors and nurses. Consequently, SCH must offer salaries that can compete with those urban and suburban facilities. Other rural hospitals in the state face similar situations.

Urban and suburban hospitals have an unfair advantage because their bank books, sweetened by a lopsided Medicare reimbursement plan, are better equipped to dole out salaries. Salaries that rural hospitals are hard pressed to match.

Rural hospitals face the threat of shutdown because they continue to lose money and cannot hire and retain the necessary medical staff. Doctors and nurses and equipment are rather good things to have around a hospital. They tend to lend an air of healing to the place.

It is extremely important that rural hospitals remain viable centers for comprehensive medical care for the thousands of Virginians who rely on them. Were these hospitals to close or become some kind of nursing home, rural communities would be tremendously hurt. Some people will be able to live in rural America, but it will be a much poorer and dangerous place to live.

Economic development in rural communities would be severely crippled if their hospitals ceased to exist. Would industry rather locate in a community with its own hospital or a community in which the closest hospital was 50 miles away?

Retirees, who contribute socially and economically but do not ask for many services requiring a lot of tax dollars (schools, for instance), would find some place else to live. Housing development would burn up like mist in the sun. Young families? Are they going to want to raise their children where quick and thorough medical care is unavailable? The list goes on and on.

Emergency medical care would be much more distant if rural hospitals closed. In many cases, that would mean the difference between life and death. Rural hospitals close and rural America goes on the intensive care list. And there will be nothing to provide the intensive care.

It is essential to the continued growth of rural Virginia - and to simply maintain the current quality of life - that rural hospitals not only survive, but flourish.

Rural communities are a vital part of the American body. Lose your heart and soul and you crumble into dust.

by CNB