Last updated on September 26, 2025
They say health care is a policy problem. To millions of rural Americans, it is a matter of life and death. Our system lets hospitals collapse, patients suffer, and families go bankrupt while corporate insurers and pharmaceutical giants profit. We need a solution, and perhaps Medicare for All can help.
Rural hospitals are closing at an alarming rate. Since 2010, more than 120 have shut their doors, and hundreds more are at risk. Nearly forty percent of those that remain are losing money because patients show up uninsured or unable to pay. They provide care without reimbursement and bleed resources until they can no longer survive.
Medicaid expansion helped some hospitals. Studies show that hospitals in states that expanded Medicaid were less likely to close because fewer patients lacked coverage. But expansion is a patchwork fix. It only helps some people, in some states, under certain rules. Medicare for All removes those limits altogether. When everyone is covered, rural hospitals are freed from the crushing burden of uncompensated care. They can hire staff, keep emergency rooms open, and continue serving their communities.
The second change is just as important. Administrative waste eats away at time and money. Doctors report spending more hours on paperwork than with patients. Rural hospitals spend precious resources managing dozens of insurers, billing codes, and private networks. Under Medicare for All, one system would set rates and handle billing. Analysts estimate $600 billion in annual administrative savings, along with another $200 to $300 billion from lower drug costs. That is money that can stay in hospitals, communities, and patient care.
The opioid epidemic shows what those savings could mean. More than 45,000 Americans die from opioid overdoses in a single year. Effective treatments exist. Naltrexone reduces relapse rates far more than other medications. But the cost is staggering. A six month course is priced around $12,000, far out of reach for most families. With Medicare for All, prices could drop by 80 percent. Treatment would become affordable, and thousands of lives could be saved each year.
Addiction also undermines communities and work. Economists estimate that opioids account for one fifth of the decline in workforce participation. Drug use is significantly higher among the unemployed, creating a cycle of despair. Every one point rise in unemployment correlates with 40,000 additional deaths. If affordable treatment helped even a fraction of the millions struggling with addiction return to work, the benefits would be massive.
Medicare for All is not perfect. It will require political will and discipline. But with hospitals on life support and the opioid crisis still devastating families, timidity is a bad move. If America believes in fairness and dignity, then it must commit to universal care. Health is not a privilege. It is a right. No community, however rural or remote, should be abandoned.
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