More Free Market Failure – In Healthcare – In the Tea Party Stronghold of Sanders County Montana

by jhwygirl

Caught this one last week, the day after I pondered whether the free-market Tea Party-controlled Ravalli County Board of County Commissioners would subsidize Denny Washington’s MRL rail line into the Bitterroot.

Which they did.

And it’s not that I thought it was the wrong thing to do – the point of that musing was that when it comes down to brass tacks, the government has a role in jobs – and it isn’t always “cut taxes, cut taxes, cut taxes.”

Which hasn’t worked, yet they still beat that drum. Honestly, I think the real agenda is to dismantle government.

But I digress….

Up in the community of Noxon, Sander’s County residents are decrying the closing of the Bull River Family Medicine Clinic that is operated by the Clark Valley Hospital (located in Plains.)

The clinic serves the small communities of Noxon, Heron and Trout Creek.

The Clark Valley Hospital has operated the Bull River Family Medical Clinic at a deficit of $76K a year for the last two years.

Community members are upset with the Clark Valley Hospital for their decision, saying that “We’re the poorest part of the county, and the farthest away from the hospital. You should be doing more here.”

It’s an hour drive for residents of Noxon to the Clark Valley Hospital – and about an hour and a half drive for the residents of Heron. So this is a pretty big deal, and if I lived up there, I’d be upset with this decision.

Nor am I sitting here in Missoula, a hub of medical accessibility for easily a couple hundred thousand people, finding some sort of enjoyment out of this situation…me, someone having supported (the horror!) healthcare reform.

But it is fair to point out that Sanders County is a Republican stronghold, and a Tea Party hotbed of activity. Republicans who will continue to attack healthcare reform with every single ALEC-written law that they can put through the next session (and you can darn well bet they’ll be going after birth control, too.)

Republicans who sponsored – and passed on a party-line vote [CORRECTION: John Brenden SD18, John Esp HD61, Krayton Kerns HD58, Steve Gibson HD78 all voted “NO” to this bill. Thanks to the person who pointed this out.] – a bill that puts a referendum forward that, if passed on the ballot this fall, will somehow prohibit the health insurance purchase requirement of the federal health care reform bill.

The Bull River Clinic’s problem, it appears, is that it doesn’t have enough patients. The people in that community are going outside of their community for healthcare, while another clinic in Hot Springs – which serves the same size of population – has 3 times as many patients.

Use it or lose it, I guess. Market rules.

So the poor people or the senior citizens that don’t like to drive a hour or more to Plains or Sandpoint Idaho to see a doctor are basically shit out of luck when it comes to healthcare, because the young and those with money are able to drive for theirs.

What’s 220 miles of gasoline cost for a F-250 pickup these days?

It’s only healthcare. Having a baby? A heart attack? Take the drive, or tough it out on your own.

I sincerely hope the residents up there find a solution that allows the Clark Valley Hospital to keep that clinic open. I have no doubt there are residents up there that need those vital services.

One has to wonder how many good paying jobs will be leaving Noxon should that clinic close, too.

Hopefully the community members up there consider the implications of their vote this November. Will they elect a legislator that will support laws that ensure and enhance availability of basic services like healthcare?

Or will they vote for someone who will throw their rural constituents to the Free Market?

  1. Chuck

    Good post. Maybe we could call the Guv and ask him to help keep this clinic open before building a new clinic in Helena for state employees. My guess is that the state employees in Helena are already adequately served.

    • So Chuck? You’re advocating for the state to subsidize healthcare in Sanders County?

      Wow. Good for you. That was brave, considering your background.



      • Chuck

        What background? I am an advocate for the whole ball of wax, a government owned and operated health care system for all. That’s one reason I can’t stand Baucus.

  2. Swede Johansson

    What did Mittens just say?

    “If you’re looking for free stuff, vote for the other guy”.

  3. Swede Johansson

    Damn, just came out with the Utube.

    • Steve W

      You know, I’ve been pulling for Newt since before his 1st meltdown. A whole coed football team of candidates has come and gone since but he’s still here. Bowed but not broken. Bent and rusted but still not so trusted.

