'It can be a loss of life': First responders detail the deadly cost of rural hospital closures
Rural hospitals are vanishing, and Medicaid cuts could accelerate the collapse.
abcnews.go.com/US/loss-life…— 🦋 kris🌻⋆⋆⋆ (@eviebauer727.bsky.social) October 8, 2025 at 12:52 PM
Look, it’s just not cost-effective to keep a scatter of useless eaters alive across broad swathes of flyover country, okay? Per ABC:
… President Donald Trump’s Big Beautiful Bill slashes nearly $1 trillion in Medicaid funding over the next decade. The administration says this cuts wasteful spending and will create a $50 billion fund for rural hospitals. But many health experts say that’s not nearly enough.
Already, nearly 100 rural hospitals have closed or eliminated inpatient services in the last decade, threatening health care access to some of the more than 16 million people living in rural communities who rely on Medicaid.
While the full impact of Medicaid cuts could take years to unfold, doctors say the system is already buckling. Many rural hospitals are already operating on razor-thin or negative margins, and they see these looming Medicaid changes could push them over the edge…
A spokesman for the White House issued a statement to ABC News claiming, in part, that rural hospitals do not suffer from low margins, but low volumes.
“Rural hospitals in sparsely populated areas have chronically low utilization rates, often having more empty beds than filled ones,” the statement reads.
“Only seven percent of Medicaid spending goes to rural hospitals, and rural hospitals’ economic woes have continued to worsen despite the dramatic increase in Medicaid spending in recent years,” the statement adds.
The White House also said the Trump administration’s $50 billion Rural Health Transformation Fund is designed to “push states to adopt meaningful healthcare reforms to make rural hospitals economically viable.”
Something that has taken me some time to get my head around, but it's becoming more clear to me (or I'm just descending into poster's madness, hard to say) as we go on is that Trump and co. actually don't care about all stick, no carrot, and in fact, actually want it to be that way.
— Schnorkles O'Bork (@schnorkles.bsky.social) October 11, 2025 at 2:58 PM
These people want to reform the administrative state, tear out benefits and do eugenics, and racially remake the countries population.
There is no deliverism here, it's raw transformational politics. There will never be carrots, it's just sticks all the way down.— Schnorkles O'Bork (@schnorkles.bsky.social) October 11, 2025 at 2:58 PM
Just to remind people, the reason that Trump wants to blow up CDC is pretty easy: they want people to die.
The combination of destroying rural areas to centralize population and removing weak populations seems to be part and parcel of their strategy to remake the welfare state.— Schnorkles O'Bork (@schnorkles.bsky.social) October 11, 2025 at 2:44 PM
Same with blowing up the Dept. Of Special Ed at DoEd.
The point is literally to remove points of burden on the system through, basically, eugenics, and forcibly drop the major spend of rural welfare management— Schnorkles O'Bork (@schnorkles.bsky.social) October 11, 2025 at 2:47 PM
I don't think it has a particularly high chance of being successful simply because it's wildlly unpopular and they haven't consolidated in any way necessary to do it.
But it's sure gonna be a mess.— Schnorkles O'Bork (@schnorkles.bsky.social) October 11, 2025 at 3:04 PM
******
Months before catastrophic floods swept through an Alaska Native village on Sunday, the Trump administration canceled a $20 million grant meant to protect the community from extreme flooding. At the time, the EPA administrator said he was eliminating "wasteful DEI and Environmental Justice grants."
— The New York Times (@nytimes.com) October 14, 2025 at 8:30 PM
… The grant from the Environmental Protection Agency was designed to help stabilize the riverbank on which Kipnuk is built, protecting it from the twin threats of erosion and flooding.
But in May, the E.P.A. revoked the grant, which was issued at the end of the Biden administration, saying it was “no longer consistent” with the agency’s priorities. Lee Zeldin, the E.P.A. administrator, boasted on social media that he was eliminating “wasteful DEI and Environmental Justice grants,” referring to diversity, equity and inclusion initiatives, and programs to help communities facing a disproportionate level of environmental threats.
