Eli Saslow of the Washington Post, roving chronicler of the breakdown of the American experience, went to the open spaces of Fairfax, Oklahoma, to see a near-dead hospital. Thirty miles from the next hospital, and at the point of convergence of multiple major destructive forces in contemporary life, Saslow followed and watched the Fairfax Community Hospital staff from day to day as they worked for no wages, with $12,000 in the hospital’s bank account while unpaid bills piled up and supplies started to run out. They were hoping, with no great basis for hope, that the hospital would escape from its parent company’s bankruptcy, so that someone could take it over and start issuing paychecks and paying invoices again.
The piece oddly didn’t mention Oklahoma’s refusal to expand Medicaid, an act of performance politics that had allowed politicians to make a show of rejecting Obamacare and left their state as the second-least-insured one in the country. But it was still a tour of the collapse of the health care system in particular and rural life in general, or the health care system in general and this rural place in particular. Partly the hospital was failing because the town was failing, although as a place fails the people tend to get sicker.
Each turn and detail of the piece was worth reading to absorb; the nature of a hospital is to witness the many forms suffering can take a community. But as all the scenery of misery and misfortune went by, one sentence jumped out from the rest and made me slam on the brakes in horror. It was this:
A technician had gone $100,000 into debt after having an emergency preterm birth, because none of the hospital’s employees had benefits or insurance.
It was too recognizable to be a shock, on reflection. This is a known feature of American healthcare, that someone can be ruined financially by a completely unavoidable and indispensable medical need, that a child can arrive with an unpayable bill attached. Why would the hospital staff be immune to that, when they weren’t immune to any of the other things this country does? These people were working for free to try to hold together one piece of a system that would personally destroy them even if it were up and running as it’s meant to run.