Choosing Change for Health Care

If the Obama White House and Congress hope to fulfill their promises to reform the health care system for all Americans, they must address the fundamental health care inequities that have arisen in rural America. In particular, they should address the physical plant and technology needs of rural health care facilities, provide adequate resources to cover unserved or underserved rural areas, and fix insurance problems that cause financial stress for rural families and rural health care providers alike.
Rural America's financially stressed health care system is an expression of public policy choices. Medicare and Medicaid provide about 60 percent of rural hospital revenues. But Medicaid and Medicare reimbursement rates remain generally below actual costs of services provided. These policy choices were made by people - Presidents, Governors, Senators, Representatives... and the people in those positions can choose a different path.

Moreover, by many estimates, nearly half of the under-insured are facing collection or legal action over medical debts, increasing financial stress for rural families and rural health care providers. All of these issues conspire against rural America's web of small hospitals, clinics and nursing homes, bringing some close to the brink of closure. Thin financial margins also prevent rural facilities from making crucial investments in technology and physical plant upgrades.

Changing these circumstances is essential if the promise of health care reform is to be fulfilled.

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