Latest news with #Shepherd
Newsweek
2 days ago
- Health
- Newsweek
GOP Budget Threatens Rural Hospitals Across Several States
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. After President Donald Trump's "Big Beautiful Bill" brought in some of the biggest healthcare spending cuts in American history, there has been growing concern about how many rural hospitals, both those already at risk of closure and others, will shut as a result of the financial burden shifted to states and what that will mean for local communities. The major budget bill cuts around $1 trillion from health care spending over the next decade, with the Medicaid program taking the biggest hit. Nearly half of all rural hospitals across the country were already struggling financially before these new cuts were brought in. A Department of Health and Human Services spokesperson told Newsweek: "As mentioned in Dr. Oz's X post, 'The OBBB spends an additional $200 billion more on Medicaid moving forward than is spent this year. The only thing it eliminates is waste, fraud, and abuse.' "HHS remains committed to ensuring that Americans, especially those in rural and underserved communities, can access the care they need, when they need it," the spokesperson added. How Will the Bill Impact Hospitals? As the bill will see the federal match rate reduced for states that expanded Medicaid, as well as broader cuts, those states will be placed in a more difficult financial position— potentially slimming down services or allowing hospitals to close down. While some hospitals may merge with larger hospital systems to "weather the storm," many will look to "cut specific services and departments to save costs," Michael Shepherd, a professor of health management and policy at the University of Michigan, told Newsweek. Shepherd said that for rural hospitals, labor, delivery, and obstetrics are often cut first due to lower birth rates in rural areas, while mental health services and intensive care units could also be stripped back. "Most of the hospitals that will close in the coming years will be hospitals that are already struggling financially," he said. But, the implications on Medicaid threaten to "spread these closures nationwide once again," Shepherd said. "We may observe even higher rates of closures in the coming year." The wide-reaching effect of this could spark "intense focus on opportunities to both pursue greater efficiency and to increase different revenue sources," Elizabeth Merwin, executive director of the Center for Rural Health and Nursing at the University of Texas at Arlington, told Newsweek. It may also increase the percentage of uninsured individuals, which is "a risk for both hospitals and communities," requiring a development of "strategies to generate revenues and opportunities to support this population," she added. Photo-illustration by Newsweek/Getty Where Could Hospitals Be At Risk Of Closure? The hospitals most at risk are in states that already had "the highest percentages of rural hospitals that are open but financially struggling," Shepherd said. These states include Texas, South Carolina, Louisiana, and Kansas. Additionally, rural hospitals in states that are likely to experience the largest reductions in rural Medicaid coverage may struggle, such as Kentucky, North Carolina, Virginia, Illinois, Ohio, Pennsylvania, Michigan, and West Virginia, he added. Rural hospitals that serve a large number of older adults, such as those in Northern New England, also "have an increased risk due to aging populations, higher per-capita reliance on Medicaid, and limited alternative healthcare options," Karen Fortuna, a professor of community and family medicine at the Geisel School of Medicine at Dartmouth, told Newsweek. While Arkansas has not experienced the degree of hospital closures seen in surrounding states, the "fabric of our rural healthcare system is fraying because of increased personnel and supply costs, stagnant reimbursement, lower patient volume due to out-migration and shifts to outpatient care, and antiquated facilities," Arkansas Center for Health Improvement Interim CEO Craig Wilson told Newsweek. "Even minimal healthcare coverage loss in rural areas would push hospitals into critical territory financially," he added. Ultimately, "there is a risk to all hospitals, even those with better financial situations," Merwin said. What Does This Mean For Communities? The closure of more rural hospitals across the country will have a wide-ranging impact on local communities. Communities would lose a point of access to multiple services, "which is not limited to inpatient hospitalizations, since rural hospitals are often the hub for outpatient services, emergency medical services, and even home health," Keith Mueller, a professor of health management and policy at the University of Iowa, told Newsweek. Closures would also result in the loss of jobs, he added, which provide benefits such as health insurance. "Any time an access point for acute care is lost, a community runs the risk of poorer health outcomes due to longer travel times for emergencies and other critical care," Wilson said. Some