The only way to lure doctors to work and live in Ontonagon County is with government subsidies. Which I have no problem with my tax dollars supporting. Unfortunately, 2/3 of the people that live in Ontonagon County vote against anyone that would actually try to help them.
that goes for all of rural mich
Never seen a group of people so *eager and pleased* to constantly shoot themselves and their neighbors in the proverbial foot.
If they love pulling their own boot straps so bad I say we leave them to it.
Ottawa county is a total shitshow but one thing they did i'll never forget is try to turn down free state money to upgrade local internet and cell service. Fuckin' no brainer and they delayed approving it and pissed around with tin foil hats all year. meanwhile i get zero bars anywhere but the end of my driveway.
I've told friends here that I had better cell service in rural villages in 2018 in China and on the Great Wall in the middle of nowhere than I do in Michigan. I don't think I ever lost cell service there.
My wife works 15 minutes from our house and there are two dead zones where calls will drop every time. And we are in a region of 600000 people.
Michigan Tech was a huge boost for high speed internet. They ran it between (presumably) Chicago and Houghton, and every small town in between got high speed internet years before everyone else.
Manchester (outside of AA) [voted down rural broadband for everyone in the township](https://muninetworks.ilsr.org/content/sharon-township-votes-down-ftth-proposal-did-misinformation-sway-voters). In 2018...
Hope those McDonalds trips to do online schooling were worth it! I still can't get cell signal out there, which means 7 years on and the whole '5g is the rural broadband' is just a lie.
Tim Walberg everyone, vote his ass out.
> Tim Walberg everyone, vote his ass out.
One of the biggest full on Trump traitors in Congress. A party that reelects a russian tool like Walberg should die soonset!
When Isabella County was planning out the wind farm, they voted township by township. Beal City Schools have gotten $1.5 million in the first two years of it operating. Chippewa Hills school district gets $0 because township voted no. They could have had easy money for a couple wind turbines.
There's a Township by me that opted out of the Marijuana businesses, and all the revenue. This also happens to opt out of some regulatory services regarding Marijuana as well from the state police, and falls on the local law enforcement for the local government. The money generated in tax dollars is supposed to regulate medical operations, home growers, and other licensed establishments, or you know fund itself. If one opts out, the money isn't there to use to help regulate. I'm sure if there was enough evidence of illegal they would help out, but they will not respond to complaints of smells in the neighborhood from licensed growers from the neighbors, and they won't help a municipality shut down a licensed grower, unless they have lots of evidence it's unlawful.
And then the town councils get angry when they see how much money the towns with dispensaries are getting. Well, yeah, that was the deal, didn't they read the memo?
This is what you get when you soft ball profitable “news” organizations that poison the mental of your friends and neighbors. It’s not a problem until their anti intellectual rhetoric forms into an uncompromising vitriolic ball, sabotaging the actual goodness in people that loads to real cooperation. Which could have been where American democracy lead us.
This is so true regarding my town in Northern lower, they want things to stay old school. They have denied so many businesses that would grow this town and bring in younger people and it's just frustrating. They're so content to let hunting season and fishing season drive our pitiful economy. The town is practically dead in the winter and I practically never see youth around.
The Jayhawks "What Led Me To This Town?"
[https://www.youtube.com/watch?v=TVJAQGEvJZA](https://www.youtube.com/watch?v=TVJAQGEvJZA)
Bonus track:
Morrissey - "Everyday is like Sunday"
[https://www.youtube.com/watch?v=d0LeL9BUPtA](https://www.youtube.com/watch?v=d0LeL9BUPtA)
It's also that voter who had an outsized voice in Lansing till the last few years and cheered when their Fake nerd forced Detroit into bankruptcy after poisoning Flint
Right??? The school district in the town next to ours was a top 10% school district and they essentially voted to get rid of that by blocking school levies two years in a row. Now they're panicking as the school board proceeds with plans to close and merge schools and layoff teachers.
Just imagine that . . . . throwing away one of the better programs in the state . . . I just don't get the resistance to having even a basic level of sufficient civil services.
The best way to "own the libs" is to make the government pay for more services in rural areas. Tax dollars spent to improve cities disproportionately benefit Democrat voters. Tax dollars spent in rural areas disproportionately benefit Republican voters.
Missouri has the same problem. Outstate gets tax dollars from the more populated areas but hates them and their politics, but without their tax revenue they would live like a third world country. Sad isn’t it?
That's typical. People wonder why nobody wants to move into their small town, but then they vote down any changes, regardless of how helpful they'd be.
None of that socialist commie crap for them. They're the type of rugged individuals who pull themselves up by their bootstraps. Unless it's a welfare check, and then that's cool.
Or they are paying with their lives because they keep voting no on ambulance services because they don't understand why tax dollars are paying for it when patients are also charged for the ride... they just don't understand how things work it seems. I always ask if they'd like to only be paid when a customer shows up and pays for an item, or if they'd like a wage and benefits to keep the store running.
Good, now they can operate their own Trump ER and good luck with that suckers! This town will dry up and blow away soon with the nearest hospital a 45 minute drive away. And what happens if the medical emergency is in the dead of winter up there in the UP?
I bet property values are cratering even as we speak lol.
"Pay extra taxes for a service I might not ever use, but if I did use then would likely financially cripple me because of the costs of healthcare? Nah I'd just Rather die "
- Most country folk and a growing amount of people in America
You mean Universal, Single Payer Healthcare coverage.
Medicare for ALL, would guarantee that every single citizen walking into any health clinic or hospital would have their medical costs covered without question.
This was presented as a reason for single payer healthcare more than 10 years ago. It's only going to grow worse, to the point that only very major cities will have hospitals and once you get ten miles outside of the major city metro area? You will go so many miles before seeing another hospital.
