I was reading yet another article from our local friends on the left about St. John’s financial woes. Lots of hand-wringing, lots of finger-pointing, but not a whisper about the real culprit behind this mess: Obamacare.
If you’re wondering why St. John’s Health is suddenly pinching pennies, cutting staff, shuttering clinics, and fretting about property tax revenue, don’t blame bad luck. This is what our healthcare system has looked like since the Affordable Care Act reshaped the industry: less money coming in, declining quality of care, and a community standard that keeps sliding downward.
Last year alone, St. John’s posted a $19.4 million operating loss — the biggest financial gut punch in its history. In response, leadership is now laser-focused on “financial stewardship” (read: slashing costs and squeezing revenue). That means second-guessing whether to rehire nurses, cutting traveling providers, trimming IT contracts, and praying more people show up for scans at their shiny new imaging center.
Meanwhile, property tax relief passed by the Legislature shaved off another $1.1 million in expected revenue. To plug the hole, St. John’s is already floating the idea of hiking its own mill levy, meaning you, dear taxpayer, may end up covering the shortfall.
The hospital says labor eats up 63% of net revenue, far higher than the 50% “healthy” benchmark. Translation: staff are expensive, and St. John’s would love to cut deeper. But how exactly do you maintain “five-star care” when your main strategy is not replacing the people who deliver it?
Not Just Jackson’s Problem
The brutal reality is this isn’t just a local issue; it’s the national healthcare framework failing rural America. Across the U.S., more than 600 rural hospitals are at risk of closing. The common themes: rising uncompensated care, more patients shifting to Medicare and Medicaid (which reimburse less than private insurance), exploding administrative costs, and regulations that tie hospitals’ hands.
Hundreds of hospitals have closed or stopped providing inpatient care over the past 15 years. Hundreds more are teetering, forced to scale back services like obstetrics, emergency care, or specialty clinics, the very things communities count on. Jackson, wealthy zip code or not, is facing the same storm.
Meanwhile, Abroad… “Universal” Isn’t Working Either
Advocates often point to Canada and the UK as models of universal healthcare. But let’s be honest, the cracks in those systems are gaping.
- Canada: Patients routinely wait months for surgeries, MRIs, or specialist appointments. In fact, the average wait time from seeing a family doctor to getting treatment by a specialist was over 27 weeks in 2023, the longest ever recorded. Care is technically “free,” but when you’re sitting in pain for half a year waiting for treatment, is it really accessible?
- United Kingdom: The NHS is collapsing under its own weight. Millions of Brits wait more than a year for routine operations, and the system is plagued with chronic staff shortages and strikes. The government keeps pouring in tax dollars, but patients still face record-long waits for emergency care, some waiting more than 12 hours in ER corridors before seeing a doctor.
Both systems prove that when the government tries to “guarantee” healthcare, the result isn’t better access or better care; it’s rationing. Services get watered down, waitlists explode, and outcomes worsen. The U.S. isn’t immune to these pressures. With Obamacare’s framework, we’ve imported many of the same problems, more bureaucracy, less competition, and a race to the bottom for community hospitals.
Chasing Philanthropy Instead of Patients
On paper, there are bright spots: a new psychiatrist is on the way, oncology services are growing, and maybe, someday, Jackson Hole gets a linear accelerator for cancer treatment. But those headlines mask the harsher truth. This is a health system that just shuttered clinics in Lander and Grand Teton National Park, walked away from partnerships with Teton County, and now leans on philanthropy to build workforce housing.
In fact, $37.7 million of the $53.7 million cost of St. John’s new employee housing project is coming from public or philanthropic dollars. Think about that….we’re now crowdsourcing housing for nurses and staff just to keep the hospital doors open.
The Bigger Picture
Hospital leadership admits one of their biggest financial drains is the steady migration of patients onto Medicare. Why? Because federal reimbursement rates don’t cover actual costs. Add in uncompensated care, more regulation, and top-heavy billing bureaucracies, and you’ve got the exact recipe Washington baked into the system.
The result is playing out right here in Jackson Hole: fewer services, stretched staff, and administrators more focused on revenue collection teams than bedside care.
Where Do We Go From Here?
Jackson deserves better than this. A community like ours, wealthy, generous, and full of talent, should not have to accept a healthcare system built to fail. We don’t need more empty promises from Washington or another round of bureaucratic Band-Aids.
The solution isn’t doubling down on the same broken model. It’s opening the system to true competition, innovation, and local choice. Patients should be empowered to shop for care the way they shop for everything else. Providers should be rewarded for outcomes, not paperwork. And hospitals like St. John’s should be freed from crushing regulation so they can focus on patients instead of mill levies and billing audits.
Because if the current trajectory holds, the question won’t be how St. John’s balances its books in a few years. It’ll be whether Jackson still has a functioning community hospital at all.
AntlersArch founder and the voice behind Teton Tattle.
