Editors Note: New Rural Policy Organizer, Virginia Wolking, makes her Blog for Rural America debut below. Welcome, Virginia.

Health care reform has all sorts of Iowans fired up.  Health care practitioners, farmers, young folks, and retirees are all in desperate need of health care reform. “I’m tired of having to apologize to hard-working people who aren’t receiving good health care”  said a Medicaid recipient at a recent health care reform forum in Cedar Falls, Iowa.

His feelings were echoed by others in Cedar Falls, Mason City, Ottumwa and Grinnell, Iowa, where many people said they were “embarrassed, disgusted, and simply fed-up” with our current health care system.

The forums drew a wide-range of Iowa citizens from physicians and nursing educators who are concerned about the shortage of health care practitioners in rural areas to farmers and small business owners who risk everything to continue their operations without health insurance or pay a pretty penny for mediocre health insurance coverage.

I was surprised to find that a few common issues were discussed at length at almost every forum.  Iowans are especially concerned about portability, the shortage of health practitioners in rural areas and affordability of health insurance for all.  

Portability
Many young people at the forums emphasized the need for health insurance that is portable, not tied to employment or geographic location, because young people themselves are largely “portable.”  A young woman described the situation of several friends who after working on a 2008 presidential campaign, experienced the double-whammy of both being out of work and without health insurance.  Click here to find out more about a public health insurance option that provides health insurance independent of employment.

Physicians from both and Ottumwa and Grinnell were particularly concerned about health insurance "gaps" or time periods when people are likely to be uninsured.  Gaps in health insurance are common when young people are searching for their first job and between retirement and eligibility for medicare.
 
Attracting Medical Practitioners to Rural Areas
Physicians noted the enormous shortage of medical practitioners in rural areas.  Many practitioners emerge from medical programs wading in debt and go on to practice in urban areas, where they often receive a higher salary.  The Robert Graham Center, a policy research organization focusing on family medical and primary care, published this article, on solutions to the rural physician shortage.

The dean of health and public services at Des Moines Area Community College told of the college's long waiting list for their nursing program "the problem is not the number of people who want to go into nursing, she said, it's that we don't have enough Masters of Science in Nursing educators to teach them."

Affordability for Farmers, Small Business Owners and the Self- Employed
After being refused health care coverage by her husbands insurance due to preexisting conditions, a farmer from Grinnell, IA was madder than a sow bear with a sore paw.  She told me she was a farmer and was not interested in going to town to work solely for health insurance.  She refused to follow a common path in farm country, where farmers' wives head to town to work in order to obtain health insurance coverage for their families.  She was on the farm to stay.

She told me health care was an enormous obstacle to beginning and existing farmers as she rocked her six-month-old son at the Grinnell health care forum.  She busily scanned the room looking for the half-dozen people she had personally invited to the forum, eventually finding her family physician who spoke persuasively about the need for a public health insurance option, where people would be able to purchase health insurance not tied to employment, geographic location and without fear of being denied for preexisting conditions.  She then introduced me to her husband, who had come to the forum on his birthday.

Instead of stewing in her own anger or whining about the injustice of being denied health care coverage, she had taken action to determine the direction our health care system is headed and served as an enormous inspiration to me and others at the forum.

I left the meetings energized and motivated to continue working for health care reform that works for all of us, refuses to neglect rural areas and serves small business owners and the self-employed.    I agree with a man from Mason City,  "Let's not patch it" he said, "lets get it done."