Small rural hospitals, clinics and health care providers face steep challenges in U.S. health care, including staffing shortages and financial strain largely caused by complicated payment systems that don’t meet unique needs.

This is aggravated by the fact that rural counties, in which two-thirds of Maine folks live, tend to have higher rates of economic distress and at the same time lower rates of health insurance coverage.

As the U.S. healthcare system becomes more financialized, private equity is moving in, seeing opportunities to profit from peoples’ illnesses through the takeover of facilities and providers with added administrative fees and stringent cost-cutting measures. Can anybody really say that big money’s involvement will address rural health care needs?

Other countries, with universal systems and better health outcomes than ours, empower their governments with negotiating global budgets with hospitals, helping rural hospitals and prioritizing community and hospital needs over profits, achieving coverage at lower cost, and with more equitable funding.

For the U.S. this would require a complete rethinking of how our health care is financed. In fact, that may be happening.

Here’s what the Maine Medical Association proclaimed in its recent health care reform statement: “… we are calling for federal health care reform that … (will) protect consumers and providers from private profit-driven motives… . The time … to have guaranteed, affordable (health) care is long overdue.”

It is definitely time for rethinking the financing of U.S. healthcare.

Henk Goorhuis, MD, Auburn

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