This time from Michigan.
Federal cuts pinch rural health care
Darren Seymour held Penny Dick’s arm as she walked cautiously across the living room, her breathing labored and an oxygen tube trailing behind.
Seymour, a physical therapist, visits Dick’s home in rural Gladwin County twice a week to helps the 59-year-old heart patient rebuild her strength. In about two months, Dick has gone from being barely able to walk 10 feet to pacing the length of her home three times.
It’s the kind of help that 20,000 of Michigan’s sick stand to lose in the wake of reductions in how much Medicare pays to treat people in rural areas, where homes are miles apart and the nearest hospital could be an hour away.
Until last month, agencies that provided home health services to rural areas received 5 percent more funding than urban systems because of the time and gas it takes to drive between homes.
Without the money, agencies nationwide are cutting back staff, eliminating programs and scrapping services to rural areas.
The health care crisis is mounting all across the nation, but moves like these exasperate the problem for rural areas already at a disadvantage.
Much of the problem with current rural health care is that rural health policy is by and large a by product of national health policy. A market/price competition based health policy doesn’t work terribly well anywhere, but it works even less well in rural areas where service providers are geographically dispersed if present at all.
Cutting the budget to Medicare support programs in rural areas and expecting them to make up the money somewhere else is less then realistic given the lack of health care professionals in rural areas and a deteriorating health care infrastructure that exists in rural areas.
To add to the problem cuts like this and the TennCare cuts come at a time when rural areas are becoming increasingly elderly.
Update: This story from Oregon tells of a program designed to train nurses for rural areas. Students train remotely from the communities that they will serve after they graduate. More of this sort of thing begins to get at the problem of a failure to distinguish rural health policy from urban health policy.