[r85] Rep. Pond Column (4/2/2009)

Thursday, April 2, 2009

Start Date: 4/2/2009 All Day
End Date: 4/2/2009

This week, I attended the Indiana Rural Caucus meeting. The topic was health care reform in rural Indiana.


In our district, we are fortunate to live close to excellent health-care facilities and specialists. Most rural communities in Indiana are not as lucky as ours.  In some communities, satisfactory ambulance services are not available.


The purpose of the caucus is to better educate ourselves about the most important issues for rural Indiana communities and what we can do about them.


Joining us at the meeting was a panel featuring Brian Tabor and Spencer Grover of the Indiana Hospital Association and Don Kelso, president of the Indiana Rural Health Association.


This meeting was an eye-opener. Currently, Indiana has more than 50 medically underserved counties; 28 counties do not have obstetric care. These are serious concerns we must work to address.


There are nine issues I believe need to be addressed to have quality health care reform in rural Indiana:


  1. The rural economy is now based on self-employment and small business. Since the late 1990s, rural areas have undergone a significant decline in manufacturing jobs and a rise in service sector jobs. Many of the jobs lost had employer-sponsored coverage, while the new service jobs do not always offer medical coverage. Rural Hoosiers generally have less insurance and are more dependent on individual insurance.


  1. The rural health care delivery system is stressed. Health care infrastructure in rural communities usually involves a network of small hospitals, clinics and nursing homes that are underfunded. This makes it difficult for these facilities to upgrade their devices and machines. Medicaid and Medicare account for 60 percent of rural hospital revenue.


  1. A shortage of health care providers and workforce. More than 82 percent of all rural counties in the United States are classified as medically underserved areas. Only 9 percent of America's physicians practice in rural areas. As of now, according to surveys, only 3 percent of medical students plan to practice in a rural area. So even rural medical centers with great facilities can have problem keeping adequate medical staffing.


  1. The rural population is aging. An increasingly aging population needs greater medical care, and that can tax an already financially strapped rural health care system.


  1. The rural population is sicker and more at-risk than the urban population. The Center on an Aging Society at Georgetown University reported that the U.S. "rural population is consistently less well-off than the urban population with respect to health." The Kaiser Commission on Medicaid and the Uninsured also reports that even though there are higher rates of disabled in rural communities - which require more health care needs - rural residents receive less care when compared to urban residents. Rural populations have arthritis, asthma, heart disease, diabetes, hypertension and mental disorders at a higher rate than urban residents, statistics show.


  1. There is a need for preventive care, health and wellness resources. Rural communities have problems with quality nutrition and activity. This struggle then leads to our current health pandemic, obesity. Studies have suggested a rural community's strong social networks may actually reinforce unhealthy eating and sedentary behaviors.


  1. There is a lack of mental health services in rural Indiana. In the United States, more than half of the counties do not have any mental health professionals. To fix this disparity, it has been suggested to offer incentives to mid-level mental health providers (not including specialists) to practice in rural areas.


  1. There is an increasing dependence on technology, and rural areas do not have the resources to support the technology. Broadband and advanced telecommunication technology is not accessible to many rural areas in the country. Hospitals now use technology for billing, sending prescriptions and sending X-rays. Modern hospitals cannot properly treat patients to today's standards without this communication technology.


  1. Rural emergency medical services are underfunded and understaffed. Rural communities often have problems with ambulance coverage for their areas. There are sometimes communications issues for EMS and hospitals.


The Indiana Rural Caucus will look for ways to use federal stimulus money to reform rural health care.


Please contact me with concerns and comments you may have. I enjoy hearing from constituents and appreciate their insight. Contact me by mail at the Statehouse, 200 W. Washington St., Indianapolis, IN 46204, by e-mail at h85@iga.in.gov or by calling toll-free 1-800-382-9841.