The crisis gripping the health care system in the US is intensifying, with unprecedented numbers of hospital closures on the horizon and new mass layoffs among health care workers. As the world enters the fourth year of the pandemic, and the mass infection policies of the Biden administration and governments around the world continue to ensure the pummeling of health systems, hospitals are also being flooded with children and adults suffering from respiratory illnesses such as respiratory syncytial virus (RSV) and influenza.

In the US alone, by official counts 1.14 million Americans have died from COVID-19, with 20,000 deaths occurring since the start of the new year. A staggering 450 people are dying each day, according to the current seven-day average. Despite President Biden declaring the pandemic over, those infected with the coronavirus are still presenting in hospitals. 

The US health care system is reaching its breaking point, exacerbated by hospital understaffing, particularly among nurses. When one hospital closes, the impact on an entire region is immense. The current rate of hospital closures and layoffs exposes a system organized on the basis of profit, and which lacks any significant planning to provide high quality medical care. 

A recent report in Becker’s Hospital Review noted a vast array of “workforce reduction efforts or job eliminations that were announced within the past three months and/or take effect over the next month,” within health systems. The list includes: 

• Oklahoma University (OU) Health, a teaching hospital in Oklahoma City, which is eliminating “about 100 positions as part of an organizational redesign.”  

• Integris Health, another Oklahoma City-based health system, is “eliminating 200 jobs to curb expenses.”
• ProMedica in Toledo, Ohio, plans to lay off 262 employees, to take effect between March 10 and April 1. 
• On November 11, St. Vincent Charity Medical Center in Cleveland, Ohio, closed its emergency room and inpatient care services, laying off nearly a thousand workers. 
• Memorial Sloan Kettering Cancer Center is laying off 337 employees across 14 sites in New York City, or about 1.8 percent of the cancer center’s 22,500 workforce.
• Pikeville Medical Center in Kentucky laid off 112 employees at the end 2022. 
• Desert Springs Hospital Medical Center in Las Vegas is notifying its workers of upcoming layoffs with its transition to a freestanding emergency department, which will affect 970 employees.
• Kaweah Health in Visalia, California, aims to eliminate 94 positions after lowering its workforce by 106. 

In addition to mass layoffs across the industry, high-level hospital closures are on the horizon with hundreds of jobs at risk. 

A staggering 631 rural hospitals are at risk of closure, with more than 200 hospitals at immediate risk, according to the Center for Healthcare Quality and Payment Reform. Six states are facing the shutdown of at least half of their rural hospitals.

In rural Alabama, 48 percent of hospitals are at risk of closing, with 16 percent in immediate danger. Urban hospitals have been overwhelmed consistently throughout the pandemic due to chronic understaffing. Frank Thomas, CEO at Citizens Baptist Medical Center in Talladega, told the Birmingham Business Journal, “Another problem that has really been difficult through COVID and even as we’re coming out of COVID is the rural hospitals’ ability to transfer patients to a higher level of care in urban markets … When a rural hospital gets a sick patient who maybe needs a higher level of care that the hospital can’t provide, they need to transfer to that higher level of care. And it has just been very difficult for rural hospitals to transfer patients because the urban hospitals are full or either they’re suffering from staffing shortages.”

While rural hospitals are closing at faster rates, urban hospitals are not immune to the closures. Last November, Atlanta Medical Center (AMC), in Atlanta, Georgia, closed, leaving tens of thousands of patients deprived of health care and laying off hundreds of employees. These events, which result in a decline in available health care despite very high demand, illustrate the eroding health care infrastructure in the US.

The impact on surrounding hospitals in Atlanta has been devastating, with the closure of AMC leaving a city with half a million people with access to only one level one trauma center, at Grady Memorial Hospital. Since the closure, there has been a 20 percent increase in trauma patients at Grady, and a 40 percent rise in obstetrics and NICU care, according to Chief Health Policy Officer Ryan Loke. Just three days after the AMC closure, the impact on surrounding hospitals was so immense that the emergency room at Wellstar Atlanta Medical Center was forced to close due to rerouted patients. Severe overcrowding was also reported in the emergency room at Piedmont Atlanta Hospital. 

In Washington D.C. in 2019, one year before the pandemic, the city council voted in favor of plans to close United Medical Center in January 2023. Arnel Jean-Pierre, a nurse who was working at the hospital told the Talk Poverty web site, “The end result is a lot of people are going to suffer.” UMC is the last hospital in nation’s capital not located in the northwest quadrant, the city’s wealthiest section. Jean-Pierre said, “They’re paying taxes just like the folks in Georgetown, [wealthy DC neighborhood]. Why should they have the delay in health care when they face a stroke?” While UMC remains open for the time being, it is unclear when it will shutter its doors. 

Although these trends increased under the pandemic, they are nothing new. According to Fierce Healthcare, the nonprofit Chartis Group, health consultants in Boston, “found that over the past 13 years, 143 facilities have closed and another 453 are vulnerable to shutting their doors.” 

These mass layoffs and closures could not come at a worse time, with potentially deadly long wait times at ERs across North America. Health Services Research journal examined 5 million discharge records from California between October 2015 and the end of 2017 and found a 5.4 percent increase in the chance of death from any cause when a hospital’s emergency room is overcrowded. 

These conditions are connected to the nationwide nursing shortage, with a report from McKinsey & Company last year predicting a shortfall of up to 450,000 registered nurses in the US by 2025.

While health systems in the US and Europe struggle with closures and layoffs, governments are pouring billions of dollars into the NATO proxy war in Ukraine. This past week in the UK, tens of thousands of nurses, EMTs and first responders struck against attacks on the National Health Service (NHS) and for safe staffing.

In the US, the assault on health care workers’ conditions and patient care takes place as for-profit and “non-profit” hospitals alike continue to rake in astronomical profits and pay their CEOs exorbitant salaries. The transformational change necessary requires that health care workers unite internationally to put an end to the for-profit delivery of health as part of the broader fight for socialism.

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