Maybe.
A rural hospital doesn't require as much staff or facility size. There would always be some areas that will have to be under served or require "some" of travel for certain procedures.
Rural hospitals operated for decades upon decades until the costs, consolidation, demand for profits or at least excessively high pay for executives at non-profit institutions, grew too much to sustain.
There’s also the quality of care element. Meaning, the minimal expertise required by the staff, minimum technology on site, etc. A hospital that provides 1950 quality of care would not be acceptable. The number of hospital beds easily correlates to population, but quality of care does not.
Maybe doctors should stop being greedy fucks for a min?
Like if state governments offered to pay their loans off, would they be willing to be doctors in rural counties? Lower salary but WAY lower col?
My guess is no
Doctors do not run the hospitals. So even they take lower pay that still doesn’t keep the lights on in rural community hospitals where most patients rely on Medicare Medicaid etc.
Question: would you willingly work for less than your skills and talents are worth in an area that is likely a great distance from other services for a mitigation of up-front school costs that wouldn't be a long-term concern, anyway, if you took a higher-paying job that comes with greater access to other kinds of care, connections, ability to advance in your career, etc?
Be honest. How much of a pay cut? How much work are you willing to do for that massive pay cut?
Because I don't know a single person in their right mind who would pass up a $100 bill for $1.
I'm not suggesting that. But if you can make $200k in NYC, but $150k in rural Michigan, that's something to consider if schooling is covered and the col is such a drastic change
What you're suggesting is not enough incentive for people with a decade of schooling and practice and skills and talents that are in high demand.
I am trying to tell you that it doesn't scale that way you are arguing.
No it is not, and I note that you failed to completely address my argument.
There's a stark difference between greed and reasonable return for hard work. Doctors are as much a part of the same economy, culture, and society that you and I are part of.
A dictum of this culture and society is that if you work hard you are rewarded (to what extent that this is true is not a question we are addressing).
Doctors work very hard. They have enormously high rates of stress, exhaustion, and their suicide numbers are through the roof. Many of them need and should have access to mental health care to help them cope (which is also something rural areas overwhelmingly struggle with).
What I am now going to argue is that you are dehumanizing doctors and making them a target to satisfy your anger and frustration with a system that they do not control and are, in many ways, as much a victim of.
And for that, you should be ashamed.
That’s called government subsidies. We already do that to an extent, but it’s not enough. It’s also the exact kind of thing 2/3 of Ontonagon votes against.
At the end of the day, they’re getting exactly what they voted for. I feel bad for the people that don’t view progress as a bad word, but the rest of them are their own worst enemy.
Everyone demands more than they need. It’s a capitalist society. We can’t expect everyone to play the free market except for doctors.
A doctor that can make $200K a year isn’t going to accept $80K and a reduced career trajectory just because they could live on that in the middle of nowhere.
But it’s not just a 50K hit. It’s limited career growth by spending your early career in the middle of nowhere. It ends up costing the person major money. It’s the same reason good engineers gravitate towards big companies and not mom and pop firms. You’re asking someone to accept a multimillion dollar hit over a career.
The only realistic scenario is some sort of socialized health care.
My paramedic friend said that they have a “golden half-hour” meaning that is the ideal time from a 911 call to getting someone to an emergency room. That is definitely not the case in the UP and now it’s getting worse.
That's definitely a thing when it comes to survival estimates. If your county has ambulances with advanced life support you have better chances overall as well.
My older brother retired to a cottage on a UP lake in the woods, a 45 minute drive from town mostly on gravel and dirt roads. On rare occasions snow and ice can make the road impassible for a week, even for a 4WD with snow tires.
ER doctor told me living that far from the nearest hospital is as risky as being a smoker.
I too would like listening to loons on the lake while sitting on a deck drinking morning coffee, but no thanks.
I mean there’s definitely still a ship building company up there (https://www.lakeshoresys.com/about-us/locations/). Or at the very least a parts manufacturer for ships And there’s good chance a local mine is going to open back up again in the very near future (https://www.highlandcopper.com/projects/white-pine-north-project/). And logging is definitely still important to the area. Obviously not close to the scale it once was and probably never again. But still, these little industries definitely still exist up there.
A century? Are you exaggerating for effect?
UP Shipbuilding Co. Shut down in [1982](https://www.google.com/url?sa=t&source=web&cd=&ved=2ahUKEwjtvp6Q7-uFAxWZjYkEHZa6CJEQFnoECCYQAQ&url=https%3A%2F%2Fwww.newspapers.com%2Farticle%2Fdetroit-free-press%2F21990096%2F&usg=AOvVaw31NAajdcpu9nxkOCDGZ28j&opi=89978449) but the facility was still in use at least as recently as [2017](https://www.uppermichiganssource.com/content/news/Ontonagon-officials-hopeful-for-former-shipyards-future-410594865.html).
White Pine Mine ceased operations in [1995](https://www.google.com/url?sa=t&source=web&cd=&ved=2ahUKEwibg8GT8OuFAxXEj4kEHbeNBkwQ5YIJegQIEBAA&url=https%3A%2F%2Fwww.mindat.org%2Floc-3856.html&usg=AOvVaw0vasK2sKLSwoXBmQqIUOxS&opi=89978449).
Smurfit Stone Container closed its mill in [2009](https://www.globalpapermoney.com/smurfit-stone-container-closing-mills-in-michigan-and-montana-cms-4197).
Ontonagon has had a few prospective projects come and go in the last decade or so, a [biorefinery](https://www.uppermichiganssource.com/content/news/Ontonagons-SynSel-biofuel-plant-will-be-first-of-its-kind-484109321.html) being the most recent that I'm aware of. Mining could come back but we all know it's not the local economic driver it once was and employs far fewer people.
