Rural health care reform: What you need to know |

Rural health care reform: What you need to know

Photo by Amanda Nolz"Small farmers and rural families are very concerned about how health care reform will impact them," said Mike Begeman, vice president of public affairs at Sanford Health

“Stronger Together” was the title of the presentation given by Sanford Health’s Mike Begeman, vice president of public affairs, and Cindy Morrison, vice president of health policy at the First Annual Governor’s Agriculture Development Summit on June 30, 2010 in Sioux Falls, SD. Begeman and Morrison teamed up to answer the big questions rural farm families have about the new health care reform policies.

Sanford Health has a primary service area of 130,000 miles, operating more than 1,500 beds at 26 different hospitals. Sanford Health-Merit Care is ranked among the nation’s top 50 integrated health care systems and is the largest, not-for-profit rural system in the country, according to Begeman. Yet, despite Sanford’s size, he assured the group that the company hasn’t forgotten where they come from.

“No matter how big we get, we never forget our roots in the Dakotas and the rural communities that we serve,” said Begeman. “We haven’t lost sight of that, and we never will.”

Good to note, but what is Sanford’s view on the new health care law, the Patient Protection and Affordable Care Act (PPACA)? Because the law includes an overwhelming number of health-related provisions such as subsidizing insurance premiums, expanding Medicaid eligibility and establishing health care exchanges, all to be paid for by a variety of taxes, Begeman and Morrison sorted through the pages of documents and presented the information deemed most important for rural families.

“As I travel across the rural areas of South Dakota, I hear from small farmers and rural families, and they are all concerned about how health care reform will impact their lives,” explained Begeman.

“There is a lot of misinformation about health care reform,” added Morrison. “The reality is that about 30 percent of our population is paying too much for health care, or they don’t have any at all. In South Dakota, 10 percent of folks don’t have insurance, and in Texas, the number jumps to 39 percent.”

Morrison said that in order to stop and reverse the increase in the number of families with high health care costs, two things are needed. First, there needs to be an increase in family incomes; second, more moderate increase in health care costs are necessary. However, in a recession where incomes aren’t increasing, she said it’s easy to attest where the problem lies.

“The new law, PPACA, will have the most sweeping impact on health care since the beginning of Medicaid,” affirmed Morrison. “By the end of the decade, the law will be implemented and we will see a much more universal health care system than we have ever seen before.”

Morrison said to expect a prelude in the next three years for the reform to begin adjusting insurance, raising new revenues and of course, working through the thousands of pages of regulations that are called for by PPACA. By 2014, she said to anticipate the “big bang,” which will give insurance coverage to more than 19 million people in the U.S. The mandatory insurance coverage has many great benefits; however, she said there are huge concerns, as well.

“The new system is well-positioned to meet the challenges of health care reform, but Sanford Health does have its fair share of concerns, especially when we think of the rural areas in the Dakotas,” explained Morrison. “Cuts to providers, increased taxes, a lack of reform for medical malpractice lawsuits and a difficulty in recruiting doctors to practice in rural areas could all pose problems for South Dakotans.”

She said the new health care law will offer payment incentives for doctors to provide quality care instead of volume of patients, which is good for those needing medical attention, but could cause a shortage of physicians.

“If people have insurance, they use it,” noted Morrison. “I’m worried about Medicaid. I’m worried about surges in emergency room visits. And, I’m worried there will be a shortage of doctors in rural areas. Recruitment to our area is going to be huge.”

Morrison closed by sharing that farm families can expect legislation each year on health care in order to tweak the bill. She said that Massachusetts has served as a lab rat for this reform, but within four years, all of the U.S. will be included in the lab project.

Certainly, PPACA will bring some interesting changes to the health care system; and for rural families, more people will be insured, more doctors will need to be recruited and additional grants will have to be given to train these rural physicians.

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