Political observers such as yours truly can rattle off a list of public policy items – hot-button issues that really fire people up: crime; inflation; gun control; abortion; LGBTQ rights. But few issues motivate people in Connecticut more than the potential loss of healthcare services.
That’s because it’s an intensely personal matter. After all, healthcare is one of the few areas of our lives whose privacy is guarded by a federal law, HIPAA, which protects sensitive patient health information from being disclosed without the patient’s consent or knowledge.
So when a move is made to take away healthcare services, we take it personally. That explains the strong reaction from men and women alike to the so-called Dobbs decision, the landmark Supreme Court ruling that removed the constitutional right to an abortion.
Another new battle has opened up on the healthcare front – one that strikes at the core of our quality of life in rural Connecticut. According to the American Hospital Association, 136 rural hospitals closed in the U.S. between 2010 and 2021, with a record 19 closures in 2020 alone. Despite our state’s reputation as a collection of wealthy suburbs and poor cities, the Connecticut Housing Finance Authority reports that of the state’s 169 municipalities, some 93 towns, or 55%, qualify as rural.
There’s a whole host of reasons for the hospital failures but the AHA principally cites the effects of the COVID-19 pandemic, “low reimbursement, staffing shortages, low patient volume and regulatory barriers.” And there are a number of causes for diminished patient volume. Off the top of my head, I can think of a few from personal experience.
There are so many more reasons not to go to hospitals than there were even 20 years ago. I’ve had two colonoscopies in my 65 years. My first was done at Sharon Hospital. The most recent, two years ago, was performed efficiently at an outpatient endoscopy center in Torrington.
Two years before that I had hand surgery at a same-day surgical center. If I suspect I have pneumonia or bronchitis on the weekend, I usually go to one of those urgent care centers, dozens of which have sprung up seemingly everywhere in Connecticut, for a quick X-ray.
Both of those outpatient examples really cut into the bottom line for hospitals because surgical units and emergency department care are important sources of revenue. Meanwhile, hospitals still have to maintain maternity wards and intensive care units, which are typically less profitable but still labor-intensive. That’s where a demonstration Sunday in the Northwest Corner comes in.
By my estimation, roughly 300 people attended a rally on the town green to “Save Sharon Hospital.” Its parent, a regional nonprofit medical chain called Nuvance Health, is seeking state approval to close the hospital’s maternity ward, now known in healthcare parlance as a “birthing center,” and downgrade its intensive-care and surgical units. These cuts are sought despite a five-year agreement Nuvance signed in 2019 with the state Office of Health Strategy to keep several services, including the birthing center and ICU, operating.
Area residents are understandably concerned about these potential closures, which in some cases will necessitate much-increased travel times during periods of great personal stress. As you might expect, the rally attracted numerous elected officials, many of whom are running for office.
Beyond the citizen activism on a beautiful Sunday fall afternoon, the most encouraging aspect of the event was the bipartisan nature of the attendees. I recognized scores of Democratic and Republican officials, including several from the state of New York, whose nearby residents comprise about 70% of the patients and employees at Sharon Hospital. A couple of beloved physicians affiliated with the 78-bed hospital also spoke against Nuvance’s proposal.
Sen. Richard Blumenthal and Rep. Jahana Hayes, both Democrats in re-election battles, promised to fight to save the hospital, prompting cheers of approval. Blumenthal, he reminded us, is no stranger to the area and the cause. As state attorney general, he was involved in the battle challenging the sale of the nonprofit independent Sharon Hospital to investor-owned Essent Healthcare in 2000.
Three of the region’s members of the General Assembly were also present, including Democratic Rep. Maria Horn of Salisbury and Republican Steven Harding of Brookfield. Both spoke passionately about preserving the hospital, which first opened in 1909. Harding is also running for state Senate against Democrat Eva Bermudez Zimmerman, while Horn has only token opposition. Two elected officials arrived from across the border, including Dutchess County Legislature Chairman Gregg Pulver, a Republican who assured Nutmeggers that New York is on their side.
As my colleague Hugh McQuaid reported yesterday, Nuvance’s “request mirrors similar efforts to shut down smaller maternity facilities by Hartford HealthCare at Windham Hospital and Trinity Health of New England at Johnson Memorial Hospital in Stafford.” So hospital downsizing is happening in both our front and back yards.
In addition, there has been considerable consolidation in the industry. To wit, recent acquisitions by Nuvance, Hartford Healthcare and Yale New Haven mean that those three organizations will account for nearly 70% of the state’s hospital infrastructure, leading to fears that even higher costs are inevitable for lack of competition, and that more services will be cut in the name of stamping out duplication.
Finally, a new report from the March of Dimes found that loss of maternity care is reaching the critical stages, with 36% of U.S. counties constituting “maternity care deserts,” meaning they have no obstetric hospitals or birth centers and no obstetric providers. A similar phenomenon has affected pediatric care, in part because, as the New York Times put it, “Adult beds are more lucrative than children’s beds.”
As a resident of the state’s Northwest Corner, I share the concerns of my neighbors that a reduction in services or the closure of Sharon Hospital would be a disaster. But I also fear that if the state forces Nuvance to continue to operate money-losing services as a condition of its license, the company might very well turn the hospital into an outpatient center or just shut it down altogether. Then there would be no 24-hour emergency department either. And where would we be then?
A hearing on the matter before OHS slated for yesterday was postponed without explanation. There has been no word on when it will be rescheduled. Officials from Nuvance and OHS should brace themselves. There will be a lot of angry people there from both sides of the border – and both sides of the aisle.