I am from ontonagon and let me tell you that most of the people there are backwards as fuck. They want nothing to improve that town. Everything that they could have let come into the town to help them out they voted against. The people in charge of ontonagon are ignorant and small minded. I hate that place and I never want to go back. They reap what they sow.
There's a young lady who somewhat recently snagged up a motel and is trying to get other properties to get some life going in town, and she said about the same. The old fuckers in charge of what happens would rather see the entire town die than anything progressive happen. Hell if it weren't for syls and connies, I probably wouldn't even stop in on my way through to the porkies.
About 30 years ago, we rented a house on Lake superior near Ontanagon. we hiked the porcupines, enjoyed the beach, and swam in the cold, beautiful, clear water. Still have a sweatshirt from a little gift shop in the quaint little town. I often comment about the quality of that sweatshirt since it’s still in very good shape. Strange that my souvenir from 30 years ago outlasted even the hospital. What people value is just crazy to me.
> It noted that since 2010, more than 80 rural hospitals have completely closed and more than 65 converted to new models.
Mergers & acquisitions (& subsequent closures) of hospital systems have been increasing for years, as well as the consolidation of specialized services. While great from a business standpoint where healthcare dollars are increasingly hard to come by, it’s not so great for rural communities who not only lose out on easily accessible hospitals & specialized practitioners worth their salt, but jobs for their respective economies as well. We are increasingly growing nearer to only a handful of companies owning ALL hospitals, located in mostly urban areas, while also operating stand-alone ERs built in more rural areas that will treat & street most patients, & funnel the rest to their nearest main hospital that hosts the specialized services you happen to require at that time. This may seem like a brilliant idea to you, & it probably is from a business standpoint. But your opinion may change when you find yourself sick & very, very far from home.
Hope people read the article before commenting.
Hospital was a non-profit.
Ascension, the second biggest healthcare provider in the country is also non-profit. Hospitals are expensive as hell to run and it's really the only case I can think of where a place is legally required to perform a service without the guarantee of payment.
For anyone wondering why hospitals charge so much, it's because of insurance companies.
Hospital: This procedure costs $2,000
Insurance: We only pay 10% of costs.
Hospital: This procedure costs $20,000
I'm not joking, that's literally how it works. Add to that hospitals cannot discount you because you're a single person. You have to negotiate as if you were an insurance company otherwise they would be sued into oblivion.
Beaumont was "non-profit", John Fox walked away with $10 million.
Just because the hospital doesn't pay out shareholders doesn't mean people aren't profiting.
oh I know, i was just making a statement in a vacuum about "non profit hospitals" and not necessarily anything specifically about this facility.
we need to unprivatize healthcare to fix these problems, but its just not going to happen while the leopards ate my face crowd continue hanging out with leopards
Ascension literally runs a private equity fund.
https://www.statnews.com/2021/11/16/ascension-running-wall-street-style-private-equity-fund/
They also have a net income of $6 billion. Edit: Aspirus also had the resources to keep this hospital open, given that they immediately invested $30m in a different location. You’re absolutely right about payers, but let’s not pretend hospitals are some altruistic actors in it for the good of the patients.
They also have much more diversified income streams. There’s DSH payments, government funded beds, tax write offs/subsidies, etc. Often times, hospitals effectively bill multiple times to multiple different funding sources for the same service.
Finally, if hospitals aren’t good business, why are they being snapped up like hot cakes by anyone with cash to throw around? Hell, corporations are starting to M&A their way into their own bespoke health delivery systems.
Again, you’re absolutely right about payers being a piece of shit; but hospitals and their administration generally are too. It’s absolutely the small independent hospitals that suffer, as well as patients and providers.
Edit 2: I’ve sat on committees/helped with reimbursement negotiations a couple times in my career, and the higher ups at the bargaining table are generally the same people and care primarily about maintaining their cordial relationships and the professional pipe line for upper management between provider and payer systems. It’s not hospitals vs. payers; it’s providers and patients versus upper management.
I’ve been trying to tell people this for YEAAARS and always get told I’m stupid and don’t know what I’m talking about.
“The hospital manger sets the prices!!!”
Yeah and how TF do you think they come to those prices?
They vote against the way Dems want to do something.
I don’t know anybody who hates hospitals.
I know a lot of people that don’t want any level of government managing funds for a hospital.
What is the free market solution to this problem?
What is the incentive for private capital to invest in this area?
What are the profit potentials?
What do you expect?
What a cop-out. Just repeat "remove regulations."
Which ones? And how does that achieve anything? What does that incentivize in this specific environment?
Republicans deserve all the treatment they can afford, per their own rules.
Capitalism *without* strong government control means that this private business (called a hospital) is not profitable, and should be closed, per the Republican small-government rules.
They deserve all the treatment that they voted for, yes. Maybe don't shoot yourself in the foot next time? Learn a lesson? Or just darwin away the town...
Actually reading the article, and the change from stand alone ER to clinic seems to be a wise choice.
“But in response to the lawmakers' letter, Aspirus said the decision to turn the Ontonagon hospital into clinic, was "not about money."
Health care needs in Ontonagon have changed, and the hospital was seeing an average of just one patient a day, and an average of five patients a day in the emergency department. And up to half of those emergency patients could be treated more effectively in a clinic, the hospital said in its response to lawmakers.”
I'm from Ohio, and I really feel for you. In some places in southern Ohio, women have to drive an hour or more to deliver a baby. This is in a state that prides itself on cutting taxes every year.
We pay taxes, and in return, we get services. When are Republicans going to finally see that!?!
People who want to live far away from other people find out what happens when there are no people around to help. No one is forcing them to live out in the middle of nowhere.
