The Iowa Hospital Association says the down economy is having an impact on the state’s 117 hospitals. I.H.A. spokesman Scott McIntyre says the economy is hitting hospitals hard on a couple of fronts.

McIntyre says the amount of charity care and bad debt has gone up by 13-percent, and the economy had eaten away at hospital investments, which has reduced hospital margins below one percent. McIntyre says the increase in charity care reflects the increase in unemployment.

He says more people are losing their jobs and losing their health insurance and needing more help from hospitals. McIntyre says hospitals experience big losses with Medicare and Medicaid — but the federal stimulus package does have some Medicaid money in it.

He says the key is to make sure that the money that’s meant for Medicaid is actually spent on Medicaid, and he says they have faith the legislature will do that, but says they will be there to remind them of the burden of the program.

The latest employment report shows the medical field is one that has jobs available. McIntyre says that’s true, but the economy could have an impact too. McIntyre says the health field is still a good one, but he says it’s not a question of having the jobs available, it’s a matter of having the money to pay people.

McIntyre says so far hospitals haven’t had to make big layoffs, but some such as Mason City, have had to make changes in their services. McIntyre says 45% of Iowa hospitals lost money on operations and 45% of Iowa hospitals lost money on total revenue in the fourth quarter of 2008. That compares to 45% losing money on operations and 20% on total revenue in 2007.