If I had posted a recent article you would have said that wasn't evidence of a long term trend. The problem has gotten worse and it's impacting the entire country now. My family members work at hospitals in rural eastern WA, and not only has the local hospital system there already collapsed, but the entire Providence medical system for all of the Pacific Northwest is at risk of going under too. This is a direct result of uninsured migrant workers and medicaid underpayment.