Archived Opinion

‘Born in Franklin’ may never be heard again

‘Born in Franklin’ may never be heard again

At some point in the future, here’s something you might never hear again: “I was born in Franklin.”

Look no further than this Macon County town if you want stare right in the face of the agonizing state of the health care crisis in this country. Due strictly to bottom-line concerns, officials who run Angel Medical Center say come July the hospital will no longer deliver babies. Too expensive, too much of a losing proposition.

It doesn’t matter how you feel about Obamacare or some other as-of-yet unreleased GOP plan, but the truth is that too many Americans are getting a raw deal when it comes to health care. I mean think about that: delivering babies is a losing proposition for a hospital. 

Normal business practices are not relevant in our health care system. One would think that if you provide a young family with a life-affirming, positive experience having children, you would have just earned lifelong customers who would seek your services again and again and again when other ailments came along. Send this family to another community to deliver, and, well, you might not get that family back in your health care system.

What’s surprising in this decision is that Franklin is not some little hick town in the hinterlands. Yes, it is a small, rural community, but it is in decent economic shape. It’s burgeoning downtown features many successful entrepreneurs, it has the software and retail giant Drake Enterprises that provides about 800 jobs, and its nearness to metro Atlanta and to many outdoor treasures makes it a hotspot for travel and tourists. Like much of Western North Carolina, it has a fascinating and vibrant mix of long-time local families and transplants.

But that doesn’t matter when it comes to the one sector of our economy that defies most normal business truths. Health care isn’t completely private, isn’t completely government-run, and isn’t funded completely by health insurances companies. 

Related Items

Here’s what Mission CEO Ron Paulus said at a news conference:

“We are very sorry that we cannot keep this program open. We looked at every possibility that we could conceive of … we just couldn’t find a way.”

Paulus blamed changes to the Affordable Care Act, cuts to Medicaid and Medicare, and the North Carolina General Assembly’s refusal to expand government subsidized health care for the poor for Mission being $34 million behind in its revenue projections for this year.

State leaders certainly played a role in what is playing out in Franklin. Their refusal to expand Medicaid — which is government subsidized health care for the very poor  — because of its association with the Affordable Care Act is totally the work of the GOP-led General Assembly and former Gov. Pat McCrory. Thirty-one states have expanded Medicaid, and they are getting our tax dollars. Though North Carolina is now supposedly considering the expansion, in some cases — like at Angel Medical Center — the damage is already done.

That refusal cost the state billions of dollars in federal money and left many working poor in a coverage gap — making too much money (around $20,000) to get tax credits to buy insurance and not poor enough to qualify under Medicaid rules. So when they go to hospitals, hospitals don’t get paid. Hospitals lose money. Like at Angel. And so they have to cut services, like delivering babies. 

State leaders, here is where you can take a bow and acknowledge your role in what is happening in Franklin.

At Angel Medical Center in Franklin — which Mission owns — 77 percent of the patients are either uninsured or on Medicaid and Medicare. Reimbursed subsidies for that care does not cover cost of delivering that care, Paulus said.

In most markets the split between private insurance and those getting subsidies or are uninsured is closer to 50-50, so hospitals can shift costs to insurers.

Paulus said, “There just aren’t enough people to shift that cost to.”

There are no easy answers to this situation. The reality is that the quality of life for Franklin residents will be worse come July as we continue to rural areas slip further and further behind their urban counterparts. 

(Scott McLeod can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.)

Leave a comment

Smokey Mountain News Logo
Go to top
Payment Information


At our inception 20 years ago, we chose to be different. Unlike other news organizations, we made the decision to provide in-depth, regional reporting free to anyone who wanted access to it. We don’t plan to change that model. Support from our readers will help us maintain and strengthen the editorial independence that is crucial to our mission to help make Western North Carolina a better place to call home. If you are able, please support The Smoky Mountain News.

The Smoky Mountain News is a wholly private corporation. Reader contributions support the journalistic mission of SMN to remain independent. Your support of SMN does not constitute a charitable donation. If you have a question about contributing to SMN, please contact us.