A Collision Course Between Policy and Reality
In this post, I will reveal to you an impending collision of
~~ a chronic problem in the American health care system
~~ and a current piece of legislation in front of Congress
that could destroy local hospital access for 56 million people in the USA in a matter of months.
This is a long-term weakness of the US healthcare system and a short-term budgetary philosophy that could end up in disaster. Let me show you where these two trends intersect and what might happen if they do. Check it out.
A Systemic Threat Few Are Talking About
Hello again. Dr. Dike Drummond here just outside of Tacoma, Washington, with a quick thank you. Thank you for your time and attention for today's important podcast. I'm going to sound the alarm on an intersection of the American health care system, politics, and population health in the USA in a way that nobody else is talking about. And I really appreciate your attention.
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Fortunately, I’ve got a bit of a happy ending—or at least, there appears to be a way to stop this freight train from running right off the tracks.
As I'm writing this, it's May 8th of 2025.
Donald Trump and his regime have just survived their first 100 days in office, and they're working on what they’re calling a “big, beautiful funding bill” for the government. The plan? Cut Medicaid and other health-related programs, trim fat, and give large tax breaks to the wealthier end of the American economic spectrum. Hey, what could go wrong, right?
The Fragile State of Rural Hospitals
Except here's something I want to bring back on your radar. Maybe it was never on your radar at all. A litany of articles has shown just how fragile the American rural health care system is—especially rural hospitals. Let me trace the last three years of this crisis:
January 2023: 600 rural hospitals at risk of closing; 200 at immediate risk. (1)
November 2024: 705 rural hospitals at risk; 364 at immediate threat. (2)
March 2025: 768 rural hospitals at risk; 315 at immediate risk (Centers for Healthcare Quality and Payment Reform). (3)
February 2025: 46% of rural hospitals operating in the red; 432 vulnerable; 18 closed or converted last year (CHART report).(4)
Now connect the dots.
🔴 Rural hospitals are already teetering.
🔴 The majority of their funding comes from Medicaid.
🔴 If this bill guts that support, we could lose hundreds of rural hospitals with a single stroke of a pen.
What “Rural” Really Means—and Why It Matters
Now, you may be saying: "Who cares if a hospital closes in the boonies?"
Let’s define "rural": fewer than 500 people per square mile.
In the lower 48 states, 71% of land mass is classified as rural—3.12 million square miles.
Living in those areas: 56.8 million people, or 16.7% of the U.S. population.
What happens if we defund Medicaid? Rural hospitals close. Large swaths of America become health care deserts. Your ability to survive a trauma or illness becomes dependent on your zip code.
The Political Irony: Red Counties at Risk
Here's the twist:
Look at a map of the 2024 presidential election results.
Red counties (Trump) vs. blue counties (Harris). Now overlay that with a rural population density map.
The correlation is striking—the rural counties that are most at risk are the same counties that voted Republican.
🔴 If this bill passes, the health care system will collapse for the citizens who elected this administration.
🔴 The rural hospitals they depend on will vanish.
🔴 Those 56.8 million people—fully capable of swinging local, state, and national elections—will lose access to care.
A Call to Action: Can Common Sense Prevail?
I can only hope meaningful feedback comes from these rural voters—feedback strong enough to pressure leaders into adjusting their Medicaid-slashing plans. Because right now, we’re looking at a policy decision that undercuts the very voters who made it possible.
🔴 Rural hospitals: already in trouble.
🔴 Medicaid: about to be gutted.
🔴 Result: hundreds of hospitals gone, millions stranded without care.
And no one in the national press is talking about it.
I'm sounding the alarm.
I don’t believe the Trump administration understands the consequences of collapsing Medicaid in rural America. But I’m watching. And I hope you are too.
Let’s pray for some humanity, wisdom, and courage in the weeks ahead.
That’s it for today’s post. Keep doing your great work, keep breathing, and have a great rest of your week.
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REFERENCES:
(1) https://www.orthoatlanta.com/health-news/hundreds-of-hospitals-could-close-across-rural-america
(2) https://www.porh.psu.edu/705-rural-hospitals-at-risk-of-closure-state-by-state/
(3) https://www.healthcare-brew.com/stories/2025/03/17/700-rural-hospitals-risk-closing
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PLEASE LEAVE A COMMENT:
Does this situation concern you?
How do you expect this to play out?