It is unclear whether the work funded by the grant would have prevented the tragedy on Sunday, which left one person dead and two missing in the neighboring village of Kwigillingok. But the disaster laid bare the area’s vulnerability to flooding and the consequences of the Trump administration’s cuts to environmental programs…
Rayna Paul, the environmental director for Kipnuk, could not be reached for comment amid cellphone service outages in the aftermath of the disaster. But in a court filing in litigation over the funding’s cancellation, Ms. Paul said the money was “essential to prevent environmental and cultural catastrophe.”
Kipnuk, a village of about 970 people along the Bering Sea, is built on permafrost, ground that has been frozen in some cases for hundreds or thousands of years. Climate change is heating the Arctic region more rapidly than the rest of the planet and the permafrost has started to thaw….
The remnants of Typhoon Halong unleashed record-breaking storm surge in Kipnuk over the weekend, Ms. Nieminski added. Emergency management officials rescued at least 51 people in Kipnuk and Kwigillingok on Sunday, while more than 1,000 remained in emergency shelters on Monday.
Without the federal funding, residents and leaders of Kipnuk would probably not have the resources to pursue the riverbank stabilization project on their own. The village has an average annual income of $12,107 and a poverty rate of more than 26 percent. The homes lack running water, and the only buildings with flushable toilets are the school and the laundromat.
“The Native Village of Kipnuk does not have taxing authority and cannot raise funds itself for riverbank stabilization, or anything else,” Ms. Paul wrote in the court filing. “It depends on grants to fund local government projects.”
******
What they want is to have the troops shoot homeless people. That's the goal here, that's what they want.
— Schnorkles O'Bork (@schnorkles.bsky.social) October 12, 2025 at 2:14 PM
Only The Elite are allowed to use potentially deadly mind-altering drugs, untermenschen!
Elon Musk has backed Salesforce CEO Marc Benioff’s call for federal troops to be sent to San Francisco, a city that has become the latest flash point in President Donald Trump’s escalating campaign to deploy the National Guard to Democratic-led cities…
Musk’s endorsement came in response to a post by Thom Wolf, a recovery advocate and former homeless resident, who cited data showing more than 4,300 overdose deaths since 2020 and 90 kilograms of fentanyl seized by the San Francisco Police Department in the past year…
Musk emphasized that downtown San Francisco “is a drug zombie apocalypse” in another reply to a post by tech journalist Andrew Côté which described Market Street as a “disaster.”
“It’s zombie town,” Côté wrote, adding that city leaders had failed to address the issue adequately. “It’s a morass of human misery, suffering, and crime.”…
According to a July San Francisco Chronicle analysis, reported violent crime fell 19% and property crime 25% in the first half of 2025, continuing historic declines from the previous year.
Still, frustration persists over the fentanyl epidemic, which has killed thousands even as overall violence wanes. The tension between those calling for stronger enforcement and those warning against federal overreach highlights San Francisco’s political and cultural divide…
Baud
I don’t think Trump wrote this.
Shalimar
Hospitals are supposed to have more empty beds than full ones. Being at capacity all the time is bad, and Covid showed us that Trump can fix the utilization rate problem very quickly.
Baud
I don’t mean to pick on this poster, who I assume is asking in good faith what can be done, but elections have consequences.
I feel too many people on our side believe they have some magic power that they can invoke that makes electing Republicans less consequential than it is.
Maybe that comes from decades of propaganda about how both sides are the same.
Many good people are doing what can be done, but in the end, it’s for the Republicans to decide because they are in power.
AM in NC
I don’t know what would get through to rural MAGOP voters, but – “REPUBLICANS are closing your hospitals, taking your health insurance, killing your farm jobs, stripping funding from your schools, so there will be NO jobs for you where you live. They want to force you to move to the cities (just like in China) because they believe rural life is too expensive for our nation to support” might eventually get through to some who are seeing the devastation around them AND are terrified of the “scary, dangerous hellscapes” that are American cities.
Use their fears, judo-style, to turn them against the GOP. And repeat, repeat, repeat, repeat this message, especially on media that reaches rural voters.
mappy!
Organized crime masquerading as a political party, led by the head of a crime family, supported by grifter wannabes. $50B up for grabs here, 1T there…
Suzanne
To note: population is centralizing — urbanizing — at a rapid rate, in this country and all over the entire world. It is, to a large extent, unavoidable at this point. The modern economy simply does not require large percentages of the population in agriculture and resource extraction.
