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Viewpoint: Hospitals need 340B more than ever

By Michael D. Shaw

Hospitals are essential for the people they serve. Nowhere is that more relevant than among North Dakota's rural hospitals, which have limited resources, poor staff retention, recruitment problems, and insufficient Medicare and Medicaid reimbursement rates.

These hospitals need Congressman Kevin Cramer's support, since he is a member of the

House Energy and Commerce Committee, which can save these hospitals from closing.

These hospitals confront an existential crisis, where 47 such institutions in North Dakota

can barely survive to help the communities they represent. These same hospitals depend

on the 340B drug pricing program, which provides uninsured and low-income patients with discounted medications.

Without the 340B program, whereby drug companies have (as a result of this action) a guaranteed pipeline to millions of consumers for their products, rural hospitals cannot continue to give patients medications at an affordable price.

It is unacceptable for these drug companies to profit so much, while they attempt to eliminate a program that helps so many for so comparatively few dollars. Faced with an unhealthy, aging and uninsured population, too, living in a rural area now constitutes a health risk.

340B is, therefore, vital to almost 60 million Americans who live in rural areas or struggle to find acceptable care. (The program has an insignificant effect on the pharmaceutical industry, given the subsidies the government provides.)

That means 340B is as much a lifesaving resource for rural hospitals as it is a source for dispensing life-saving medication to patients. Bear in mind, too, that rural hospitals do everything — everything — to help the least among us, including offering transportation to ensure people receive care.

That trip is worthless without 340B, because the little money these residents have is just enough to pay for the medication they need to be or stay healthy. The pharmacies that participate in this program recognize this fact, which is why they seek to help these hospitals. To abandon 340B is to, then, abandon millions of our bravest Americans.

According to the Department of Veterans Affairs, 5.2 million veterans live in rural areas, where more than half of them receive health care through the VA. Among these rural citizens, up to 435,000 of these men and women are veterans of deployments to Iraq or Afghanistan. And 54 percent of rural veterans earn less than $36,000 per year.

We must not burden these hospitals with another challenge, since rural areas have a higher rate (by 9 percent) of diabetes and much greater risk (by 39 percent) of heart disease than non-rural communities. Even worse, according to the Centers for Disease Control and Prevention (CDC), is that the rate of death from opioid-related overdoses is 45 percent higher within these underserved parts of the country.

From a shortage of doctors to physical isolation between the facilities they run and the people they serve, rural hospitals fight a daily battle to keep themselves alive so they keep their patients alive.

And yet, rural hospitals continue to close. With 80 such hospitals no longer in business, and 40 percent operating in the red, 340B is the only thing preventing more hospitals from locking their doors and ceasing to serve their respective communities.

Too many jobs are on the line, and too many towns are on the brink of fiscal collapse and too many people are on the precipice of physical catastrophe, for 340B to end. This program makes sense because it saves us considerably more dollars and cents.

We need this program, now more than ever.

Michael D. Shaw is a columnist and biochemist.

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