Commentary

The ACA: Here Are (Mostly) Reasons Why Not


 

References


Rural Health Care: Dearly Departed
I’d like to get you up to date on the rural health care crisis that the ACA has directly caused, as you make no mention of this tragic disaster in your editorial. My wife and I are an MD/PA team and have been the only medical providers in our town since 2003. More than 90% of our patient base was federally designated poor folks, but the ACA forced us to close our doors in August 2014.

The National Rural Health Association has been tracking rural hospital closures, but no one is tracking the hundreds of clinics like mine that closed as a direct result of the ACA. I know of seven practices within a 30-mile radius that have closed. One of our hospitals, with a payroll of $11.3 million, recently closed. All of these clinicians will now be on unemployment, further increasing our deficit.

In our community, 11,000 people now must drive long distances or use the ED for health care. People who do not live rurally do not understand the situation—and many don’t care, as the focus is on urban and city medicine. Early in my career, I worked with the National Health Service Corps to pay off student loans; our entire county in Minnesota had a population of only 10,000—a thousand people less than the northern California town my clinic was in. But we had a full hospital and clinic (albeit with little in the way of funds to support them).

The President could have assembled a Healthcare Advisory Taskforce of city, urban, and rural CEOs, docs, advanced practice providers, etc, to evaluate how the ACA would impact each sector. Instead, we now have a rural health care crisis as a result of “health care reform.”

Don Sakal, MMSc, PA-C
Magalia, CA

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