But it doesn’t have to be done via literal withdrawal of medical care.
Suzanne
@AM in NC: I don’t think that’s the fear. My MIL would rather die than give up her rural lifestyle, and if that means a day of travel to MD Anderson or somewhere, she would do that. She’s a loyal Dem, though. She is a smart lady who knows the score.
What tears her up the most is that her kids don’t want — and in fact, cannot have — her lifestyle. It literally isn’t sustainable and she gets to see her grandkids once a year. Again, to an extent, it’s unavoidable economically. But killing primary and emergency care in rural areas is an exceptionally cruel way to do this.
prostratedragon
Pretty sure it’s more about managing people than rationalizing the health care system. As noted above, the destruction of the CDC is a big tell.
p.a
These “Real Murcans” have been subsidized since the Progressive Movement but especially since the New Deal. Everything. Roads, power, communications, (even in today’s cellular wonderland) medical. This could be a real learning moment. I kid.🙄
Everything below a certain population density is a money loser for providers. (And until now, conservaturds have done a good job keeping those rules in place & funds flowing WHILE KEEPING THEIR CONSTITUENTS IGNORANT ABT HOW THINGS WORK.)
prostratedragon
Clearances Redux.
Suzanne
@p.a:
This is true, and it’s gotten more true as healthcare as advanced. Takes a lot of people to pay for a 3T MRI or a linear accelerator.
But, you know….. we can make the choice, as tax paying citizens, to keep those hospitals afloat. Healthcare, education, public transportation….. these are, quite literally, what I pay my taxes for.
narya
@Baud: exactly: it’s their policy and platform and actions. So people not liking what they’re doing threatens them—the Rs want us to LIKE what they’re doing.
Baud
@Suzanne:
We make that choice. Rural voters don’t.
When Dems had the white vote, they at least practiced white socialism. Not so much with the current Republican party.
Baud
@narya:
Yes. They want our approval and respect. That’s why you see so much propaganda chiding us when we don’t treat them as reasonable.
ETA: See Trump’s obsession with the Peace Prize. It’s a symbol of respect.
Suzanne
@Baud: Let’s be clear: they don’t want our respect. Respect is a dynamic among equals.
They want our esteem.
Gvg
I think for a lot of them it’s not eugenics. That would mean too much thought, and comprehension.
Trump and a lot of people are doing it out of business habit. They really are cutting waste. They don’t even see it as impacting people, even when the people are themselves. That’s why the rural voters are also not getting for so long that they are the wasteful spending that they are voting to eliminate. Treating people as things. Run government like a business. Think in slogans. Think a huge national economy runs like a bigger family budget because how else can most people understand issue except by relating it to their own life experience?
Government is not a business. It’s the air businesses breathe in. It’s the air we all need to breathe in. It can be stability, safety, a good climate that allows you to be free and build a business or retirement, or it can be mean, unpredictable, expensive, unreliable and impossible to grow your business. That is also why you don’t want them having an opinion on your religion.
People need to re examine what some words mean and especially certain dogma phrases. They should have been warned when rural roads started getting removed because it was too expensive to repave them. pre FDR a lot of America didn’t have electricity or safe water, or roads. Without those roads, the farm produce doesn’t get to market, and that includes for even Big Ag. I wonder if Big Ag knows how much it needs the same things as the small farmers. They still have to have employees, with families. They aren’t immune. Their profits are going down too.
Baud
@Suzanne:
I’d say they want us to respect them the way children are supposed to respect their parents. But I’m ok with esteem too.
prostratedragon
Coast Guard and AK National Guard are on it.
MagdaInBlack
@narya: @Suzanne: At this point, it is not a want from them. They are demanding it
@Baud: Authoritarian parents who beat their children into submission and call that submission “respect.”
Another Scott
@Gvg: +1
They aren’t destroying rural hospitals because they want people to move to cities. They mostly hate cities.
They are destroying rural hospitals because they want to shrink government so they can 1) pay lower taxes, 2) have more economic power, 3) have more political power, and 4) punch down on people and institutions they don’t like.
If they cared about efficiency, they would be all in on telemedicine and advanced (and affordable) medications, reducing stress, etc. What’s best for the population doesn’t enter into their thinking. At all.
