Beware Republican Legislators and Candidates Who Want To Close Montana’s Rural Hospitals

doctor examining a baby
doctor examining a baby in a hospital

For all their talk about supporting the “Montana way of life” and our small towns, Montana Republicans are awfully willing to undermine the economic viability of those towns and the health of the people who live in them.

Even though the evidence is clear that Medicaid expansion has saved rural hospitals in Montana and across the country, some Republicans want to tear down the program, not just because they oppose an Obama success story, but because they don’t believe that people in our small towns deserve access to decent health care in their communities.

Consider the responses to this post by Senator Bruce Tutvedt, who shared an article noting that almost 3/4 of the rural hospitals that have closed in recent years closed in states that did not expand their Medicaid services.

That’s former legislator, current legislative candidate for House District 26, and dedicated opponent of first responders Jeremy Trebas opining that rural hospitals “should be closed.”

That’s Representative Greg Devries, who believes we should shutter public schools and let parents put their children to full-time work on farms, opining that there is no right to a local hospital and suggesting, it seems, that times were better when settlers headed West and Pa would die of dysentery before you hit Oregon.

It’s perhaps unsurprising that Trebas and DeVries oppose health care access for their fellow Montanans. After all,  what can you expect from a legislator who voted against healthcare for firefighters who developed cancer in the line of duty and one who was admonished by the House twice, once for trivializing the genocide against American Indian peoples in the state?

Why their comments matter, though, is that Trebas and DeVries simply lack the guile to mask their intentions. Far too many Montana Republicans in the Legislature will rail against Medicaid Expansion from one side of their mouth while claiming to defend rural medical facilities from the other.

We should be thankful for candidates like these two: they’re expressing the real agenda of Montana Republicans, which is to ensure that people in our small communities can no longer seek medical attention when they need it.

The next time a Republican candidate says he’ll overturn the Medicaid expansion that has helped Montana so much, remember these two and their comments. While most political candidates can better manage their rhetoric, the simple truth is that electing a Republican legislature and governor will mean the death of far too many of Montana’s rural hospitals, Montana’s communities, and Montana’s people.

If you appreciate an independent voice holding Montana politicians accountable and informing voters, and you can throw a few dollars a month our way, we would certainly appreciate it.

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About the author

Don Pogreba

Don Pogreba has been writing about Montana politics since 2005 and teaching high school English since 2000. He's a former debate coach, and loyal, if often sad, fan of the San Diego Padres and Portland Timbers. He spends far too many hours of his life working at school and on his small business, Big Sky Debate.
His work has appeared in Politico and Rewire.
In the past few years, travel has become a priority, whether it's a road trip to some little town in Montana or a museum of culture in Ísafjörður, Iceland.


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  • Commie that I remain after 77 years, I don’t think DeVries and Treba’s (nor Daines or Gianforte’s) viciousness is typical of MT Republicans. But your framing and theirs as “No Rural Hospitals vs Rural Hospitals” misses advances in communications, medicine, and transportation completely. MT has (real-time) telemetry to connect any patient with any medical provider. MT has sophisticated specialty providers in its major medical centers 24/7 (impossibly expensive in rural hospitals). MT medicine, with specialty diagnostic nursing and PAs can triage (and act on) most problems quickly, and 24/7 air transportation, and good roads have changed things. No more data communications isolation, mud roads and daylight only flying.
    More and more, small, “local” hospitals are becoming an expensive cameos. Invest instead in local 24/7 triage and ICU (stabilization) centers: restore ventilation, stop the bleeding, treat the shock, and get the person to comprehensive care facilities quickly. This was learned 55-60 years ago in Viet Nam.

    • The majority of Republican legislators definitely voted against the Medicaid expansion that keeps these hospitals alive, though. That’s why I appreciate Trebas and DeVries telling the truth.

    • Mr Donnes – You are correct that there have been many impressive advances in communication, telemetry, and training for rural medical facilities and personnel. I believe, though, that I would prefer my first-level treatment to take place in a well-lighted, well-equipped hospital, staffed by competent, trained professionals; rather than in a moving vehicle, on poorly-maintained roads, by minimally-equipped, minimally-trained volunteer EMTs.

      What we learned in Viet Nam (and Korea before that) was that emergency triage and stabilization were indeed better than a hasty field bandage and cries of “Medic!!” But thousands of GIs still died under fire who would have survived if there were proper facilities available. You emphasized, “…and get the person to comprehensive care facilities quickly.” ‘Quickly’ is a relative term, and certainly a local, rural hospital is more quickly arrived at than one that, even by air, is hours away.

      Plus, the exorbitant cost of medical transport by air is currently a hot-button issue, and the same voices that bemoan the “wastefulness” of rural medical facilities are the loudest when it comes to sticking patients and victims with those charges.

      Medicaid expansion has proven itself to be a far better and more economical addition to the structure of treatment in Montana than any other proposed alternative. It would seem to be simple common sense to affirm and incorporate those advances, and look then to other improvements in results and sustainability that might be feasible.

  • Granite County(GC) has a “rural hospital” in name only. Nothing but a “nursing home” that’s lost it’s nursing home statice so no nursing home rules or inspections apply. The district “trustees” all supported Medicaid Expansion. Nice con for “swing bed” billing. No one opts to go to the “hospital”. Even part of the county legally withdrew from the district and another area considering it. Sometimes the emergency doors are locked and no one but the Sheriff’s Dept responds to 911 medical assistance calls. If they do respond, you’re either carted by ambulance or airlifted to another hospital that HAS full service. And the GC “rural” hospital gets its chunk of the billed amount. Oh but we do have a new used CAT Scanner and its own new suite. So I guess all the “swing bed” long term patients and any ER patients will be CAT scanned to pay so the cost for it and all the personel needed to run & read the results will be covered. All thanks to govt involvement in our health care, which IS NONE OF IT’S BUSINESS to begin with. What a racket!

  • The local Republicans here in Ravalli County that voted to expand Medicaid specifically to keep the doors of the rural hospitals open are now being viciously attacked by establishment Republicans and their central committee for being RINO’s. No good deed goes unpunished.

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