COVID-19 vaccine: Get the latest updates on children’s doses, booster shots and more. Learn More

COMMENTARY: Healthcare’s Double Whammy

Tim Size
Executive Director, RWHC

(The Rural Wisconsin Health Cooperative is owned and operated by 44 rural acute, general medical-surgical hospitals, including Tomah Health.)

It is no secret that all of Wisconsin, rural and urban and across multiple sectors is facing substantial workforce shortages. But spoiler alert, our ability to access timely healthcare is facing a future that will dwarf today’s current challenges.

We have known for decades that the retirements of the very large baby boomer generation born following the end of World War II, along with the major increase in demand for health care that aging creates, means that healthcare workforce shortages will get much worse before they get better.

The Wisconsin Department of Workforce Development projects a 12% gap in Registered Nurses (RNs) by 2025, a 17% gap by 2030 and a 27% gap by 2035. The Wisconsin Council on Medical Education and Workforce in a separate study says the same thing and across most categories of healthcare workers–it’s not just nurses and doctors–professionals from medical lab workers to paramedics are and will be in increasingly short supply.

The American Hospital Association has called the workforce shortage hospitals are already experiencing a “national emergency.” To prevent the worst of this expanding crisis, we need a healthcare workforce recovery similar in scale to the Marshall Plan after War World II when the United States provided massive assistance to restore the economic infrastructure of postwar Europe.

Major targeted State and Federal investments are needed yesterday to expand student interest in the healthcare professions and to expand educational opportunities to match the rapidly growing need for care within all of our communities.

The shortages have consequences for all of us–from a recent issue of U.S. News & World Report: “Staffing shortages are now the nation’s top patient safety concern, forcing Americans to endure longer wait times when seeking care ‘even in life-threatening emergencies,’ or to be turned away entirely.”

The second gut punch impacting the stability of our healthcare system, rural and urban alike, as reported by the Wisconsin Hospital Association and many others: “hospitals and other care providers are facing significant cost pressures which are leading to less resources for patient care and community services. Since 2019, annual operating costs for staff and supplies have increased $2 billion in Wisconsin hospitals while reimbursement from Medicaid, Medicare and commercial insurance companies has not come close to keeping pace with costs, resulting in double-digit budget deficits for Wisconsin hospitals.”

Scott Becker, publisher of Becker’s Healthcare recently shared this observation, “When I see health insurers report another great quarter of profits and at the same time even large health systems report billion dollar plus losses, I’m reminded of the old adage–‘The house always wins.’ ” As noted in a previous Eye on Health commentary, here are just a few of the health insurer behaviors ramped up under the flag of “not our business to worry about rural healthcare”:

-A “just say no culture” for medically necessary patient care
-Requiring patients to leave town for services available locally
-Retroactive denial of claims for needed emergency room care
-Refusing to sign-up new physicians recruited to replace those retiring

Beyond our critical primary role of providing local access to quality health care, the 44 local rural health systems that are the Rural Wisconsin Health Cooperative (RWHC) are a major driver of Wisconsin’s rural economy. If rural Wisconsin didn’t have these local healthcare systems, what would be the impact on our rural economy? Using a formula developed by the University of Wisconsin Extension and data from the Wisconsin Hospital Association, we estimate that RWHC hospitals create nearly 30,000 jobs–17,000 hospital jobs and more than another 12,000 community jobs with over $4.3 billion in income for our rural communities.

Bottom line: We all have a lot to lose if we don’t successfully address the very real threats to our ability to receive local healthcare. We need political leaders of all stripes to come together and address the unprecedented threats to the very foundations of the core healthcare services we and our communities need and depend upon.

Tomah Health