      I suppose it’s my loyalty that won’t let me quit him. I never was distracted by that shiny Michelle and nor was I waylaid by the Pizza mogul. It was Newt and it’s still Newt, for me.

      Cause I just can’t quit him.

      Who are you backing, Swede? Still solid with Newt? Did you get him on the ballot here in MT?

      And Mittens is the guy giving away all the yard signs and the bumper stickers. Well, him and Ron Paul. Newt and Santorum can’t afford to give away free stuff since they don’t have a lot of financial backers.

      One thing is certain, if gas were $2.50 a gallon, Newt could afford to do more campaigning and even more people might not like him, once they got to know him.

      • Swede Johansson


        This trial by fire has been good for Mitt. Basically been tractionless, but when he’s forced to go “tea party” on some plant he gains more respect.

        Maybe that’s good. If we’re stuck with him I just hope he doesn’t forget the ones who got him there.

        *anybody but Obama.

        • Steve W


          Stuck with the architect of the Obama healthcare initiative? Romney Care came first, Obama Care came second, what’s 3rd?

          Standing by your man is tough work.

          It’s easier to just close your eyes and open your mouth wide and swallow.

          *Someone Like Obama

  4. Zero Tolerance

    I fail to see how a clinic that has no business, and subsequently closes, represents a “free market failure.” By definition, in a free market, businesses grow and prosper or shrink and die according to their usefulness to the public. Apparently, in this case, the public found no use for the clinic.

    Anyway, after reading your post twice, I was unable to find any constitutional basis requiring the government to provide free or subsidized healthcare. So this must be some kind of moral issue with you, correct?

    — Max Bucks

    • JC

      Maybe you should learn how to read the Constitution, then. The Taxing and Spending Clause surely allows the government to provide subsidized health services.

      Of course, you’re probably one of the people that want the Supreme Court to not only decide against the ACA in the upcoming weeks and kill it, but want it to declare Medicaid unconstitutional.

      I think that most compassionate people in our society are coming to believe that health care is not best served by a
      “free market system” that operates based solely on profit and utility.

      And your understanding about the public’s use for the clinic is based on ignorance. Many of the local people use and want the clinic to stay. Your statement: “the public found no use” is a gross exaggeration and oversimplification of the issue. There are many solutions to help the clinic continue to provide services. Of course, those of you with a frontier mentality would be happier with a lay doctor who would take chickens as barter for an elixir than a health care system that served people first.

      Health care in your world would best be served via WalMart, and associated models of “free market healthcare.” Fortunately, you are in a distinct and very small minority.

      • Zero Tolerance

        I see you have recovered from your last beating rather quickly. What did the medicine man charge you? Or do heap big braves get free treatment?

        Anyway, you make a lot of assumptions, enough to gag a horse, in fact. I will not bother to address them. I will only point out that:

        1. The fact that Congress has the power to collect money and spend it is not the same as “requiring the government to provide free or subsidized healthcare,” to quote myself. The government may choose to spend the people’s money however it thinks necessary. But there is no constitutional mandate for the government to provide free or subsidized healthcare.

        2. “[C]ompassionate people,” to use your phrase, are free to make their own choices as to how they spend their own money. However, when they attempt to make choices about how to spend other people’s money, via a government transfer, then the people must decide. If they vote down free or subsidized healthcare, then you, compassionate fellow that you are, will just have to live with. Or you can stop trying to pick people’s pockets to pay for your compassion and write a check on your own account.

        — Max Bucks

        • JC

          If things that don’t require a congressional constitutional mandate become “moral issues” for you, then good luck with your proselytizing. It will get you no where with the majority of americans who believe the government should, and does, provide safety net services, and subsidize services in outlying rural areas. Ever hear of rural electrification? Incentives for doctors and other health care professional to practice in underserved communities and rural areas?

          An America built on your moral foundation is not one that most people would choose to live in.

          And about assumptions–you make more than your own share to be dissin’ me on them. And racist remarks? Yours speak loud and clear in english.

          And government transfers? Why don’t you divulge all the ones you get before you bitch about others’. Your “I got mine and the rest of you suck” mentality is really transparent here.

