Rural health

Regarding “Rural communities need health care infrastructure” (Page A13, Thursday), I found the piece by Dayna Steele to be accurate in general, but there are a couple of items that should be put in perspective. She talks about the need for rural hospitals, but the reality is that many that have closed in recent years should have been closed years ago.

After World War II, the Hill-Burton Act funded construction of hospitals across the United States, a large number in rural areas. Over time, hospitals became more advanced, and correspondingly, more costly. The more time passed, the less these hospitals could afford modern equipment, to the point that many were running on equipment that should have been scrapped years earlier. In addition, specialists to run modern equipment, and the doctors that could utilize this equipment, had no incentive to go to these hospitals. A death spiral was started.

In addition, many procedures that required hospitalization are now done on an outpatient basis, so fewer beds are needed. So, the author’s opinion that these hospitals might be replaced by urgent care centers is not all bad. A new type of medical center, one that is focused on outpatient procedures, and with telemedicine, and perhaps a couple of inpatient beds, might be the solution. Furthermore, it might begin to introduce a little financial sanity into the cost of health care today.

Phillip Knox, Houston