This article was originally published on The Conversation. Living in rural America certainly comes with a number of benefits. There is less crime, access to the outdoors, and lower costs of living. Yet, not everything is rosy outside the city limits. Rural communities face growing infrastructure problems like decaying water systems. And they have more limited access to amenities ranging from grocery stores to movie theaters, lower quality schools, and less access to high-speed internet.Advertisement: Yet perhaps most daunting are the tremendous health disparities rural Americans face, in terms of both their own health and accessing care. As a number of my recent studies indicate, these disparities may be exacerbated by insurance carriers and the networks they put together for their consumers. A sick system that’s getting worseAdvertisement: At the turn of the last century, cities were known to be cesspools rampant with disease. Much has changed since then. Today, health care disparities between urban and rural America have indeed reversed. And they are growing wider. Part of the problem is demographic. Over the last several decades, many rural areas have lost a large share of their residents. In many areas, the young are moving away, leaving an aging population behind. Besides being older, those staying behind are poorer and have lower levels of education. To make things worse, they are also more likely to be uninsured. And they tend to be sicker, exhibiting higher rates of cancer, heart disease, stroke and chronic lower respiratory disease. It comes as no surprise that their life expectancy is generally lower as well.Advertisement: The demographic challenges are made worse by the limitations posed by the health care system. For one, rural areas are experiencing tremendous health care provider shortages. Access is often particularly limited for specialty care. But much more mundane health care services that most of us take for granted, like hospitals — including public hospitals and maternity wards — are also affected. Politics have made rural access challenges worse in many places. Partisan opposition to the Affordable Care Act has led many states with large rural populations, like Texas and Kansas, to refuse to expand their Medicaid programs or support enrollment in Affordable Care Act marketplaces. This stance is particularly damaging because the program provides a crucial lifeline to rural providers.Advertisement: A stark divide Rural communities across the country face tremendous health care access issues. And as recent study my colleagues and I did of access to cardiologists, endocrinologists, OB-GYNs and pediatricians shows, insurance plans may further complicate the issue. Focusing on California, we compared access between plans sold under the Affordable Care Act and commercially available plans. We also made comparisons to a hypothetical plan that included all of the state’s providers. In theory, this would be the plan ava
As rural Americans struggle for health care access, insurers may be making things worse
This article was originally published on The Conversation. Living in rural America certainly comes with a number of benefits. There is less crime, access to the outdoors, and lower costs of living. Yet, not everything is rosy outside the city limits. Rural communities face growing infrastructure problems like decaying water systems. And they have more limited access to amenities ranging from grocery stores to movie theaters, lower quality schools, and less access to high-speed internet.Advertisement: Yet perhaps most daunting are the tremendous health disparities rural Americans face, in terms of both their own health and accessing care. As a number of my recent studies indicate, these disparities may be exacerbated by insurance carriers and the networks they put together for their consumers. A sick system that’s getting worseAdvertisement: At the turn of the last century, cities were known to be cesspools rampant with disease. Much has changed since then. Today, health care disparities between urban and rural America have indeed reversed. And they are growing wider. Part of the problem is demographic. Over the last several decades, many rural areas have lost a large share of their residents. In many areas, the young are moving away, leaving an aging population behind. Besides being older, those staying behind are poorer and have lower levels of education. To make things worse, they are also more likely to be uninsured. And they tend to be sicker, exhibiting higher rates of cancer, heart disease, stroke and chronic lower respiratory disease. It comes as no surprise that their life expectancy is generally lower as well.Advertisement: The demographic challenges are made worse by the limitations posed by the health care system. For one, rural areas are experiencing tremendous health care provider shortages. Access is often particularly limited for specialty care. But much more mundane health care services that most of us take for granted, like hospitals — including public hospitals and maternity wards — are also affected. Politics have made rural access challenges worse in many places. Partisan opposition to the Affordable Care Act has led many states with large rural populations, like Texas and Kansas, to refuse to expand their Medicaid programs or support enrollment in Affordable Care Act marketplaces. This stance is particularly damaging because the program provides a crucial lifeline to rural providers.Advertisement: A stark divide Rural communities across the country face tremendous health care access issues. And as recent study my colleagues and I did of access to cardiologists, endocrinologists, OB-GYNs and pediatricians shows, insurance plans may further complicate the issue. Focusing on California, we compared access between plans sold under the Affordable Care Act and commercially available plans. We also made comparisons to a hypothetical plan that included all of the state’s providers. In theory, this would be the plan ava
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