          • Zero Tolerance

            I said constitutional mandate, not “congressional mandate.” I hope the distinction does not escape you, otherwise, what follows will go over your head, also.

            There is no fundamental right to healthcare in America. Repeat that several times, then continue reading.

            Free or subsidized government healthcare is nothing more than a wealth transfer from the productive element in society to the unproductive element. It is a specific type of welfare, similar to Food Stamps being given to people who are not starving so that they can use the money they saved to buy other things. No doubt, more people would take nicer vacations, have platinum-level cable TV service, and eat out more often if they did not have to fork over their own cash to pay their medical bills. But every grownup knows he has only so much money to spend at any given moment, and some things must take precedence over other things.

            As for your revolutionary hogwash, I find it rather ludicrous to imagine a mob attacking anyone over a lack of free or subsidized healthcare. I mean, according to you, they would be sick and dying already. That is not exactly fighting shape.

            — Max Bucks

            • JC

              I don’t have a problem with wealth transfer from the rich to the poor for health care. What I have is a problem with wealth transfer from the poor to the rich in order to feed their addiction to money and power.

              I heard it said tonight that it is only a class war when the have nots fight back. I believe that the rich have been waging a class war on the unrich for a very long time, and it will soon come to an end.

      • Swede Johansson

        You siting the Q poll just released JC?

        Here’s the question. “The poll asked respondents to choose between one of two statements:

        A) Medicare should remain as it is today, with a defined set of benefits for seniors. OR B) Medicare should be changed so that seniors who join Medicare in 2022 receive a fixed amount of money from the government each year that they can use to shop for their own private health insurance policy”

        Which seems fair enough, except maybe they should have stated in option “A” that if it remains It’ll go broke, presumedly before 2022.

        So, if you want to be covered by MC for a few more years stick your head in the sand and vote status quo.

        • JC

          Who was talking about Medicare? I was referencing the SCOTUS hearings on the ACA provisions on Medicaid. SCOTUS could scuttle Medicaid with one fell swoop after it hears arguments next week. Which, while many conservatives would applaud, it would take essential medical services away from 50 million people, and empty nursing homes of millions of elderly who depend on the program to provide housing.

          Adding 50 million people to the uninsured rolls would double the uninsured rate in America to around 30% All of whom’s emergency medical costs get shuffled onto the insured and those with enough money to pay cash. And the social costs of another 50 million people going untreated–mostly young mothers with children already in poverty, and poor elderly–would be staggering.

          You guys ready for that scenario? Because if you are, you might want to start building some gates around your favorite health care clinics before they get overran by the downtrodden.

          Anything you guys can do to hasten the revolution, just keep on beatin’ that free market drum, because when things get bad enough, there won’t be enough military-industrial-security police state complex to protect the haves from the haves-in-waiting. The illusion of the possibility of success for free market capitalism–particularly in the realm of health care– will be the downfall of america.

        • Zero Tolerance

          The best solution is to give everyone their Medicare money back (with a 4% ROI), and let them pay for their own healthcare needs.

          Of course, you would have to get the government out of the healthcare business first, since it is the government’s interference in the system that is causing healthcare costs to skyrocket. (The government did the same thing to house prices and college costs, but that is another topic.)

          — Max Bucks

          • JC

            What you going to do with all the little old ladies with no families who get shuffled out to the curb when their Medicare + 4% ROI runs out?

            Bring on the death panels.

            • Zero Tolerance

              What did we do with the “little old ladies” in the nearly 200 years before Medicare?

              — Max Bucks

              PS: When you read about someone dying on the hospital steps for lack of money, let us know.

              • JC

                So your solution is for people to beg for free services from hospitals, which will just raise your rates and charge you & I more to provide it.

                Gotta love that free market philosophy. You guys have really got it all figured out.

    • Let’s try it this way ZT – when a bunch of Tea Party conservatives whine to the free market that “We’re begging you, on two knees, to rethink your attitudes toward us,” and “We’re the poorest part of the county, and the farthest away from the hospital. You should be doing more here,” THAT is a free market failure.

      How is healthcare not a moral issue, Max? I mean, really? A doctor standing in a room watching a person die of a heart attack – is that not a moral issue?

