In South Dakota, Monument, Avera and Sanford operate as a triopoly and as virtual monopolies in their own markets. It’s disaster capitalism for oligarchs and religionists masquerading as health care.
Senator Jon Tester (D-MT) has known about the monopolistic nature of rural hospitals for decades. And after Amtrak's Empire Builder derailed near Joplin, Montana many of the injured passengers were unable to find medical care because area hospitals were overwhelmed with unvaccinated Republicans. The Benefis Health System hospital in Great Falls is about 100 miles from Joplin. Today according to WalletHub Idaho is the third most lucrative state for doctors just behind Montana and South Dakota.
Leaders in Montana, whose population is nearly half rural, credit Medicaid expansion as the reason their hospitals have largely avoided the financial crisis depicted by the report despite escalating costs, workforce shortages, and growing administrative burden. [Operating in the Red: Half of Rural Hospitals Lose Money, as Many Cut Services]There is a growing movement among Democrats and others to fund Medicare for all but I like the idea of rolling the funding for Obamacare, TriCare, Medicare, the Indian Health Service and the Veterans Health Administration together then offering Medicaid for all by increasing the estate tax, raising taxes on tobacco and adopting a carbon tax.
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