Grr …
Thanks.
Best wishes,
Scott.
narya
@Baud: well, and, Obama got the Peace Prize. The same Obama who mocked him and how DARE he. Soooo tired of all this fragility, not least because of the harm the Fragile Ones inflict.
Gloria DryGarden
@prostratedragon: good. Thank goddess!
Gloria DryGarden
@MagdaInBlack: “ authoritarian parents who beat their children into submission and call it respect”
bingo. You have hit the nail on the head; it’s so accurate it takes my breath away.
also, and beat their wives into submission… insist on women’s submission to their husbands.
the demand for respect has seemed to come with increasing coercion, persecution, offers to prosecute. (Edited to put it in past tense, so as not to affirm it and create more of it)
Gloria DryGarden
@Baud: are we children, then? Or chattel? Sheep? Cannon fodder? Units of labor? Disposable Property? Assets?
All this time I thought we were human beings with inherent value..
Baud
@Gloria DryGarden:
That’s cuz you’re woke.
Gloria DryGarden
@Baud: wake up, little Suzy, wake up. Wake up all you assholes, wake up… (screaming it)
referencing again that sign I saw yesterday, make america compassionate (again). Just not sure about the again part.
Meanwhile, it’s nice to get such a compliment.
Geo Wilcox
It’s starting here already…
motherjones.com/politics/2025/09/the-forgotten-history-of-disabled-children-under-nazism/
Sister Machine Gun of Quiet Harmony
Maybe I need to go into the bootstrap selling business across rural America. /s
In all seriousness, they voted for this. We can’t protect them from their choices, but pointing it out to them over and over again may make it eventually sink in.
The Other Bob
When Democrats take action to save rural hospitals, like the ACA, the Republicans who represent these areas claim ACA is harming rural hospitals and the rural areas elect more Republicans and form the Tea Party.
If rural hospitals are important, let the Republicans save them.
Paul in KY
@AM in NC: Sounds good. How about though: “REPUBLICANS are closing your hospitals, stealing your healthcare, killing your farm jobs, stealing from your schools, so there will be NO rural jobs for YOU!!. They want to force YOU to move to the city (just like in China) cause they think rural life costs them money!!”
Not a lot pithier, I must confess. Both 100% true though!
Paul in KY
@Suzanne: They really want our envy. Envy that we’re not them and so forth.
Paul in KY
@MagdaInBlack: The beatings will continue until morale improves…
Steve in the ATL
@Gvg:
This cannot be said enough.
different-church-lady
It’s all in 1984: the visceral thrill of boot stomping on human face, forever!
Steve Paradis
@Baud:
This is where I look up the example counties and find that they went 60-70% Trump in the last election.
But why look up what I already know?
TXG1112
Rural areas are expensive to maintain and don’t support Democrats in any case, so it’s much better for Trump to take the blame for Americas “Great Leap Forwards” and making rural parts of the country unlivable. In my most dark and cynical moments I sometimes think that making all these yahoos move to more urban areas might be the only way to get Americans to believe in society again.
WTFGhost
Low utilization makes for low margins – often negative margins! – as overhead eats up any “profit” you’ve priced into your utilization price. Small rural hospitals won’t have nearly-full utilization except during Covid-19 and such, and that’s how it’s supposed to be! So Trump is saying “only suckers and losers would run a hospital in rural areas; they should be thanking me for helping them dump a worthless investment!”
TONYG
These rural voters literally value their “whiteness” higher than the value of the lives of their families. What can be done about these people?
TONYG
@WTFGhost: The fact of the matter is that services in low-population areas (that is, rural areas) will inevitably lose money, and must be subsidized by affluent urban areas. Rural voters are too fucking stupid to understand this, so they continue to vote for politicians who try to destroy them.
Gvg
this is a dead thread but rural voters have been lied to for so many generations that they mostly cannot know they are wrong about facts. They aren’t even choosing whiteness, they really do not know they are subsidized in everything from roads, hospitals, electricity, crop insurance and lots of other things. I don’t think most of the politicians from there know better either. Around 2000 I realized the republicans being elected to Congress believed the nonsense that the prior generation sold to gain power (Gingrich). Nobody gets elected without flattering the voters some. But voters should know to have an attitude of shopper beware.