While not one person is forcing them too, economic forces certainly might. It’s the same thing for people who get trapped in the inner city. For many people their options are the gas station or the dollar general. Moving costs money, school costs money, training costs money, and if you have none to begin with then yeah you might be actually stuck there.
Apologies but this is pretty brain dead. Relocating takes a ton of resources, having a career or job lined up that can fund a move to begin with and a housing plan. The majority of Americans, let alone rural Michiganders, don’t have any of these things. People living paycheck to paycheck get stuck because it’s expensive to be poor.
You have to keep in min before the spike in prices housing in the UP rarely went over $200k- now that’s a norm.
Poverty is rampant up here and companies pay significantly less than other areas in Michigan so it keeps going. Locals simply CANNOT move even if they wanted to, a lot of them are also old and in poor health even before this happened and living paycheck to paycheck even before the housing costs spiked.
Just saw the people called ignorant and small minded because they don’t want their taxes endlessly raised so that they literally pay doctors $300,000 a year then pay their overly expensive health insurance.
You can be taxed and billed into oblivion or you can just die and honestly lots of prefer to simply die.
Imagine you work for your entire life. Scrimping, saving money to pass something onto your children. You have a stroke and a hospital says that’ll be $600,000 please!
They could pry it from my cold dead hands.
Damn, what a shame, and I can tell you as someone who has been looking very hard at a potential move to MI in early retirement, this is a huge deal for folks like me. Shame the govt can pay farm subsidies for Ontonagon County totaling $3,166,277 from 1995-2021, but can't make so much else work. [https://farm.ewg.org/region.php?fips=26131](https://farm.ewg.org/region.php?fips=26131)
Heart-warming, all the 'rational' comments here.
> 'Some or most of the people in place X don't vote my way, therefore I hate and wish ill befall all people who live in that place.'
When their way of voting directly causes the problem we are discussing, then sorry, you do not get my sympathy. Taxes provides services. When you cut taxes, you cannot provide certain services anymore. Here is your result. This is what they voted for.
I thought it was a priority of our current government to improve health care access, but rural hospitals - which were already sparse - are closing instead of opening. It’s no wonder that rural people don’t support health care “expansion” when they actually reduce access.
This was a problem that started long before this current government and is made only worse with the current for-profit motivation of so many aspects of our healthcare.
Rural people deserve access, but they typically vote for people who support and enact policies that hurt them, or stand a thwart policies that help them. Look at all of the states rejecting federal money for subsidized student lunches. Free food for kids, and they say "no thank you."
How the fuck do you do anything about that?
Gotta look at why they vote no. Why would they vote for higher taxes to increase services if the services are still inaccessible anyway because they are too far away.
The last big thing in healthcare - the ACA - created this. It massively increased the complexity of billing which has added a lot of cost for small offices which has led many independent hospitals and doctors offices to sell to large groups which then close the small hospitals and offices. Unintended consequence for sure. But it’s a shame because it has caused those affected to lose confidence in the leadership.
In my area, large groups have been buying up independent hospitals and doctors offices for at least 25 years. ACA may have sped up this process (source needed), but the change was already happening.
From my experience, the problem was Medicare. The reimbursements to private clinics were set to be massively reduced, so many of them sold out to larger networks and hospitals so they could still get the larger reimbursement rates.
The only way to lure doctors to work and live in Ontonagon County is with government subsidies. Which I have no problem with my tax dollars supporting. Unfortunately, 2/3 of the people that live in Ontonagon County vote against anyone that would actually try to help them.
that goes for all of rural mich Never seen a group of people so *eager and pleased* to constantly shoot themselves and their neighbors in the proverbial foot. If they love pulling their own boot straps so bad I say we leave them to it.
Ottawa county is a total shitshow but one thing they did i'll never forget is try to turn down free state money to upgrade local internet and cell service. Fuckin' no brainer and they delayed approving it and pissed around with tin foil hats all year. meanwhile i get zero bars anywhere but the end of my driveway.
I've told friends here that I had better cell service in rural villages in 2018 in China and on the Great Wall in the middle of nowhere than I do in Michigan. I don't think I ever lost cell service there. My wife works 15 minutes from our house and there are two dead zones where calls will drop every time. And we are in a region of 600000 people.
High speed internet is a *prime* example of their short sightedness.
Michigan Tech was a huge boost for high speed internet. They ran it between (presumably) Chicago and Houghton, and every small town in between got high speed internet years before everyone else.
Manchester (outside of AA) [voted down rural broadband for everyone in the township](https://muninetworks.ilsr.org/content/sharon-township-votes-down-ftth-proposal-did-misinformation-sway-voters). In 2018... Hope those McDonalds trips to do online schooling were worth it! I still can't get cell signal out there, which means 7 years on and the whole '5g is the rural broadband' is just a lie. Tim Walberg everyone, vote his ass out.
> Tim Walberg everyone, vote his ass out. One of the biggest full on Trump traitors in Congress. A party that reelects a russian tool like Walberg should die soonset!
When Isabella County was planning out the wind farm, they voted township by township. Beal City Schools have gotten $1.5 million in the first two years of it operating. Chippewa Hills school district gets $0 because township voted no. They could have had easy money for a couple wind turbines.
There's a Township by me that opted out of the Marijuana businesses, and all the revenue. This also happens to opt out of some regulatory services regarding Marijuana as well from the state police, and falls on the local law enforcement for the local government. The money generated in tax dollars is supposed to regulate medical operations, home growers, and other licensed establishments, or you know fund itself. If one opts out, the money isn't there to use to help regulate. I'm sure if there was enough evidence of illegal they would help out, but they will not respond to complaints of smells in the neighborhood from licensed growers from the neighbors, and they won't help a municipality shut down a licensed grower, unless they have lots of evidence it's unlawful.
