Shuttered Hospitals and the Reopening of America

In late April, Williamson Memorial Hospital, the only hospital providing essential health services in the coal mining community of Mingo County, West Virginia, closed its doors. It is one of twelve rural hospitals to close since the start of the year. Rural counties across the US face similar dangers in the ongoing COVID-19 pandemic: despite having at-risk populations that are generally older and have a higher frequency of underlying health conditions, medical care is becoming increasingly inaccessible. These contradictions expose the inherent carnage of capitalism—a system that sacrifices human lives at the altar of capital—and the urgent necessity for socialism.

Without the necessary and preemptive efforts to prevent its spread, COVID-19, which initially affected more urban areas, has made its way into at least 86% of rural counties in the nation. And although urban areas still have higher rates of COVID-19, rural areas are experiencing a faster growth rate in both cases and deaths. Within two weeks in April, rural counties on average saw an alarming 125% increase in cases, and a 169% rise in deaths, in comparison to urban counties, which faced on average a 68% increase in cases, and a 113% increase in deaths.

Brian Kemp COVID-19 Crisis
Brian Kemp, Governor of Georgia, has initiated the rapid reopening of businesses in the state. / Image: Office of U.S. Senator David Perdue

The data show that there is a clear need to slow the spread of the virus in rural areas; however, lives are blatantly ignored in the interest of profit. For example, on April 24, Governor Brian Kemp reopened the state of Georgia’s hair and nail salons, as well as its tattoo parlors. Three days later, he permitted dine-in services at restaurants to resume. But in this same state, we find Randolph County, a small county with only 6,800 residents, suffering the nation’s highest death rate. Moreover, Georgia is home to three of the nation’s top five rural counties with the highest coronavirus death rates. Despite these alarming statistics, and the clear need for increased restrictions, Georgia’s governor has eagerly done the bidding of the capitalist class at the expense of public health. We see similar cases across the US, as states move to lift restrictions, even though high infection and death rates would strongly warrant the opposite response.

As states reopen, however, and thus exacerbate the infection and death rates, rural hospitals struggle to keep their doors open. Before the COVID-19 outbreak, half of all rural hospitals in the nation were operating in the red. A study by the University of North Carolina found that 172 rural hospitals have closed since 2005. In 2019, more rural hospitals closed in one year than all other years on record. These hospitals have struggled for years due to reductions in federal funding and decreasing patient populations. In addition, those they serve are older, poorer, sicker, and less likely to be insured, have high-deductible insurance policies, or depend on Medicaid and Medicare, which do not fully reimburse hospitals for the cost of treatment. As a result, counties across the nation face a growing health care desert, with nearly 11 million Americans residing in counties without a hospital, as of 2019.

The profit-oriented health system—already grinding rural hospitals into the ground—further endangers them and their dependent residents amid the COVID-19 pandemic. Hospitals around the nation have stopped providing “non-essential” procedures such as colonoscopies, mammograms, and physical therapy—services that have kept these facilities afloat for years. The egregious cost of care for a hospitalized and uninsured COVID-19 patient—an average of $73,300—serves to further exacerbate their risk. When infection rates increase, there is no question that these small hospitals, unable to afford to provide treatment, will plummet further into financial difficulties. More and more hospitals will be forced to follow in the steps of Williamson Memorial, leaving residents without basic and essential health services in the middle of a global pandemic.

In addition to closing hospitals, essential nurses and support staff are being furloughed, and their wages and hours cut across the nation. In fact, a recent study by the US Department of Labor found that at the height of the pandemic so far, employment in health care declined only second to that of the food service industry. Under capitalism, hospitals are just another business, and when a hospital’s revenues plummet, the facility must cut costs—starting with its workers. While some hard-hit cities like New York, New Orleans, and Detroit cried for help as their health care workers, inadequately equipped with PPE, fell sick, masses of trained workers were told to stay home.

Healthcare Workers COVID-19
Essential healthcare workers are being furloughed while COVID-19 spreads across the US / Image: Sasin Tipchai from Pixabay

In an interview with the LA Times, Lori Isham, a pre-op nurse in California notes the irony of the situation: “It’s embarrassing… Everyone was like, ‘Come out of the woodwork: If you haven’t finished nursing school, we need you, and if you’re retired we need you,’ and we’re like, ‘We’re laid off.” All across the nation, nurses are speaking out about the absurdity of this situation and the hypocrisy of the capitalist state. Even in the emergency rooms of hospitals facing an influx of COVID-19 cases, workers are being sent home.

This is the consequence of a healthcare system built around the narrow interests of the profit motive. The capitalists may point the finger at this monstrous virus, blaming it for all of our ills. But while the bourgeois politicians proclaim the need for the “unity” of the American people, their actions expose their true allegiance—to capital. This reality is all the more evident in the face of this pandemic. The increasing danger for rural America is the result of a profit-motivated, rather than a need-based industry of health care, that has been starving health services of resources in these areas for years. The anarchy of the market has proven so inefficient that the danger for rural Americans today is not a lack of hospitals, machinery, nor skilled workers to save lives in the middle of a pandemic. Rather, it is that these hospitals are empty, the tools unused, and the workers sit in enforced idleness.

As we explain in our program to combat COVID-19 and capitalism, only by nationalizing the entire health sector and integrating it into a democratically administered public health provider can we ensure the necessary and quality health care services for everyone, no natter what part of the country they live in.

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