studies have shown that mortality risk is higher following closures, much of which is due to the increased travel distances required to receive medical attention, Shepherd said. "If you have a stroke or a heart attack, having an additional 45-minute commute can be the difference between survival and death," he added. Other studies have revealed that the loss of hospitals has negative consequences on birth outcomes as well, Shepherd said. The "likely decline" in access to physical and mental health care for vulnerable groups will see more patients "delaying care and accessing care at high-cost facilities such as emergency rooms," which can "drive up the cost of healthcare and lead to worse patient outcomes," Fortuna said. What Options Do States Have? States have a number of options to navigate the difficult path ahead. There is also some help offered in Trump's budget bill, as $50 billion has been allocated over five years to all states for a variety of purposes, including payments to rural facilities. However, these options are not without their complexities. "States can attempt to raise more money within the state to bolster their Medicaid programs," Shepherd said. However, doing so requires raising taxes in "a political environment where that has become difficult to do." He added that some states may consider rescinding Medicaid expansion "to save resources for those below the poverty line or cutting the number of services provided by their state's Medicaid program." But, Shepherd said that "will not help hospital finances and will likely lead to increased 'uncompensated care' costs for the hospitals." "More emphasis needs to be placed on identifying cost-effective care to ensure funds available are optimally used to meet the communities' needs," Merwin said. She said that cost-effectiveness studies offer decision makers "needed information to understand cost in relation to outcomes that can benefit patients and communities." There may also be a push for "telehealth expansion," Fortuna said, meaning patients would have access to digital care if hospital buildings have to close. "The integration of artificial intelligence into health systems may be necessary to optimize scarce resources," she added. Ultimately, "to survive, rural health streams will need to innovate." Some states are already beginning to act in light of the bill's passage. Some are "trying to maximize their federal matching dollars from Medicaid while they still can, bolstering state grant programs for rural health care workforce and facilities, and boosting Medicaid reimbursement rates," Carrie Henning-Smith, co-director of the Rural Health Research Center at the University of Minnesota, told Newsweek. Regardless, though, "states face funding and policy limitations on what they can do to shore up their rural health care infrastructure," she said. "Without federal support and federal solutions, population health outcomes for the entire country may suffer." While states have difficult financial decisions to make, Wilson said, "local communities will also need to engage in some difficult conversations about the extent to which they want to financially support their hospital to keep care local."
IOL News
2 days ago
- Politics
- IOL News
Lilongwe court set to rule on Sheperd Bushiri's extradition case in September
The High Court in Lilongwe will make its decision in the review application by controversial couple Shepherd and Mary Bushiri against their extradition to South Africa in September. Picture: Facebook In September, the High Court in Lilongwe will announce its ruling in the review application brought by controversial couple, Shepherd and Mary Bushiri pertaining to their extradition to South Africa. The self-proclaimed prophet took to Facebook on Thursday to announce that he was awaiting justice. "No matter how long the river may be, it has its end. We're waiting for justice, a fair trial, and safety, which we were deprived of in South Africa due to law enforcement corruption and... several assassination attempts we survived," he said. Bushiri and his wife violated their bail conditions when they fled the country in 2020. They face a string of charges, including rape, fraud and money laundering. In April, Bushiri criticised the National Prosecuting Authority (NPA) decision to sell his private jet, calling it 'not only unjust but also seems to be a clear case of persecution.' 'I am commenting on this matter because it was dismissed in Malawi courts — as the court already made its ruling. The recent announcement by the National Prosecuting Authority (NPA) of South Africa to sell my private jet has left me astonished, given the circumstances surrounding this decision,' Bushiri said in a long statement on Facebook. This follows a ruling by the North Gauteng High Court in Pretoria, which reportedly granted the NPA permission to sell Bushiri's luxury jet, valued at R50 million. The sale is part of an ongoing legal battle tied to an investigation into alleged financial crimes. The court's decision was made after the NPA applied to liquidate the aircraft to recover assets linked to Bushiri's criminal case.