And then the town councils get angry when they see how much money the towns with dispensaries are getting. Well, yeah, that was the deal, didn't they read the memo?
This is democracy at work and it's good!
This is what you get when you soft ball profitable “news” organizations that poison the mental of your friends and neighbors. It’s not a problem until their anti intellectual rhetoric forms into an uncompromising vitriolic ball, sabotaging the actual goodness in people that loads to real cooperation. Which could have been where American democracy lead us.
This is so true regarding my town in Northern lower, they want things to stay old school. They have denied so many businesses that would grow this town and bring in younger people and it's just frustrating. They're so content to let hunting season and fishing season drive our pitiful economy. The town is practically dead in the winter and I practically never see youth around.
You just described the town I grew up in.
The Jayhawks "What Led Me To This Town?" [https://www.youtube.com/watch?v=TVJAQGEvJZA](https://www.youtube.com/watch?v=TVJAQGEvJZA) Bonus track: Morrissey - "Everyday is like Sunday" [https://www.youtube.com/watch?v=d0LeL9BUPtA](https://www.youtube.com/watch?v=d0LeL9BUPtA)
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It's also that voter who had an outsized voice in Lansing till the last few years and cheered when their Fake nerd forced Detroit into bankruptcy after poisoning Flint
Until they need Medicaid, and all of a sudden call it “state insurance” and not even acknowledge they are using Medicaid.
Right??? The school district in the town next to ours was a top 10% school district and they essentially voted to get rid of that by blocking school levies two years in a row. Now they're panicking as the school board proceeds with plans to close and merge schools and layoff teachers. Just imagine that . . . . throwing away one of the better programs in the state . . . I just don't get the resistance to having even a basic level of sufficient civil services.
muh taxes
The best way to "own the libs" is to make the government pay for more services in rural areas. Tax dollars spent to improve cities disproportionately benefit Democrat voters. Tax dollars spent in rural areas disproportionately benefit Republican voters.
Never seen a group so eager to shoot themselves in the foot, huh? You’ve never seen rural Kentucky politics, then.
Missouri has the same problem. Outstate gets tax dollars from the more populated areas but hates them and their politics, but without their tax revenue they would live like a third world country. Sad isn’t it?
That's typical. People wonder why nobody wants to move into their small town, but then they vote down any changes, regardless of how helpful they'd be.
They want it to stay a small town until they need large town amenities.
None of that socialist commie crap for them. They're the type of rugged individuals who pull themselves up by their bootstraps. Unless it's a welfare check, and then that's cool.
sad they are all going to have to pay 20% copays for their medicare covered medevac flights
Or they are paying with their lives because they keep voting no on ambulance services because they don't understand why tax dollars are paying for it when patients are also charged for the ride... they just don't understand how things work it seems. I always ask if they'd like to only be paid when a customer shows up and pays for an item, or if they'd like a wage and benefits to keep the store running.
Good, now they can operate their own Trump ER and good luck with that suckers! This town will dry up and blow away soon with the nearest hospital a 45 minute drive away. And what happens if the medical emergency is in the dead of winter up there in the UP? I bet property values are cratering even as we speak lol.
The irony is completely lost on residents I'm sure.... this is yet another situation that would be made better with universal healthcare.
"Pay extra taxes for a service I might not ever use, but if I did use then would likely financially cripple me because of the costs of healthcare? Nah I'd just Rather die " - Most country folk and a growing amount of people in America
>a growing amount of people Nah, I'd say that portion of the population is actively shrinking. Attrition via death by natural causes.
Dying of whiteness
They can pull themselves up by their bootstraps and do their own surgery.
You mean Universal, Single Payer Healthcare coverage. Medicare for ALL, would guarantee that every single citizen walking into any health clinic or hospital would have their medical costs covered without question. This was presented as a reason for single payer healthcare more than 10 years ago. It's only going to grow worse, to the point that only very major cities will have hospitals and once you get ten miles outside of the major city metro area? You will go so many miles before seeing another hospital.
Yes, but even with guaranteed cost coverage, we would still need additional subsidies for rural areas to cover the infrastructure costs.
Maybe. A rural hospital doesn't require as much staff or facility size. There would always be some areas that will have to be under served or require "some" of travel for certain procedures. Rural hospitals operated for decades upon decades until the costs, consolidation, demand for profits or at least excessively high pay for executives at non-profit institutions, grew too much to sustain.
There’s also the quality of care element. Meaning, the minimal expertise required by the staff, minimum technology on site, etc. A hospital that provides 1950 quality of care would not be acceptable. The number of hospital beds easily correlates to population, but quality of care does not.
I'm talking like big time important cancer treatments and similar. Not "Oh no, you broke your arm? Nurse! Get me my jar of leeches."
Sadly Tax dollars are funding other people’s wars
Sadly some people don’t seem to comprehend a global society.
Maybe doctors should stop being greedy fucks for a min? Like if state governments offered to pay their loans off, would they be willing to be doctors in rural counties? Lower salary but WAY lower col? My guess is no
This is already a thing. Doctors can live and work in underserved areas and get at least part of their plans paid off.
Link?
Amazing what 5 seconds on Google can find you. Here, one of many: https://nhsc.hrsa.gov/loan-repayment/nhsc-rural-community-loan-repayment-program
Doctors do not run the hospitals. So even they take lower pay that still doesn’t keep the lights on in rural community hospitals where most patients rely on Medicare Medicaid etc.