      • Zero Tolerance

        What you are talking about is not a “free market failure,” as I have already adequately explained. Rather, you are just ridiculing some locals for their hypocrisy. And that is fine with me. I do it here all the time.

        As for the moral aspects of providing healthcare, I do not see it as a moral issue. I see healthcare the same as any other service, i.e., I approach the subject pragmatically. And if I were to meet someone like you, who claimed there was a moral issue involved, I guess the first question I would ask is, “What is the basis of your morality?”

        — Max Bucks

        PS: Your doctor example is not very good, because doctors have pledged themselves to heal the sick as part of their admission into the medical profession. A doctor is not under a moral obligation to help a heart attack victim but rather under a professional obligation to help. This is no different from a off-duty police officer seeing a crime being committed. He will act to stop the crime because he has sworn to do so.

        • JC

          Professional obligation, moral obligation, whatever. You’re ready to take advantage of either, and for the rest of us to pay the cost.

          You’re just a selfish SOB.

          • Zero Tolerance

            Oh, I see. This is a sharing thing, like in kindergarten, right?

            Grow up, dude. Get a handle on real life. When a government forces people to pay other people’s bills, that is not “sharing.”

            — Max Bucks

            • JC

              I’m not talking about the government forcing anybody to do anything. It is you that are forcing the costs of uncompensated health care onto hospitals and doctors.

              Take a little responsibility for your ideology for once. Man up and acknowledge your only solution for health care for those who can’t afford, or who are denied health insurance is to shift costs onto providers, who then will redistribute them to those who can pay.

              NO matter how you look at it, your plan is redistribution. Except that in your case it’s redistribution forced by private corporations.

              • Zero Tolerance

                Not at all. In my system, which is the same system that existed for 200 years before the government started meddling in the healthcare system, doctors and hospitals are free to treat whomever they please and charge whatever they want. And if they screw up by charging too much or delivering bad service, they can go out of business just like any other business.

                I am not forcing anything on anyone. That’s your trip.

                — Max Bucks

              • JC

                And for the rest there are leeches, bloodletting, and opium elixers.

                Go back to your frontier mentality and live in the dark ages. Doesn’t work in the 21st century.

        • A doctor IS under a moral obligation to help a heart attack victim.

          YOU are under a moral obligation to help a heart attack victim if you have the ability to help.

          • Zero Tolerance

            OK, lady, what is the basis of this moral obligation you proclaim? Where is this morality written or taught? Who subscribes to it? And what happens if your moral law is violated?

            — Max Bucks

  5. Zero Tolerance

    [This is a reply to JC, directly above. Sorry if it is misplaced.]

    People can beg for whatever they please. All they need is a piece of cardboard and a crayon.

    “Please help. Desperately need season ski pass.”

    So what is your point? A doctor or hospital gets stiffed on a bill and then spreads the loss around to paying customers? How long do you think that doctor or hospital will stay in business?

    Your solution is to create a permanent loss in the whole system that will be spread around to people who do not even use the system.

    As for the free market philosophy you seem to condemn, one thing you should always keep in mind: It made America rich. Without it, we would not even be discussing the possibility of wealth transfers or free healthcare, because we would not have a pot to piss in.

    — Max Bucks

    • Steve W

      Stealing land and resources made America rich, ZT. You don’t think anyone paid market value for it do you?

    • JC

      So your plan for those who can’t afford health care, who can’t get health insurance because of preexisting conditions, and are too old to be insured or pay the cost is to just die.

      Alan Grayson was right. You guys worship the death panel:

      “Don’t get sick, and if you do get sick, die quickly.”

      • Zero Tolerance

        As I said before, you assume enough to gag a horse.

        Your proclivity for putting words in other people’s mouths is so ridiculous, you might as well be talking to yourself.

        — Max Bucks

        • JC

          Just because you can’t articulate a rational health care system doesn’t mean I’m not going to pin the tail on your donkey.

          You are so consumed with your ideology you don’t have a whit of compassion for your fellow citizens.

          • Zero Tolerance

            Oh, there we go with that “compassion” thing again. And you are criticizing me for not articulating a “rational health care system”?

            — Max Bucks

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