195 size does not matter - editorialpinups

May 18, 2026 Becker Hospital Review email had an article “‘The day we can’t make payroll, it’s over’: Inside 1 rural Minnesota hospital’s fight to stay afloat”

The article title gives the impression that a rural hospital is dealing with a financial problem.  The hospital is.

The Madelia Health is a rural hospital serving a number of rural Minnesota communities including New Ulm (hometown of former Major League and all star MVP Terry Steinbach). The hospital has been operating on a line of credit for the last two years.  It is a 25-bed critical access facility with negative days of cash on hand.  This causes an uncertain future.

Madelia Health has closed several lines service including a retail pharmacy and home care,  It will also be closing an under performing clinic. The article does not say how these services will be replaced. I did look up and there is Lewis Family Drug in Madelia to cover the pharmacy question.  Home Care looks to be covered by companies based in other locations in the state.  (One note on Home Health Care is that the rules differ by state.  As a home health care agency may not have an office in a town they may be able to service a town without an office in the town.  Illinois requires contiguous county coverage, that is If county A is next to county B and the office is in county A and there is a client in county A then county B can be serviced.  I county F is not next to county A or B, then an office would need to be in county F unless there are active patients in the counties between F and either A or B.)  I am not sure of the clinic question.

Some of the causes for the cash flow situation include the closure of UCare in Minnesota which effectively stiffed Madelia Health and a few other medical providers.  The article mentioned that another medical system, Hennepin Healthcare (formerly Hennepin County Medical Center  is short also.  The state Government is supplying $205 million dollars to Hennepin Healthcare with up to $500 million available through 2031.

Hennepin Healthcare is a 484-bed acute care hospital with a large fleet of ambulances serving fourteen cities in Hennepin County including its location city of Minneapolis. Established in 1887 as the Minneapolis City hospital, it includes emergency medicine, surgery, psychiatry, home care, hospice, and rehabilitation, alongside a nationally recognized trauma center.  It is home to the Hennepin Healthcare Research Institute (HHRI), established in 1952, which focuses on acute care/trauma, addiction, health services, and infectious diseases. (references from search.brave.com summary.)

We keep hearing about the problems that are had with rural health care and the stress on rural medicine and hospitals. And I agree, that is true.  But Hennepin Health is not rural medicine.  There is a common element. UCare and its ineptitude.  Stiffing the vendor.  Is it a matter of UCare not collecting enough money for their promises?

I started the study of health care funding all the way back to the Hillary Care days. Sat on a round table discussion for the St Cloud Times back in that era. Today I am studying the whole process.  My head spins.  The ACA seems to be nothing more than a bit of a ponsi scheme. All sorts of money collected but the funding problems still occur.

The problem with health care funding is determining what is needed and what health care really is.  We have gone from the days of fixing wounds to trying to fend off physical ailments.  We have medicines and concepts of medicines that the mainstream promotes but the questions of their promoters and suppliers keep being asked.  There is the rejection of alternative medicines and open source healing methods.

There is a lack of community for medicine as compared to eighty to one hundred years ago. In the past towns and villages would recognize the need for a medical practitioner and would get together set up a base funding including a location, supplies, and financial support for the practitioner.  Religious groups pitched in with their religious mission of medical thought.  Maternity services would be offered by religious orders in the Roman Catholic church and then expanding to other medical services.  Protestant religious groups would also form medical groups, clinics, and hospitals.

Unless the medical practitioner was an all out drunk or totally inept, life and healing was accepted. Now we have billboards on the sides of the highway soliciting injury patients for lawyers.  Not just for malpractice, but for proving blame of the injuries to find someone to pay the bill.  Juries that try to apply value to injuries or possible untimely death.

From that more simpler model it seems that medicine has become more complicated. Science has added options for maintenance and cures that did not exist eighty to one hundred years ago.  Longevity has increased.

But there are also abuses, profiteering, and the lack of acceptance of death and human abilities. Locations of manufacture, retail price for Americans being somewhat higher than other parts of the world, profits that seem high and costs which shut out possible patient use, medical fraud at all levels and malpractice and the threat of malpractice causing defensive medicine.  The numbers are beyond comprehension.

In other words, expectations, product, and service requirements.  Who controls what. Can a patient say I will not sue you if you fix the cut with a bandage?  A Suture? Super glue?  Is there not personal responsibility on the part of the patient?  Is there not the responsibility that we can be her today and gone tomorrow?

This article started with a small rural Minnesota critical care hospital with twenty-five beds inadvertently became a question of what is the real problem with medical funding when the problem also affects a 484-bed acute care hospital with a large fleet of ambulances serving fourteen cities including Minneapolis.

The best minds not connected with politicians and those that have too much invested in the current system need to get together and create a solution.  Will it happen?