People who live in the small rural communities of Kansas rely on the critical access hospitals that serve their hometowns. Yet, keeping those hospitals afloat is a constant struggle that requires extraordinary investment from taxpayers -- fewer of whom are left each year to support those hospitals.
The situation isn't being helped by the bullheaded decision by Gov. Sam Brownback and the Kansas Legislature to reject a federal expansion of Medicaid. Health care officials repeatedly have stressed failure to accept the expansion will leave more people relying on emergency room services -- the most costly form of care which oftentimes go unpaid. Complicating the issue further is those same hospitals also will experience a reduction in Medicare reimbursement, a measure based on the assumption that hospitals would offset the decrease by increased coverage through Medicaid.
That reality puts the burden of financing rural hospitals squarely on the backs of the rural residents who want and need those hospitals in their communities. Throughout the state, voters have approved local bond issues and other financing to upgrade, repair and finance the operations of their small hospitals.
Yet the long-term reality is those communities can't support their hospitals indefinitely. With an aging population, the tax base shrinks each year. And like when a school closes in a rural community, the closing of a hospital makes it harder for those towns to attract new residents, who can help support the hospital, the local school district and small businesses.
Topeka, however, seems to have little concern for the future of rural Kansas. The state's decision makers flatly have ignored this issue because the reality -- that they're systematically killing western Kansas communities -- doesn't blend well with their ideologically driven campaign messages. Additionally, the proven support from taxpayers to keep these hospitals afloat undermines the thin and thoughtless message there's no such thing as a good, or useful, tax.
Perhaps someday, concern for the real issues facing the rural parts of Kansas will supersede elected officials' desire to retain their seats in Topeka. Then the state can begin to explore ways to make health care accessible and affordable to Kansans in the smallest towns -- and that can begin with the simple decision to accept an expansion of Medicaid.
Until then the burden and the cost will remain on individual communities that already struggle to keep their towns inviting and viable in the face of constant disregard from the people who could provide some relief with a simple "yes."
Guest editorial from the Hutchinson News.