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Wanted: Hospitals that Fully Serve Their Communities

On March 28th, with just 3 days notice, the hospital in North Adams, Ma. closed, leaving residents with no immediate access to health care.

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What happens to a poor, working class rural community when its hospital closes  –  with three days notice?  That’s what residents of North Adams, Massachusetts and surrounding towns have been trying to figure out since the North Adams Regional Hospital closed its doors on March 28th.   While local and state politicians scurried to at least keep the emergency room open, members of the two hospital unions, a local labor coalition and other residents temporarily occupied the hospital.

The politicians have so far been unable to even keep the emergency room open, a facility that saw about 20,000 visits just last year.  Now residents face a 45 minute drive to Pittsfield’s hospital, a drive even longer in wintry weather, and even further for rural residents who live in southern Vermont and up on Florida Mountain.  One of the leaders of the sit-in was Michael D. Wilber who, 30 years earlier, as union president, led a struggle to force X-Tyal Corporation to pay its workers after the company skipped town without any notice.  It was no consolation to Wilber, or anyone else, that the hospital gave three days notice.

The closing means the loss of 530 full-and part-time jobs at the hospital, including the local hospice and Visiting Nurse Association.  Economist Stephen Sheppard estimates that the closing will result in another 230 jobs being indirectly lost with a total decline in the area’s economy of more than $96 million.  In the near run, state officials are working to establish a satellite clinic in North Adams run by the Pittsfield hospital.  That hasn’t happened yet and even when it does, the full array of services will not return nor will anywhere near the number of health-related jobs.

NARH’s ceo and board have provided little detail on the precipitous closing other than to say the hospital is broke.  The attorney general, Martha Coakley, a native of North Adams and a candidate for the Democratic nomination for governor, has promised to investigate.  State Treasurer Steve Grossman, also a candidate for the Democratic gubernatorial nomination, came to a North Adams prayer service two days after the closing and said the state has a “moral responsibility” to keep health services going.

But that moral responsibility hasn’t led to any state dollars flowing to the hospital.  Ironically, less than four weeks before the closing, the state House of Representatives voted to support a grant of more than $25 million to the Massachusetts Museum of Contemporary Art  for renovation and expansion.  The museum is located in North Adams, on the site where in 1986, the city’s biggest employer, Sprague Electric Company, closed its gates.  The museum, known as MASS MoCA,  earlier received a multi-million dollar grant from the state to get started, and was billed as an engine of economic development for the area.   Its promise of directly and indirectly creating some 600 full-time jobs has not even been half fulfilled, and the goal of bringing about a vibrant Main St. economy remains an empty hope.

The community needs both art and health care, but right now the latter is suffering.  The need for health care and a functioning hospital is strong, but the “supply” of health care dollars has dried up.  Sending millions of tax-payer dollars to the museum to indirectly save the community is an example of “supply side” economics, a policy that has never worked.  The money hasn’t “trickled down” to provide good jobs and a vibrant economy in the North Berkshires.

North Adams is not the only community to see its hospital close.  About a third of U.S. hospital emergency rooms have been shuttered over the past two decades and 18 hospitals in the U.S. shut their doors just this past year.  The closings have disproportionately hit poorer communities, where patients rely on Medicare and Medicaid with low hospital reimbursement rates.

To say that our health care system is broken is an understatement.  Until the medical needs of all Americans, poor and working class as well as middle class and rich, are fully met, that system is a failure.  In 2010, I interviewed Julie Pinkham, Executive Director of the Massachusetts Nurses Association, about the North Adams hospital for a documentary film I wrote and directed, “Farewell to Factory Towns?” (DVDs available from Class Action) .   Pinkham had the following to say, in a way presaging the future events:  “You know they always talk about community hospitals.  It’s a great p.r. strategy for the most of the health care environment.  They talk about their community hospital, but health care in general has moved to a business model and it may not be that the management of the hospital is the community hospital anymore, but [for] the people who work in the hospital, it is the community hospital.”

 It was heartening to see so many North Adams residents rise up and protest the hospital closing, but it will probably take a very strong state-wide movement, and more likely a national one, to bring health care justice to the northern Berkshires and the rest of the country.  Only then will be able to see full-service hospitals that indeed serve the community.