The cost, access and quality of rural health care has reached a crisis level.
Health care is delivered in America thru a public-private partnership (PPP) valued at over $3 trillion. It consists of employer-based insurance, government programs to insure our elderly, vulnerable and veterans and an individual market for everyone else.
The Affordable Care Act was the latest addition to the PPP. It created state-based markets for insurance, expanded Medicaid and supported innovation. Most importantly, it guaranteed access regardless of pre-existing conditions and set universal standards for all insurance plans.
Opportunities to make our PPP more effective.
First, encourage every state to expand Medicaid, benefiting millions of rural Americans.
Second, bolster the individual insurance market by raising the 400 percent of poverty cap on subsidy eligibility for those purchasing insurance in the marketplace. It is also essential that the reinsurance program authorized in the ACA be given greater support.
Third, pass a 10-year reauthorization and expansion of community health centers (CHCs). CHCs are an invaluable source of quality, reliable care in rural America that can mean the difference between life and death to isolated Americans in urgent need of care.
Community Health Centers
Health centers combine the resources of local communities with federal funds to establish neighborhood clinics in both rural and urban areas around America.
Health centers provide comprehensive care to over 28 million patients at 11,000 service delivery sites in every state and territory. Health centers save the health care system more than $24 billion annually in reduced emergency, hospital, and specialty care costs.
The National Association of Community Health Centers (NACHC) was founded in 1971 to “promote efficient, high quality, comprehensive health care that is accessible, culturally and linguistically competent, community directed, and patient centered for all.”
The Health Center Advocacy Network is a robust grassroots network of over 175,000 Health Center Advocates, fighting for good policies and sustainable funding for America’s Health Centers.
Telemedicine and Rural Healthcare
Telehealth is defined as the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration.
Technologies include video conferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.
Rural residents who do not have broadband cannot tap basic resources such as medical records, educational services, career training, and financial tools. Functioning in the modern marketplace without adequate broadband can be a significant difficulty for businesses and commercial enterprises in rural communities.
Fifth, give health practitioners the latitude to provide care in the settings where they work. That includes nurses, nurse practitioners, physician assistants and pharmacists. Referred to as “expanded scope of practice,” empowering providers in rural America with adequate authority to provide necessary care is essential.
Scope of Practice
Sixth, address the extraordinary deficiencies in the Indian Health Service (IHS). It is a tragedy that Native Americans living on reservations are relegated to care unfit in third- world countries. IHS budgets have been grossly underfunded and recruitment of high quality, professional providers has been a major failure. The time has come for our country to recognize its obligations and confront this crisis.