Rural hospitals in America are in danger, and some 18 such facilities in Utah are no exception.

A University of Illinois study disclosed a few days ago that as many as 600 of the nation's 2,700 rural hospitals could soon close because of economic fluctuations and medical technology advancements they cannot afford.Contributing to the problem is a federal medicare formula that pays rural hospitals less than urban hospitals for treatment of the same medical condition. New studies find nothing to justify the disparity, and the National Rural Hospital Association has filed suit to remedy the situation.

Rural hospitals also suffer from federal regulations that tend to drive up costs by requiring man-power levels not justified by patterns of the use of those hospitals. And, to compound the problem, rural areas no longer can rely on a federal program that required student loan recipients to spend time in rural communities as part of their loan repayment plan. That program drew 23 doctors to rural Utah five years ago. Without it, Utah attracted no new doctors this year.

Rural hospitals cannot expect the federal government to solve all of their problems, but they do have the right to expect fair treatment. To that end, a more equitable distribution of medicare and medicaid funds is clearly in order.

Many hospitals could help themselves by following the innovative concepts being pioneered in Nephi and Gunnison, where the two hospitals are developing a shared service program. This will provide patients at both hospitals access to new technologies at a more competitive price, as well as ensuring that local hospitals continue to exist. Such facilities are needed if doctors are going to remain in rural practices.

It will take a joint effort on the part of the government and the hospitals to keep this vital element of the U.S. medical community viable. If rural hospitals keep closing their doors, more Americans will be deprived of ready access to competent medical care.