Access to quality health care is a genuine worry for families across Utah. As the director of an independent rural health center, I am particularly concerned about providing the highest standard of care to people who have chosen to live in a rural area and need access to appropriate care.
Most Utahns, and most people in this country, don’t grasp the precarious nature of rural health care. The services that rural hospitals provide are very high quality, but they simply cannot offer the breadth of services that larger urban centers can provide; with that comes some unique financial challenges. It is also more difficult to recruit physicians and other health care providers to a rural environment. They have to want to live and practice in a rural area, which can be very rewarding, but not as financially lucrative as can be a practice in a more urban environment.
According to the National Rural Health Association, 25 percent of the country’s population lives in rural areas, but only 10 percent of the nation’s doctors live in these areas. Those providers are often overworked and underpaid, but give outstanding care to the patients they treat. Despite those efforts, a recent article in The Street stated that the death rate of rural Americans under the age of 24 is actually 25 percent higher than their counterparts in urban areas.
Rural populations also have higher percentages of hypertension, alcohol and smokeless tobacco abuse, deaths from car accidents due to longer ambulance response times, aging populations and increased suicide rates — particularly among men and youths. The rate for women is precariously approaching that of men.
Amid these factors, the independent rural health care providers, like Gunnison Valley Hospital, are committed to serving our at-risk population. And while we do face challenges, we are appreciative of the state and federal programs that work to ease this burden.
There are state and federal programs established to assist our centers, such as the Medicare 340B drug pricing program that allows our hospitals to purchase certain drugs at a substantially discounted rate, which can help us meet our financial obligations. The program’s guidelines are simple: pharmaceutical companies that want to participate in Medicaid must sell their drugs to rural hospitals at discounted rates.
Congress is currently evaluating the status of the 340B program, which truly worries me. Our facility — like many rural health care providers across the country — depends on 340B to remain financially viable and, frankly, keep our doors open. In fact, since 2010, 43 rural hospitals have closed throughout the country.
Gunnison Valley Hospital and other rural facilities like Gunnison are examples of how hospitals can survive using smart management, best practices and efficient utilization of programs like 340B.
The general belief of my colleagues in the health care field is that Congress is receiving pressure from pharmaceutical companies to either drastically reduce the program or end it all together. This would be a travesty. If the 340B program were eliminated, it would add only a miniscule amount to the drug companies' profits, which were $771 billion in 2013.
The bottom line is this: safety net hospitals like mine rely on 340B for the financial security it provides and in helping us provide to our populations in rural markets access to critical medical services. We are the first line of defense in providing health care to rural communities throughout Utah, and limiting access to low-cost medication for the sole purpose of financial gain is just wrong. Our delegation to Congress should act in the best interest of its rural population and assist us in continuing the highest quality of care.
Mark Dalley is head administrator at Gunnison Valley Hospital.