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State's leaders must be cautious in their decisions affecting h

West Virginia ranks second in the nation in rural population. The Mountain State also has the oldest population in the nation, and its poor socioeconomic status compounds the poor health status from which it also suffers. So it is not difficult to understand last week's news that 12 rural hospitals have lost money two consecutive years and are at risk of closure and elimination of services.

This is a fairly sizable chunk of the state's 69 hospitals which have all recorded losses in patient services, while federal and state reimbursements continued to fail to cover costs for approximately half of West Virginia's patients. The state has 1.8 million residents. The news is especially grim when we consider that it is hospitals that provide the only acces to health care in many of the communities in West Virginia.

The crisis is going to mean different things for different citizens -- dependent upon where they live. But be assured, it will be a drastic change for the worse if things continue as they are, according to John D. Law, director of public affairs for the West Virginia Hospital Association in Charleston.

Residents use rural hospitals as their source of essential health care services. Basic acute care to the state's citizens includes emergency room treatment, long-term care, ambulance service, obstetrics, home health and primary care. Rural hospitals have provided outpatient services to those who are in need of them. The number of outpatient hospital visits in West Virginia's rural hospitals has hovered around the annual level of 1,550,000.

WVHA's latest figures show that of the patients who use hospitals in the state, there were 305,423 admissions, but the number of outpatient visits has been 5,731,699.

It is not rocket science to realize that operating margins in hospitals are declining as costs continue to skyrocket. This is especially true in the rural hospitals.

Here is yet another thought. Those people living in the non-rural areas of West Virginia may see hospital employees losing their jobs. In many of the state's 55 counties, hospitals are major employers. So many areas will be faced with further job loss, according to informatioin from WVHA. We may see hospitals either eliminate non-essential services or simply close. State consumers could then face the prospects of being treated with less modern facilities and equipment -- second-rate medical care.

Law indicated that it was in the 1960s that the federal government invested millions of dollars to build a system of hospitals throughout the U.S. to care for elderly Medicare patients, including people in rural Mountain State areas. To provide perspective, the system is now about to collapse due to the age of hospital physical plants and the lack of capital. Still, despite declining operating margins in hospitals, health care costs have continued their rapid rise.

In short, hospitals are a large part of the "safety net" for patients needing services in West Virginia, which has some of the highest death rates in the nation from cancer and heart disease. It does not take a brain surgeon to determine that without having adequate financial resources, hospitals cannot devote their resources to health improvement.

We would advocate that legislators should stand firm against policies that further reduce payments to hospitals or that increase the cost of providing care, but support health care funding improvements for the state's citizens. And we would strongly urge community leaders to demand that their legislators and policymakers fully evaluate the impact of their decisions on access to patients locally -- especially in the rural areas.

Robert F. Stealey

Telegram Editorial Board chairman

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