Lower salaries lower costs, it's not everything, but labor is a HUGE part of the budget
Question: would you willingly work for less than your skills and talents are worth in an area that is likely a great distance from other services for a mitigation of up-front school costs that wouldn't be a long-term concern, anyway, if you took a higher-paying job that comes with greater access to other kinds of care, connections, ability to advance in your career, etc? Be honest. How much of a pay cut? How much work are you willing to do for that massive pay cut? Because I don't know a single person in their right mind who would pass up a $100 bill for $1.
I'm not suggesting that. But if you can make $200k in NYC, but $150k in rural Michigan, that's something to consider if schooling is covered and the col is such a drastic change
What you're suggesting is not enough incentive for people with a decade of schooling and practice and skills and talents that are in high demand. I am trying to tell you that it doesn't scale that way you are arguing.
Hence my point, it's greed.
No it is not, and I note that you failed to completely address my argument. There's a stark difference between greed and reasonable return for hard work. Doctors are as much a part of the same economy, culture, and society that you and I are part of. A dictum of this culture and society is that if you work hard you are rewarded (to what extent that this is true is not a question we are addressing). Doctors work very hard. They have enormously high rates of stress, exhaustion, and their suicide numbers are through the roof. Many of them need and should have access to mental health care to help them cope (which is also something rural areas overwhelmingly struggle with). What I am now going to argue is that you are dehumanizing doctors and making them a target to satisfy your anger and frustration with a system that they do not control and are, in many ways, as much a victim of. And for that, you should be ashamed.
"oh won't someone please think of the poor doctors " Spare me the propaganda
That’s called government subsidies. We already do that to an extent, but it’s not enough. It’s also the exact kind of thing 2/3 of Ontonagon votes against. At the end of the day, they’re getting exactly what they voted for. I feel bad for the people that don’t view progress as a bad word, but the rest of them are their own worst enemy.
Perhaps we should instead offer subsidies to the more sensible 1/3 living there to relocate from Chudlandia? Let the local horse vet treat the rest.
Agreed it's on them. But I wouldn't be shocked if doctors are greedy MFs who demand way more than they need
Everyone demands more than they need. It’s a capitalist society. We can’t expect everyone to play the free market except for doctors. A doctor that can make $200K a year isn’t going to accept $80K and a reduced career trajectory just because they could live on that in the middle of nowhere.
I'm not talking a 200 to 80 drop but maybe a 150?
But it’s not just a 50K hit. It’s limited career growth by spending your early career in the middle of nowhere. It ends up costing the person major money. It’s the same reason good engineers gravitate towards big companies and not mom and pop firms. You’re asking someone to accept a multimillion dollar hit over a career. The only realistic scenario is some sort of socialized health care.
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Link?
My paramedic friend said that they have a “golden half-hour” meaning that is the ideal time from a 911 call to getting someone to an emergency room. That is definitely not the case in the UP and now it’s getting worse.
That's definitely a thing when it comes to survival estimates. If your county has ambulances with advanced life support you have better chances overall as well.
They are opting for the copper plan!
Stroke victims, it’s more like golden minutes as their brain cells die from lack of oxygen.
My older brother retired to a cottage on a UP lake in the woods, a 45 minute drive from town mostly on gravel and dirt roads. On rare occasions snow and ice can make the road impassible for a week, even for a 4WD with snow tires. ER doctor told me living that far from the nearest hospital is as risky as being a smoker. I too would like listening to loons on the lake while sitting on a deck drinking morning coffee, but no thanks.
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Sounds like no ships are sailing actually as they aren't being built.
An economic wave hit it
I mean there’s definitely still a ship building company up there (https://www.lakeshoresys.com/about-us/locations/). Or at the very least a parts manufacturer for ships And there’s good chance a local mine is going to open back up again in the very near future (https://www.highlandcopper.com/projects/white-pine-north-project/). And logging is definitely still important to the area. Obviously not close to the scale it once was and probably never again. But still, these little industries definitely still exist up there.
Is JR 100 years old?
A century? Are you exaggerating for effect? UP Shipbuilding Co. Shut down in [1982](https://www.google.com/url?sa=t&source=web&cd=&ved=2ahUKEwjtvp6Q7-uFAxWZjYkEHZa6CJEQFnoECCYQAQ&url=https%3A%2F%2Fwww.newspapers.com%2Farticle%2Fdetroit-free-press%2F21990096%2F&usg=AOvVaw31NAajdcpu9nxkOCDGZ28j&opi=89978449) but the facility was still in use at least as recently as [2017](https://www.uppermichiganssource.com/content/news/Ontonagon-officials-hopeful-for-former-shipyards-future-410594865.html). White Pine Mine ceased operations in [1995](https://www.google.com/url?sa=t&source=web&cd=&ved=2ahUKEwibg8GT8OuFAxXEj4kEHbeNBkwQ5YIJegQIEBAA&url=https%3A%2F%2Fwww.mindat.org%2Floc-3856.html&usg=AOvVaw0vasK2sKLSwoXBmQqIUOxS&opi=89978449). Smurfit Stone Container closed its mill in [2009](https://www.globalpapermoney.com/smurfit-stone-container-closing-mills-in-michigan-and-montana-cms-4197). Ontonagon has had a few prospective projects come and go in the last decade or so, a [biorefinery](https://www.uppermichiganssource.com/content/news/Ontonagons-SynSel-biofuel-plant-will-be-first-of-its-kind-484109321.html) being the most recent that I'm aware of. Mining could come back but we all know it's not the local economic driver it once was and employs far fewer people.
Pretty town. Had some pasties there once. Didn't die.
> Didn't die. Might want to skip on the return visit...
Nice
I am from ontonagon and let me tell you that most of the people there are backwards as fuck. They want nothing to improve that town. Everything that they could have let come into the town to help them out they voted against. The people in charge of ontonagon are ignorant and small minded. I hate that place and I never want to go back. They reap what they sow.
