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America Tonight
One morning earlier this month, 48-year-old Portia Gibbs was suddenly struck with chest pains. Her husband Barry Gibbs took her blood pressure, saw it was high, got her in the car and raced 20 miles to the nearest ambulance station.
Paramedics called in a helicopter, but it had to come in from a town 45 minutes away. Just before it landed, a paramedic told Barry that his wife’s heart had given out.
Living in the coastal North Carolina countryside, Barry Gibbs wishes there had been a hospital to care for his wife. But Belhaven’s Pungo Hospital, a rural hospital 30 minutes away which served more than 20,000 people, had shuttered its doors just a few days before.
The county’s director of emergency medical services says Portia Gibbs wouldn’t have been taken to Belhaven anyway, because it lacked the facilities to treat her critical condition. But Dr. Charles Boyette, a family physician here for 50 years and the hospital’s former chief of staff, disagrees.
“I can say that she, in my opinion, would have a better opportunity to have survived if she hadn't lost that 30 minutes of time,” he explained. “If we had this hospital open, she would have been able to be in our emergency room in 30 minutes and she would be attended immediately.”
Barry Gibbs can’t say for sure that the hospital’s closure is to blame for his wife’s death.
“I look at it this way: We didn't have the option,” he said. “I mean, the good Lord's the only one knows whether she'd have made it or not. We don't know that. They don't know that.”
But he has no doubt that more deaths will come.
“When? It has to be seen,” he said. “But that hospital has saved hundreds of lives, if not thousands.”
Now, the town’s mayor is making it his mission to do something about it.
The closure of Belhaven, owned by North Carolina hospital chain Vidant Health, has forged some unlikely allies.
To the tune of a Gospel singer, protesters gathered in Belhaven two weeks ago, holding up Portia Gibb's picture. It was the launch of Republican Mayor of Belhaven Adam O’Neal's 275-mile walk to Washington, D.C. Reverend William Barber, North Carolina’s NAACP President, accompanied O'Neal for the first leg of his walk. The civil rights group points out the racial impact of the closure in Belhaven, a predominantly African-American community.
Stopping at towns and tweeting along the way, with longtime civil rights activist Bob Zellner by his side, O’Neal’s mission is to shame Vidant Health for the closure of the area’s only hospital and largest employer – and to pressure the federal government to do something about it.
Friends that walk together:)!!!! pic.twitter.com/GSKe6Fn8rk
— Adam O'Neal (@MayorONeal) July 19, 2014Belhaven Pungo hospital opened in 1949 after Congress mandated federal aid to rural hospitals. For this sprawling slice of North Carolina, where cotton is still king and fishermen eke out meager livings in the marshes, the hospital provided the only critical care for 1,000 square miles.
“It was essential for health care of this region because we've got mostly elderly and poor people comprising about 85 percent of the population,” said Boyette, the former chief of staff. “And that hospital really has been a godsend, not only for health care but for the economics of the area, too.”
But the economics of serving that elderly, poor and rural population became a money-losing proposition. Vidant Health said the hospital was hemorrhaging up to $2 million a year, and was serving fewer than 20 people a day, reported The Wall Street Journal. The rising costs of providing care have further squeezed rural hospitals like Belhaven, and when states such as North Carolina refused to accept a Medicaid expansion, it was a painful kick to an already limping animal.
“The cost of doing business was going up and the reimbursements were going down,” said Boyette.
After shutting the hospital, Vidant opened a 24-hour clinic in Belhaven, but it doesn’t provide critical care. The town’s mayor and the NCAAP have filed a formal complaint asking the Justice Department to investigate. They say the company broke a promise to keep Belhaven open.
“They came in and ripped the heart out of our community, and it is so bad that I've got my fat self up and I'm going to walk to Washington, D.C. about it,” he said. “It should not be a possibility for an organization to come in and through misrepresentation, outright lies, steal away people's emergency care for 20,000 people. That should be against the law.”
In a statement, Vidant President Roger Robertson insisted, “The town agreed to the closure if it was unprepared to take over hospital operations.”
O’Neal adamantly denies that.
“We never agreed to close the hospital,” he said. “I hate to call people liars, but they continuously lie.”
When it comes to health care, the mayor has taken a different tack from other Republicans. The new federal health law planned that those who couldn’t afford insurance would be covered by an expansion of Medicaid, almost entirely funded by the federal government. But 21 Republican-led states, including North Carolina, declined the offer. According to a national survey by the Colorado Hospital Association, hospitals in states that expanded Medicaid experienced a significant increase in Medicaid charges so far in 2014 and a 30 percent drop, on average, in charity care.
O’Neal believes his state is shooting itself in the foot, with residents paying money in taxes that could have been returned to them in coverage.
“We're sending our tax money away? Two billion dollars a year away?” he said. “I don't see where that makes sense.”
Rural hospitals like Belhaven, because they often serve more low-income and elderly populations, are extremely vulnerable to shifts in Medicaid and Medicare. At least 14 rural hospitals closed in 2013, according to the National Rural Health Association.
“More rural hospitals have closed in the last year than the previous 15 years. That's a problem,” O’Neal said. “That means people all across this country don't have emergency care any more. That means people are dying needlessly all over this country.”
As he began his two-week odyssey to Washington, supporters honked their horns. Josephine O’Neal offered the mayor a prayer from her stoop. Last August, she broke her hip in a car accident. Luckily for her, the hospital was still open.
“I was blessed to have to have this hospital so close,” she said. “And if my hip had not been broken today, I would've walked a little ways with Mayor Adam.”
Part of Fault Lines' investigation into "The Coverage Gap," the new dichotomy in U.S. health care — where poor residents of some states have no access, while those in other parts of the country do.
These infographics lay out the consequences of not expanding Medicaid for the millions of low-income Americans who will remain without the health care they would have had if their respective states had chosen otherwise.
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