MODERN MEDICINE HAS AN OFTEN BRUTAL REALITY

If a doctor were transported by time machine from 1891 to the current day, he would stand awestruck at the ad~vance~ments of a century on his profession. To twist a phrase, there has never been a better time and place to be sick than now and in this country. So why does the health care field seem in such disarray? In fact, while medical progress continues to be made, the finances of this enterprise are in a constant state of flux. This wavering condition finds both bad and good in a marketplace where people foot the bill for health concerns.

Chaffee is a recent casualty of the medical field's volatility. The town's hospital closed its doors Friday after a game struggle to remain financially solvent against increasing odds. It is not the first small community in this area to lose a medical facility; Cairo is five years removed from this modern-day reality and is dealing positively now with the stages that come next. Other community hospitals in small towns might witness this recent closure as an omen, something their own grim ledgers are perhaps hinting at.

To some extent, Chaffee and Cairo fell victim to the same circumstance. Both are within quick driving range of two large, regional hospitals in Cape Girardeau; when in-patient care was required, many persons in the smaller communities opted for these more advanced facilities. As the administrator for the Chaffee hospital pointed out, there was a lot of verbal support from the community, but little else. And in the fiscally sensitive world of modern medicine, the support had to be more than just spoken to make a difference.

Still, civic-mindedness does not necessarily go hand-in-hand with personal health care. People choose a hospital for their own needs, not to satisfy the demands of community betterment. In this case and others, people were given a choice and the marketplace cast its lot. How can that be viewed as bad in a free enterprise system? Competitiveness and independence among hospitals promote greater efficiencies and breakthroughs, with the consumer ultimately to benefit from better medical care. The failure of socialized medicine would be that no such incentives would exist with such a system.

We can not overlook, however, the bitter quality of a community hospital's demise. In addition to the job losses and damage to civic prestige, there is the fact that the people least able to travel to the regional hospitals older people probably, or those of lower incomes will be the ones to suffer most. We must also lament the fact that governmental shortcomings namely the slow reimbursements of Medicare and Medicaid contributed to the Chaffee hospital's demise. In a cash flow quandary to begin with, Chaffee's facility found it could not meet its obligations while waiting for public treasuries to pay their bills. Bigger hospitals face the same problem but can accommodate the delays; at Chaffee, the slow payments were fatal.

At both Chaffee and Cairo, efforts are being made to provide a degree of medical care for citizens. This is the changing face of health care in small towns. You can argue that it is good or bad; you can't deny that it's reality.