Too Small To Fail

Posted on July 23, 2010


A few weeks ago I attended the National Rural Health Association’s Annual Rural Health Conference and was able to immerse myself in a different realm of the healthcare industry, rural care.  As I pondered healthcare and design from the slightly scaled down and small town perspective, I asked myself what would happen if the only hospital in a county or multi-county area threatened to close?

The government terms some of these hospitals critical access hospitals (CAHs) because they provide essential care to an underserved demographic. Although status as a critical access hospital allows a facility access to additional government monies and reimbursables, one policy misstep in a broad stroke attempt to fix healthcare (e.g. stringent requirements to incorporate certain new and expensive technologies in a short time frame) and unintended consequences could financially strain or wipe out some smaller facilities.

This made me think: during the government’s bailout of various failing industries—insurance, auto, airlines, banking—the phrase “too big to fail” was often used as a rationale for why to step in and save a particular company with taxpayer money. In the rural hospital realm, many patients have no plan B if their hospital were to reduce services or even close. My perspective gained from the conference had me wonder about rural healthcare:  is there an equally valid (and debatable) existence as too rural to fail?

This concept begs the comparison:  the state and federal governments should protect and ensure the success of rural hospitals at least as much as they do the commercial endeavors in other industries deemed too big to fail. As healthcare undergoes some imminent changes in organizational structure, competition and reimbursement consequences from the federal changes, it would behoove everyone to remember the role rural health plays in our healthcare system—and keep an eye out for the rural brothers and sisters in the healthcare family.

Posted in: Rural Healthcare