A cautionary tale with rural healthcare


Texas Type

Apart of my childhood disappeared recently. After growing up across the street from Richards Memorial Hospital in my hometown of Rockdale, I felt helpless as I watched it close and put about 100 good people out of work.

It was another slap for rural healthcare in these United States. Our system of expensive insurance, declining reimbursements and being unfriendly to primary care doctors has claimed another victim. Now the nearest emergency care for my hometown family and friends is 30 minutes away.

Rural Texans tend to be older, poorer and less healthy than their urban and suburban counterparts, according to a report, “What’s Next? Practical Suggestions for Rural Communities,” by the Texas A&M Rural and Community Health Institute and the Episcopal Health Foundation. Consider these challenges our rural counties face:

• 35 counties have no physician;

• 80 counties have five or fewer physicians;

• 58 counties are without a general surgeon;

• 147 Texas counties have no obstetrician or gynecologist;

•20 hospitals in rural Texas have closed and the 164 remaining in rural Texas are in danger of closing. Most suffer from financial issues, a lack of patients and a lack of leadership.

It’s frustrating because healthcare just seems to get more expensive and the insurance industry has wormed its way into the middle of it. That industry, along with the federal government, have driven up costs. Now, families pay tons more than they have historically for health insurance — along with higher housing, childcare and student debt costs — while insurance companies try to provide less coverage and make it more difficult for local doctors and facilities to continue to accept insurances.

Some in Washington are advocating for a single-payer system, while others would rather move toward direct pay and skip most of the middle man (insurance) altogether.

Lawmakers don’t quite seem to have the needed urgency to address it. Most who represent us in D.C. are millionaires and have voted themselves goldplated insurance plans. They can’t relate to what Average Joes living paycheck to paycheck deal with.

Texas A&M Health Science Center, along with Blue Cross and Blue Shield of Texas is studying the health challenges faced by rural residents. It will focus on telehealth, to new types of healthcare workers, to potential partnerships and delivery tools, writes Dan McCoy, president of BC/BS Texas.

McCoy wrote that focus areas of this project will include ambulatory healthcare delivery systems, rural hospital function and future, community empowerment, and technology and health information.

The insurance leader seems optimistic. I’ll reserve my optimism for when I see health insurance and healthcare costs start a downward trend and stop eating up so much of family budgets.

Our longtime family doctor in my hometown is optimistic and thinks there will be some type of healthcare in a matter of months. Larger hospital systems like to set up clinics in surrounding rural towns. For my hometown’s sake, I hope he is right. But a clinic is still not a hospital.

When I was growing up, Rockdale was a bustling small town much like Fredericksburg. It was roughly the same size during the 1970s and 1980s.

And there are lessons about relying too much on a single entity — the “don’t put all your eggs in one basket” theory. Fredericksburg is a much more diverse economy, though it could use more.

Today, after industry loss, my hometown is struggling. And let’s face it — it’s more difficult to recruit new jobs and new residents with few or no healthcare facilities. All this just exacerbates and speeds the population flight to the state’s urban areas and the “brain drain” away from rural areas.

McCoy writes that rural Texas is still vital because most of the nation’s food supply, materials for clothing and affordable energy supplies come from rural areas. So, healthcare doesn’t need to be only for city dwellers.

Hopefully Fredericksburgers will view my hometown’s situation as a cautionary tale and continue to support Hill Country Memorial. Trust me, we never want to have to face that situation.

And cross your fingers that our lawmakers will stop yelling at each other long enough to come up with some real medicine for what ails rural Texas.