“When I was a kid, everybody had a job, everybody had health care. Now, look at the statistics,” said McMullin, one of the rafters.

There are other hospitals in the region.


Uniontown, about 15 miles away, is also in Fayette County. It has 175 beds — more than double Highlands — but no behavioral health services to treat problems like addiction. Frick, another small rural hospital about 12 miles away, technically serves neighboring Westmoreland County. For more serious conditions, and trauma care, university hospitals are about an hour away — in Pittsburgh on one end, and Morgantown, West Virginia, on the other. Patients in extremis often get stabilized at the local hospitals before transfer.

But rain and snow, combined with mountainous terrain and limited public transit, mean traveling even short distances poses hardship. “It is still challenging to have to travel even 20 miles to get your care,” said Lisa Davis, director of Pennsylvania’s Office of Rural Health, and outreach associate professor of health policy and administration at Pennsylvania State University. “It could take you all day to get to a one-hour appointment.”

In a medical emergency, getting care quickly can mean the difference between life and death

So far, the incoming Trump administration hasn’t released its health plan to replace Obamacare. But, experts say, it is likely to give the states less federal money for treating the poor. It is unclear how rural hospitals will compensate for the financial benefits they are likely to lose — or how many more rural hospitals will fall.

“What they need to do is be sure to protect the government programs: Medicare and Medical Assistance,” Andursky said. “We can’t put them at risk.”

Kaiser Health News is a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Their Repeal and Replace blog is on Twitter @Repeal_Replace.

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