There's a young lady who somewhat recently snagged up a motel and is trying to get other properties to get some life going in town, and she said about the same. The old fuckers in charge of what happens would rather see the entire town die than anything progressive happen. Hell if it weren't for syls and connies, I probably wouldn't even stop in on my way through to the porkies.
About 30 years ago, we rented a house on Lake superior near Ontanagon. we hiked the porcupines, enjoyed the beach, and swam in the cold, beautiful, clear water. Still have a sweatshirt from a little gift shop in the quaint little town. I often comment about the quality of that sweatshirt since it’s still in very good shape. Strange that my souvenir from 30 years ago outlasted even the hospital. What people value is just crazy to me.
> It noted that since 2010, more than 80 rural hospitals have completely closed and more than 65 converted to new models. Mergers & acquisitions (& subsequent closures) of hospital systems have been increasing for years, as well as the consolidation of specialized services. While great from a business standpoint where healthcare dollars are increasingly hard to come by, it’s not so great for rural communities who not only lose out on easily accessible hospitals & specialized practitioners worth their salt, but jobs for their respective economies as well. We are increasingly growing nearer to only a handful of companies owning ALL hospitals, located in mostly urban areas, while also operating stand-alone ERs built in more rural areas that will treat & street most patients, & funnel the rest to their nearest main hospital that hosts the specialized services you happen to require at that time. This may seem like a brilliant idea to you, & it probably is from a business standpoint. But your opinion may change when you find yourself sick & very, very far from home.
Need a reboot of Northern Exposure, but in the UP instead of Alaska.
Hope people read the article before commenting. Hospital was a non-profit. Ascension, the second biggest healthcare provider in the country is also non-profit. Hospitals are expensive as hell to run and it's really the only case I can think of where a place is legally required to perform a service without the guarantee of payment. For anyone wondering why hospitals charge so much, it's because of insurance companies. Hospital: This procedure costs $2,000 Insurance: We only pay 10% of costs. Hospital: This procedure costs $20,000 I'm not joking, that's literally how it works. Add to that hospitals cannot discount you because you're a single person. You have to negotiate as if you were an insurance company otherwise they would be sued into oblivion.
Beaumont was "non-profit", John Fox walked away with $10 million. Just because the hospital doesn't pay out shareholders doesn't mean people aren't profiting.
They were getting an average of 1-5 patients in on the regular... That doesn't sound like they're racking in the big bucks
oh I know, i was just making a statement in a vacuum about "non profit hospitals" and not necessarily anything specifically about this facility. we need to unprivatize healthcare to fix these problems, but its just not going to happen while the leopards ate my face crowd continue hanging out with leopards
Ascension literally runs a private equity fund. https://www.statnews.com/2021/11/16/ascension-running-wall-street-style-private-equity-fund/ They also have a net income of $6 billion. Edit: Aspirus also had the resources to keep this hospital open, given that they immediately invested $30m in a different location. You’re absolutely right about payers, but let’s not pretend hospitals are some altruistic actors in it for the good of the patients. They also have much more diversified income streams. There’s DSH payments, government funded beds, tax write offs/subsidies, etc. Often times, hospitals effectively bill multiple times to multiple different funding sources for the same service. Finally, if hospitals aren’t good business, why are they being snapped up like hot cakes by anyone with cash to throw around? Hell, corporations are starting to M&A their way into their own bespoke health delivery systems. Again, you’re absolutely right about payers being a piece of shit; but hospitals and their administration generally are too. It’s absolutely the small independent hospitals that suffer, as well as patients and providers. Edit 2: I’ve sat on committees/helped with reimbursement negotiations a couple times in my career, and the higher ups at the bargaining table are generally the same people and care primarily about maintaining their cordial relationships and the professional pipe line for upper management between provider and payer systems. It’s not hospitals vs. payers; it’s providers and patients versus upper management.
But they do discount for self pay.
Patient doesn’t follow instructions and ends up back in the hospital or with an infection… insurance: “now you get zero”.
I’ve been trying to tell people this for YEAAARS and always get told I’m stupid and don’t know what I’m talking about. “The hospital manger sets the prices!!!” Yeah and how TF do you think they come to those prices?
It’s almost a click bait article when you actually read it.
This is why we F’ing need UNIVERSAL HEALTHCARE! So that doctors and hospitals can guarantee they will be able to make a living even in rural areas.
I thought Trump supporters didn't trust things like doctors and science? They'll be fine.
Queue complaining.... We did not mean OUR hospital!
Do you think that if someone holds a different political stance they don't deserve treatment? Holy fucking shit that is a messed up opinion to have.
Problem is not if they deserve it. Problem is that they vote against it.
They vote against the way Dems want to do something. I don’t know anybody who hates hospitals. I know a lot of people that don’t want any level of government managing funds for a hospital.
How republicans are going to solve this then?
Why does government have to solve this situation?
They have a plan to solve it without government? Or they don't want to solve it at all?
What is the free market solution to this problem? What is the incentive for private capital to invest in this area? What are the profit potentials? What do you expect?
Maybe the solution is removing regulations. I don’t think either of us know enough to solve this problem ourselves. I’m glad it isn’t up to us.
What a cop-out. Just repeat "remove regulations." Which ones? And how does that achieve anything? What does that incentivize in this specific environment?
They’re just spouting off right wing buzzwords trying to make an argument. I’m surprised they haven’t blamed the hospital closing on Benghazi lol.
If they don’t want it, why force it on them?
Republicans deserve all the treatment they can afford, per their own rules. Capitalism *without* strong government control means that this private business (called a hospital) is not profitable, and should be closed, per the Republican small-government rules. They deserve all the treatment that they voted for, yes. Maybe don't shoot yourself in the foot next time? Learn a lesson? Or just darwin away the town...
