As a longtime resident of rural Michigan, I can testify that hospitals are lifelines for small communities. As the only hospital in Lenawee County, ProMedica Charles and Virginia Hickman Hospital serves nearly 100,000 community members. Without our hospital, individuals would be forced to travel half an hour to the nearest hospital in Monroe County. In an emergency, every minute counts, and a nearby hospital can be the difference between life and death. To help protect rural Michigan and the countless patients depending on access to quality healthcare, I urge lawmakers to stand firmly with rural communities and prevent further healthcare funding cuts.
At this moment, rural hospitals face unique challenges. As rural populations decline, staffing shortages become more prevalent, and hospital leadership must look for innovative solutions. Currently, rural communities have approximately 30 physicians per 100,000 people, compared to 263 in urban areas. This shortage will only worsen in coming years as over half of rural doctors are over the age of 50 and nearing retirement. Financial challenges have also drastically impacted rural hospitals, and over 130 rural facilities have closed between 2010 and 2022 alone as a result of budget cuts. Looming health cuts slated to take effect will only add insult to this injury.
In many cases, federal funding cuts will be felt most by patients in need of care. In Lenawee County, over 16% of the population relies on Medicaid to access healthcare, and over 40% of that group are children. Without healthcare coverage, it has been found that patients delay doctor visits, leading to poorer health outcomes. Further, whether a patient has insurance or not, hospitals will continue to provide treatment, carrying the financial burden on behalf of that patient.
However, operating at a loss can put hospitals and health systems at risk of service cuts and closures. In instances where rural communities lose access to a hospital, patients are forced to travel farther to find care elsewhere, putting additional strain on providers, services, and supplies. When multiple towns rely on one hospital, patients can expect longer wait times, medical equipment shortages, including available beds, and a lack of medical staff available for 24/7 emergency care. To provide better support for the communities that depend on them, hospitals must retain financial stability.
Government cuts to healthcare reduce hospital capacity and put specialty services at risk. Maternity wards, mental health programs and other essential services that support community wellbeing are often the first to close in already strained areas. Just this year, over 21 maternity wards have closed across the U.S. and in Lenawee County, the difficult decision was made to close a mental health clinic due to funding and staffing shortages. Cutting hospital services is never an easy decision, but with limited resources, rural healthcare providers must make decisions like this too often.
Rural areas see more potentially preventable deaths than urban areas, and the gap is widening. No one’s zip code should dictate their life expectancy and access to quality healthcare, but limited resources continue to threaten the capabilities of small rural hospitals. Without the protection from funding cuts, hospitals will continue to struggle under the pressure of limited funding and increased demand. To prevent this strain on critical access health systems, lawmakers must put rural communities first and protect hospitals from further budget cuts.
Dr. Julie Yaroch is president of ProMedica Charles and Virginia Hickman Hospital in Lenawee County, Michigan.
