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When rural hospitals close, towns struggle to stay open

Thu, 2014-04-10 11:15

There’s a healthcare crisis in America that you might not have heard about: Rural hospitals are closing at a rate that’s starting to get some politicians’ attention. Republicans blame Obamacare, while Democrats blame some states’ refusal to expand Medicaid. In reality, the problem started years before all that.

What's clear is that rural hospitals and the rural economy rise and fall together.

Hancock Memorial Hospital in the tiny town of Sparta, Georgia was among the first of nine rural hospitals that have closed across Georgia since 2000. Today, it’s overgrown with weeds and vines, while the roof caves on the gurneys and computers still inside.

“I mean, it was just not economically feasible to maintain the staff and the equipment,” says Robert Moore, whose family has lived in Hancock County since they were emancipated.

Sparta was once a fancy town with lots of antebellum mansions. But Moore says things really started going south in the 1990s.

“Rural Georgia was based on the textile industry, and when NAFTA was signed, all that moved to Mexico, and… sent everything into a downspin,” Moore says.

Hancock County Commission Chair Sistie Hudson says it’s not surprising that a population so small and so poor can't support a whole hospital. “There’s about 2,600 people [in Hancock County] that still work, out of the little more than 8,000 that we have,” she says.

But with Hancock Memorial boarded up, the prospects for future growth are even worse. When Hudson tries to recruit a new industrial employer, one of the first things they ask is: “Do you have a hospital?”

“You just really need a local facility just in case somebody gets hurt in these factories, you know? It’s something that they like to see,” Hudson says.

Just imagine what having no emergency room nearby would do to a company’s workers comp and other insurance costs. It’s a non-starter for most businesses. 

University of North Carolina professor Mark Holmes studied the economic impact of 140 rural hospital closures nationwide.  He found that three years out, losing a hospital costs a community, on average, “about 1.6 percentage points in unemployment, about $700 in per capita income, and that was in [year] 2000 dollars so that’d be probably about $1,000 currently."

And that’s only the effect on economic health. What about health?

Speaking on the subject a few weeks ago, Georgia state Senator David Lucas paused several times to weep as he addressed his colleagues this spring: “[It] ends up with rural communities, such as Hancock County, where 39 percent of the folks who have a stroke or have a heart attack die." That’s a lot higher than in counties with hospitals close by.

Georgia officials are exploring solutions to this problem that could become a national model – basically, a medical facility that does more than an urgent care clinic, but isn’t as big a whole hospital. But Georgia’s Community Health Commissioner Clyde Reese says America’s healthcare system doesn’t provide enough ways for the operator of that kind of place to get paid.

“They’re not going to be hospitals, they won’t be reimbursed as hospitals, they won’t be able to charge a facility fee, they won’t get the Medicaid add-on rate, etc.,” Reese says.

Reese is working on ways to fix that. Because without reimbursements, there will be no emergency care. And with no emergency care, there probably will be no new jobs in Hancock County.

Why low inflation can be dangerous

Thu, 2014-04-10 10:51
Friday, April 11, 2014 - 06:36 JOHANNES EISELE/AFP/Getty Images

Euro cents are seen on a chessboard and the word 'inflation' as a part of a advertisement on October 12, 2010 in Berlin.

Right now our inflation rate is around 1 percent. But some at the Fed say that's way too low.

The hope is to see inflation go up. But why on earth would we want to increase inflation?  

"A little bit is good, but not too much. It's like a lot of things in life -- good in moderation," says Jeremy Siegel, a professor of finance at Wharton. "Higher inflation is a bad thing, but mild inflation, statistically has been associated with very good economic times."

Siegel says during times of inflation, the dollar decreases in value. So the $100 you borrowed back in the day was worth more then, than your $100 payment today -- which means less financial burdens for consumers and more cash to spend.

And that's one reason the Fed wants to see inflation go up -- just a little bit. 

"It's not so high as to be hurting a lot of people, but it's at a level which would probably create a lot of jobs," says Gary Thayer, chief macro strategist at Wells Fargo Advisers. Thayer says the benefit of job creation would probably outweigh a slightly higher inflation rate.

