The Rest Of The Country

According to the US Census Bureau, 97% of our country’s land mass is considered rural.  80% of us occupy only 3% of our land.  Neither the national news nor the national political candidates spend a lot of time talking about rural America.  Sure, we hear about a random farm bill or how the tariffs are destroying our agriculture and the need to bail out the farmers, but that is about it.  There is one other thing that makes the national news – the horrific health and health care of rural America.

Rural America has been disproportionately impacted by the opioid epidemicRural hospitals have suffered from underfunding.  Many Red States chose to not accept federal money and expand Medicaid.  Not enough doctors, facilities, or money.

A possible solution has been offered by presidential candidate Mayor Pete Buttigieg.  This is surprising because rural America is seldom the focus of any of the candidates and because the health care plans from the people running for president are more often the objects of derision.  I’m sure you’ve forgotten Scott Walker’s or Donald Trump’s.  This blog recently reviewed Bernie 2.0, a plan designed for shouting and arm waving but not to be implemented.  So I didn’t expect much from Mayor Pete.  Here is the link:

Securing a Healthy Future for Rural America

The first thing you notice is that this is a real proposal. Agree or disagree with his policy prescriptions, you can see the thought and effort.  Instead of empty platitudes and generalizations, there are 54 footnotes.

His goals:

  • Guarantee that people in rural areas have affordable health insurance options
  • Ensure that people in rural areas have access to critical health services by increasing the availability of health providers
  • Expand access to preventive efforts and effective treatment for mental illness and addiction
  • End the rural maternal health care crisis by making it easier for women to access critical services before, during, and after pregnancy
  • Make it easier for patients to receive treatment at or near their home by expanding telehealth services
  • Strengthen rural health facilities to better address new models of health and community wellness
  • Support rural communities in meaningfully reducing local health inequities
  • Reduce obesity and combat food insecurity
  • Improve access to transportation services

Importantly, his solutions are built upon existing programs.  He works to alleviate the shortage of physicians in rural areas by expanding programs that encourage and/or incentivize doctors to work in rural areas. Some of these programs could even be used to address the shortage in primary care doctors.  He addresses the maternal mortality rates and the underfunding of rural facilities. And the expansion of telehealth, with the connected expansion of high-speed broadband across the country, will provide immediate access to transportation-challenges patients.

There is no budget for any of this in Mayor Pete’s whitepaper.  Also, no funding mechanism. I have requested details from the Buttigieg campaign.  I will post them once received.  The problems are real.  The solutions make a lot of sense.  The question is whether a future President Pete or the US Congress would allocate the funds.

Look for many of these issues and Mayor Pete’s recommendations to be incorporated in next year’s Democratic Party platform.  A few of them, like the expansion of high-speed broadband across the country might appear in the Republican Party platform, too.


Picture – A Quiet Place – David L Cunix


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