The Irish Sun
3 days ago
- Sport
- The Irish Sun
Winning jockey banned after ‘extremely unusual' incident in controversial finish to Bath race
WINNING jockey Callum Shepherd was banned and demoted after this 'extremely unusual' incident at Bath races. Shepherd and Hector Crouch were battling it out in a thrilling finish to a 1m6f handicap on Monday. Advertisement 2 Callum Shepherd on Captain Brett, against the rail, and Hector Crouch on Iwantmytimewithyou, were involved in a hugely controversial finish 2 Shepherd's arm came off his reins in what the stewards - who later banned him for five days - deemed to be an attempt to 'push away' his rival Going for a gap up the inside, Shepherd looked to be getting the better of his rival on Iwantmytimewithyou. But he was all but helpless to stop Captain Brett shifting to his right and causing a bump to Crouch's mount. In a tight, tough finish, Shepherd is seen taking his right hand off the reins. And it is at this point stewards claimed he 'extended his right arm making contact with Crouch in an apparent attempt to push him away'. Advertisement Stewards immediately moved to reverse the placings and ban Shepherd for five days - a suspension the Racing Post report called 'extremely unusual'. Their report read: "An enquiry was held to consider the placings in this race after interference inside the final furlong when the winner, CAPTAIN BRETT (IRE), ridden by Callum Shepherd interfered with IWANTMYTIMEWITHYOU, placed second, ridden by Hector Crouch. "The Stewards considered that the interference had improved CAPTAIN BRETT (IRE)'s placing as CAPTAIN BRETT (IRE) shifted right-handed making contact with IWANTMYTIMEWITHYOU taking the gelding several horse widths off its intended line. "The Stewards considered that IWANTMYTIMEWITHYOU had drawn level with CAPTAIN BRETT (IRE) and appeared to be finishing strongly at the time of the interference with the ground and momentum lost as a consequence greater than the distance of a head at the line and therefore revised the placings as follows: 1st IWANTMYTIMEWITHYOU, 2nd CAPTAIN BRETT (IRE), 3rd SNEAKY BLINDER (FR), 4th CHERRY COLA. Advertisement Most read in Horse Racing "Shepherd was suspended for five days for improper riding as at the time CAPTAIN BRETT (IRE) shifted right-handed taking IWANTMYTIMEWITHYOU off its intended line, Shepherd extended his right arm making contact with Crouch in an apparent attempt to push him away." FREE BETS - GET THE BEST SIGN UP DEALS AND RACING OFFERS Commercial content notice: Taking one of the offers featured in this article may result in a payment to The Sun. You should be aware brands pay fees to appear in the highest placements on the page. 18+. T&Cs apply. . Remember to gamble responsibly A responsible gambler is someone who: Establishes time and monetary limits before playing Only gambles with money they can afford to lose Never chases their losses Doesn't gamble if they're upset, angry or depressed Gamcare – Gamble Aware – Find our detailed guide on responsible gambling practices here.
Scottish Sun
3 days ago
- Sport
- Scottish Sun
Winning jockey banned after ‘extremely unusual' incident in controversial finish to Bath race
You had to be eagle-eyed to spot it DON'T PUSH IT Winning jockey banned after 'extremely unusual' incident in controversial finish to Bath race Click to share on X/Twitter (Opens in new window) Click to share on Facebook (Opens in new window) WINNING jockey Callum Shepherd was banned and demoted after this 'extremely unusual' incident at Bath races. Shepherd and Hector Crouch were battling it out in a thrilling finish to a 1m6f handicap on Monday. Sign up for Scottish Sun newsletter Sign up 2 Callum Shepherd on Captain Brett, against the rail, and Hector Crouch on Iwantmytimewithyou, were involved in a hugely controversial finish 2 Shepherd's arm came off his reins in what the stewards - who later banned him for five days - deemed to be an attempt to 'push away' his rival Going for a gap up the inside, Shepherd looked to be getting the better of his rival on Iwantmytimewithyou. But he was all but helpless to stop Captain Brett shifting to his right and causing a bump to Crouch's mount. In a tight, tough finish, Shepherd is seen taking his right hand off the reins. And it is at this point stewards claimed he 'extended his right arm making contact with Crouch in an apparent attempt to push him away'. Stewards immediately moved to reverse the placings and ban Shepherd for five days - a suspension the Racing Post report called 'extremely unusual'. Their report read: "An enquiry was held to consider the placings in this race after interference inside the final furlong when the winner, CAPTAIN BRETT (IRE), ridden by Callum Shepherd interfered with IWANTMYTIMEWITHYOU, placed second, ridden by Hector Crouch. "The Stewards considered that