Marketplace Morning Report for Friday, April 11, 2014by Sally HershipsPodcast Title Why low inflation can be dangerousStory Type News StorySyndication SlackerSoundcloudStitcherSwellPMPApp Respond No

Ukraine not on the agenda as IMF gathers

Thu, 2014-04-10 10:46
Friday, April 11, 2014 - 06:20 Mark Wilson/Getty Images

IMF Managing Director Christine Lagarde speaks during a media briefing at the IMF Headquarters, on April 10, 2014 in Washington, DC. Director Lagarde spoke about their agenda for the 2014 Spring Meetings that are taking place now and will end on Sunday.

The International Monetary Fund and the World Bank are set to open their annual spring meetings. It will be a busy weekend for finance ministers and economists who are visiting Washington from all over the world. Dozens of panels and speeches are on the agenda, but none are about Ukraine, a country the IMF has offered billions of dollars.

According to Ken Rogoff, former IMF chief economist, right now, “the geopolitics overrides what the finance ministers and the central bankers think.”

But at a gathering of policymakers from close to 200 countries, it is bound to come up.

“I think it’s going to be talked about behind closed doors,” says Barry Eichengreen, an economics professor at the University of California, Berkeley.  

Marketplace Morning Report for Friday, April 11, 2014by David GuraPodcast Title Ukraine not on the agenda as IMF gathersStory Type News StorySyndication SlackerSoundcloudStitcherSwellPMPApp Respond No

What Family Dollar says about the economy

Thu, 2014-04-10 10:10
Thursday, April 10, 2014 - 16:47 Ryotaro takao/ Flikr

Family Dollar exterior in Honeoye Falls, NY.

The retail chain Family Dollar said Thursday it's going to close more than 300 stores. Shrinking sales and falling profits are the proximate causes. There is a line of thinking that says, "If a discount store like Family Dollar is reporting bad news like this, maybe that's good news for the broader economy."  

Discount stores tend to do well during a downturn, when once higher-income consumers “trade down” for cheaper options, the argument goes, so perhaps the fact that discount stores are showing signs of struggle means those customers are trading back up, in response to a recovering economy.  

And it is true that Family Dollar has thrived during many economic shocks.  In fact, there’s a chart Family Dollar management recently trotted out at a retail industry conference that highlights this phenomenon -- a timeline of shocks to the American economy, events like the 9/11 terror attacks and the housing meltdown. After each of these events, you see a  steep incline on the graph, denoting earnings increases for Family Dollar. 

Family Dollar

But just because Family Dollar is floundering now doesn’t mean the larger economy is thriving. Higher-income customers may be leaving family dollar now that their economic fortunes seem to be brightening in the economic recovery.  But the story is complicated by the fact that low-income households still face high unemployment rates, and less money to spend in the wake of recent cuts to government assistance programs like food stamps and unemployment insurance.

Family Dollar

Marketplace for Thursday April 10, 2014by Krissy ClarkPodcast Title What Family Dollar says about the economyStory Type News StorySyndication SlackerSoundcloudStitcherSwellPMPApp Respond No

Don't mess with French workers' 35 hour work week

Thu, 2014-04-10 09:57

From France, home of the 35 hour work week, this item: French tech sector employees  have just struck a new collective bargaining agreement, under the terms of which they are guaranteed that after-hours emails -- as in the kind we all check on our phones while at a soccer game -- will not impinge on that aforesaid 35 hour week.

Workers now have the unimpeded right to unplug at quitting time.

To this story, one can only say, zut alors, sacre bleu and 'How do I get me some of that action'?

PODCAST: From bailout to IPO

Thu, 2014-04-10 07:16

Ally Financial is trading on the New York Stock Exchange on Thursday, under the ticker symbol ALLY. The company, you might remember, had to be bailed out by the government in 2008, as part of the Troubled Asset Relief Program or TARP, to the tune of $17.2 billion. The stock sale puts the government a step closer to sloughing off what remains of the financial crisis bailouts.

With Ukraine refusing to pay its gas bills to Russia's Gazprom and Europe looking for alternative energy sources, Russia -- it seems -- is on the outs. But now Putin is turning his attention eastward, towards China, and may be finding a friend. Ian Bremmer, president of the Eurasia Group, joins Marketplace Morning Report host David Brancaccio to discuss Russia's balancing act and why the country might try to disrupt Ukraine's upcoming elections.

Teenagers are now spending as much, if not more, on food as on clothing, according to Piper Jaffray’s semi-annual report on teen spending, out this week. And teenager's new favorite place to spend money? Starbucks.

 

 

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