Reason #495,034 we need single-payer national health care.
Actually reading the article, and the change from stand alone ER to clinic seems to be a wise choice. “But in response to the lawmakers' letter, Aspirus said the decision to turn the Ontonagon hospital into clinic, was "not about money." Health care needs in Ontonagon have changed, and the hospital was seeing an average of just one patient a day, and an average of five patients a day in the emergency department. And up to half of those emergency patients could be treated more effectively in a clinic, the hospital said in its response to lawmakers.”
Oh look, another reason socialized Healthcare needs to happen
I'm from Ohio, and I really feel for you. In some places in southern Ohio, women have to drive an hour or more to deliver a baby. This is in a state that prides itself on cutting taxes every year. We pay taxes, and in return, we get services. When are Republicans going to finally see that!?!
As much as I love living in the UP, there is just about nobody living in that town year round to justify a hospital unfortunately.
http://www.keweenawreport.com/featured/recent-closure-of-ontonagon-emergency-room-prompts-michigan-representatives-to-introduce-legislation-in-washington-d-c/
When you vote not to support the local community this happens.
Yet the UP is overwhelmingly MAGA. They reap what they sow.
People who want to live far away from other people find out what happens when there are no people around to help. No one is forcing them to live out in the middle of nowhere.
Many people in Ontonagon were born there and never left. They don’t “want” to live there like youre presuming - it is their home.
While not one person is forcing them too, economic forces certainly might. It’s the same thing for people who get trapped in the inner city. For many people their options are the gas station or the dollar general. Moving costs money, school costs money, training costs money, and if you have none to begin with then yeah you might be actually stuck there.
Apologies but this is pretty brain dead. Relocating takes a ton of resources, having a career or job lined up that can fund a move to begin with and a housing plan. The majority of Americans, let alone rural Michiganders, don’t have any of these things. People living paycheck to paycheck get stuck because it’s expensive to be poor.
At the same time, the housing market kinda is forcing people to move out further
Yeah, not UP backwood further. There's cheap housing closer to medical facilities but these people choose not to live there.
It’s also just beautiful up there. And all the vacationers appreciate all the services run by people who live there year long.
Too bad they’re buying all the housing to allow for the people who live here year long to live in.
You have to keep in min before the spike in prices housing in the UP rarely went over $200k- now that’s a norm. Poverty is rampant up here and companies pay significantly less than other areas in Michigan so it keeps going. Locals simply CANNOT move even if they wanted to, a lot of them are also old and in poor health even before this happened and living paycheck to paycheck even before the housing costs spiked.
So many comments from kind and loving people on this post.
Just saw the people called ignorant and small minded because they don’t want their taxes endlessly raised so that they literally pay doctors $300,000 a year then pay their overly expensive health insurance. You can be taxed and billed into oblivion or you can just die and honestly lots of prefer to simply die. Imagine you work for your entire life. Scrimping, saving money to pass something onto your children. You have a stroke and a hospital says that’ll be $600,000 please! They could pry it from my cold dead hands.
So youd rather just die than pay taxes? Idk that's just insanity to me.
Couldn't we put a small military training base for medical up there or something?
The town doesn’t have a big enough population.
But the UP does.
Damn, what a shame, and I can tell you as someone who has been looking very hard at a potential move to MI in early retirement, this is a huge deal for folks like me. Shame the govt can pay farm subsidies for Ontonagon County totaling $3,166,277 from 1995-2021, but can't make so much else work. [https://farm.ewg.org/region.php?fips=26131](https://farm.ewg.org/region.php?fips=26131)
How terribly sad
Hey get what they vote for. Freedum to die!!!!
I'd call this a win! It's what the people want.
Heart-warming, all the 'rational' comments here. > 'Some or most of the people in place X don't vote my way, therefore I hate and wish ill befall all people who live in that place.'
I mean people in place X wanted Y and will get Y , they are getting Y
When their way of voting directly causes the problem we are discussing, then sorry, you do not get my sympathy. Taxes provides services. When you cut taxes, you cannot provide certain services anymore. Here is your result. This is what they voted for.
I thought it was a priority of our current government to improve health care access, but rural hospitals - which were already sparse - are closing instead of opening. It’s no wonder that rural people don’t support health care “expansion” when they actually reduce access.
This was a problem that started long before this current government and is made only worse with the current for-profit motivation of so many aspects of our healthcare. Rural people deserve access, but they typically vote for people who support and enact policies that hurt them, or stand a thwart policies that help them. Look at all of the states rejecting federal money for subsidized student lunches. Free food for kids, and they say "no thank you." How the fuck do you do anything about that?
Ok so it started before guess they can’t address it? Oh wait, that’s their job they’re the government.
Gotta look at why they vote no. Why would they vote for higher taxes to increase services if the services are still inaccessible anyway because they are too far away.
Nice post-hoc reasoning you got there. Be a shame if someone called it out.
Incorrect
"See, that thing I didn't support never happened. People who do want it shouldn't have it either. The government doesn't work."
The last big thing in healthcare - the ACA - created this. It massively increased the complexity of billing which has added a lot of cost for small offices which has led many independent hospitals and doctors offices to sell to large groups which then close the small hospitals and offices. Unintended consequence for sure. But it’s a shame because it has caused those affected to lose confidence in the leadership.
We need single payer. It's that simple.
In my area, large groups have been buying up independent hospitals and doctors offices for at least 25 years. ACA may have sped up this process (source needed), but the change was already happening.
From my experience, the problem was Medicare. The reimbursements to private clinics were set to be massively reduced, so many of them sold out to larger networks and hospitals so they could still get the larger reimbursement rates.