Duluth News Tribune highlights challenges of rural health care

Essentia Health CEO Dr. David Herman sat down with the Duluth News Tribune's editorial board for a conversation around rural health care in late November.

The discussion was far-reaching and touched on a number of challenges confronting health care in rural communities. Among them: workforce shortages; reimbursement rates from government health insurance like Medicare and Medicaid that fall far short of covering the cost of care; not enough providers or nurses; and, compounding these challenges, the fact that rural populations tend to be older, with more pronounced health needs as they age.

These reasons help to explain why more than 700 rural hospitals nationwide are at risk of closing, according to the Center for Healthcare Quality and Payment Reform. That includes 364 that are at "immediate risk." In Minnesota, two-thirds of hospitals have a negative operating margin (meaning they are losing money), according to the Minnesota Hospital Association.

Dr. Herman expressed the belief that a person's zip code shouldn't determine the quality of their health care.

“To what extent should a tradeoff be reasonable?” he asked the editorial board. “When you live in a rural area, you’ve, quote, made a decision. But you may or may not have. When you’re healthy, you never think about that. When you’re 75 years old, you start to think more about where you live. But when you’re 35 and having a family and working on the farm or working in the mine, that’s not something you’re considering. So, do we tell people you can live (in a rural setting) until you’re 65, and then you have to move closer to health care? … These are conversations we need to have. Do our expectations meet realities?”

Click here to read the entire editorial.