JEFFERSON CITY — Access to health care in rural areas has always been a problem. Like many other types of infrastructure, we do not always have the population base to attract investment from the public and private sector. However, our role in the state’s economy including the agriculture industry, makes our area as vital as other areas which have a much greater population.
Regardless of whether or not you think health care is a right, and to be clear – I don’t think that it is – our rural areas of the state carry a heavier burden in costs and care because of the regulatory environment that we face. It isn’t surprising that the squeakiest wheel gets the grease on these issues, but it is unfortunate that I am learning more and more that whichever institutions in the state have the best lobbyists, will get the best benefit. And that typically means less for our rural areas.
Here are some examples:
- Nurse Practitioners help bridge the gap for access to care in our rural areas and they do a great job. In fact, my primary health care providers are nurse practitioners. However, in Missouri, nurse practitioners face burdens that make it harder and harder for them to compete in the marketplace or even provide care. I support efforts to allow nurse practitioners the freedom to more freely operate in our rural areas. The reality is we are not going to have many doctors move in and practice medicine in sparsely populated counties.
- Medicaid is a huge chunk of our state’s budget, and it is only increasing in its costs. A recent report outlined how the state could make reforms and save $1 billion on this budget buster. Our state reimburses hospitals to take care of patients across the state – and even some that are from outside of Missouri. Unfortunately, the reimbursement rate for urban hospitals can be more than double than what we receive at our area hospitals, even though they’re moving many more patients through their doors. Missouri is also the only state in the union that makes an extra payment for seeing Medicaid patients from other states, totaling $177 million. That is money that could be going to improve the quality of care in our rural areas.
- Nursing home costs through Medicaid can also be a huge burden on tax payers. In our rural areas, nursing homes provide an opportunity for residents to live out their life with dignity, while in the care of their neighbors and friends who are employed at the facility. It is also comforting to have our loved ones in nursing homes that are in our communities. It is rare to see new construction of nursing homes in our rural areas, unlike the suburban parts of our state. However, newly constructed nursing homes receive a significantly higher reimbursement per patient rate than we do in our rural areas.
These are just a few examples of how our state is setting ground rules that make it harder and harder to provide access to quality health care in our rural areas. If we had these types of costs in our concrete business back home, I would do anything I could to correct the situation. We should attack these taxpayer issues with the same vigor.
I remain committed to reducing these regulatory burdens and costs going forward and hope that you will join me in advocating for these changes.
As always, I appreciate hearing your comments, opinions and concerns. Please feel free to contact me in Jefferson City at (573) 751-7985. You may also email me at cindy.olaughlin@senate.mo.gov.