Rural Healthcare Today

My husband and I spent six hours in the hallway in the Emergency Department at Robert Packer Hospital last week. He is alright now; he had been sent there by his primary care doctor due to concerning symptoms. There were no rooms available in the Emergency Department. In fact, we were told that there were no rooms to be had anywhere in the hospital. ICU patients were using Emergency rooms and every other available room. So, they situated my husband, along with six other patients we could see, on a bed in the hallway. They gave me a chair so I could sit with him, between him and the next patient.

All of my husband’s health assessments took place in the hallway in full view and easy earshot of the other patients and hospital staff. We saw and heard everyone else’s health assessments as well. We heard the story of a motor vehicle accident told and retold. We heard full names, birth dates and test results of other patients clearly. We witnessed everyone’s depression and domestic abuse screenings. We heard and saw an elderly woman crying in pain for over an hour with no privacy for her suffering.

What’s the point of this story? Let’s set aside the immediate cause of this situation, an influx of COVID cases. Let’s set aside the flagrant (HIPPA) privacy violations. Staff were making the best of a bad situation, a situation largely outside their control.

Let’s look for the root cause of the problem. The root of the healthcare crisis in rural Pennsylvania is the market. There is no competition in healthcare in rural Pennsylvania, even when there are alternative providers within a reasonable distance.

Bradford is a border county. New York is less than ten minutes from the hospital in Sayre. From our house, in Warren Center, there are four other hospitals with Emergency Departments just as close as the one in Sayre. They, however, are all in New York and they are all out of network for our insurance.

Regional medical groups, like Guthrie, have swallowed up all of the competition within the county. They absorbed the Troy Community Hospital and Memorial Hospital in Towanda making them the only hospital provider in the county. Insurance barriers restrain us from seeking care across state lines, where Lourdes, UHS and Arnot Health all have hospitals with Emergency Departments.

What encourages these medical monopolies to flourish? Our healthcare and health insurance regulations. Begun in 1945 and continued despite efforts at reform, the current healthcare and health insurance system encourages regional monopolies. It limits patient choice and drives up cost.

We need change.