the interference had improved CAPTAIN BRETT (IRE)'s placing as CAPTAIN BRETT (IRE) shifted right-handed making contact with IWANTMYTIMEWITHYOU taking the gelding several horse widths off its intended line. "The Stewards considered that IWANTMYTIMEWITHYOU had drawn level with CAPTAIN BRETT (IRE) and appeared to be finishing strongly at the time of the interference with the ground and momentum lost as a consequence greater than the distance of a head at the line and therefore revised the placings as follows: 1st IWANTMYTIMEWITHYOU, 2nd CAPTAIN BRETT (IRE), 3rd SNEAKY BLINDER (FR), 4th CHERRY COLA. "Shepherd was suspended for five days for improper riding as at the time CAPTAIN BRETT (IRE) shifted right-handed taking IWANTMYTIMEWITHYOU off its intended line, Shepherd extended his right arm making contact with Crouch in an apparent attempt to push him away." FREE BETS - GET THE BEST SIGN UP DEALS AND RACING OFFERS Commercial content notice: Taking one of the offers featured in this article may result in a payment to The Sun. You should be aware brands pay fees to appear in the highest placements on the page. 18+. T&Cs apply. Remember to gamble responsibly A responsible gambler is someone who: Establishes time and monetary limits before playing Only gambles with money they can afford to lose Never chases their losses Doesn't gamble if they're upset, angry or depressed Gamcare – Gamble Aware – Find our detailed guide on responsible gambling practices here.
1News
6 days ago
- Climate
- 1News
More slip troubles in Muriwai: 'We need to know how did this happen'
A landslip in Auckland's west coast settlement of Muriwai has residents reliving the devastating landslides of two years ago. Muriwai was hit badly during the 2023 Auckland Anniversary floods and Cyclone Gabrielle, with large slips making some areas unliveable. The community was struck by another slip at the weekend on Motutara Rd. Fire and Emergency evacuated properties in the immediate area after Saturday's slip as a precaution. No one was injured, but the slip restricted the roads into town to one lane, and one resident says it has stirred bad memories. ADVERTISEMENT Longtime Muriwai resident Delwyn Shepherd told RNZ that the storms kept the community on edge. "I think for everyone in the community, whether you were part of the landslide zones one to five, or whether you just live within the community, there is a sense of anticipation, and definitely stress," she said. "I think you relive the event mentally, even though you know that you've moved forward." She wanted Auckland Council to do better with how it used data to warn west coast residents ahead of dangerous weather events. "As a local, I'm really disappointed, because our council is just reactive, they're not being proactive," Shepherd said. "There are plenty of smart people with good knowledge that could stop all these triggering events for people and their well-being." The latest landslip to hit Muriwai. (Source: ADVERTISEMENT Shepherd said the storms left Muriwai with an uncertain future. "There'll be more and more people, probably in the retired age, that no longer want the stress of it, that may end up selling before they intended to sell and move to a place that is not in any sort of landslide, hazard, or flooding zone." Another resident Clare Bradley said the weekend's slip happened on land that was categorised as safe to live on. "I guess the question that is upper-most in most people's minds is - the family who live in this property were thankfully away, but their home is damaged, and is the extent of the damage sufficient to have made it unsafe for them to have been living there?" she asked. "I guess that's a question that the council geo-tech team, and GHD who did the study report, will have to address to allay fears in the community that the rest of us who are living, and working, and spending our time in our category one homes are safe in the event of a future severe weather event." She said there were questions that needed answering. "We need to know how did this happen, was it avoidable, is there anything we should be doing or anything that council should be doing in order to improve stormwater runoff?" ADVERTISEMENT Auckland Council chief engineer Ross Roberts told Midday Report they were continuing their response from the 2023 storms, including moving residents out of worst-affected areas. "Along with that comes other community planning that's going on, and we're looking at what we can do in terms of infrastructure as well, but community planning and ensure that people have the understanding of the hazards and the ability to manage them is really what makes the difference here," he said. Auckland Council said the closed lane on Motutara Rd would reopen when it was determined safe to do so and once geotechnical assessments were completed.
