Underlying Economic Principles
Their access to medical treatment profoundly impacts a person’s health. One-quarter of Americans do not have access to a primary care specialist or a healthcare institution. To this day, despite the passage and administration of the Affordable Healthcare Act (ACA), one in five Americans under the age of 65 lacks health coverage (Sharp et al., 2019). As stated by the Healthy Individuals 2020 project, health promotion, illness management, disability, and early mortality may improve with ready access to high-quality healthcare. Death rates and life expectancy are worsening in rural regions, especially among women (Sharp et al., 2019). Despite what some may think, rural communities around the United States represent various demographics and life experiences. Migration patterns throughout history and the plight of refugees seeking sanctuary from persecution for their faith or politics contribute to this rich mosaic of cultures and perspectives. The poverty rate in rural regions is far greater than in urban and metropolitan areas, affecting their health.
Those living in rural regions, who are already at a disadvantage, will be the primary focus of this article. As of the 2010 U.S. Census, 17% (59 million) of the population resides in rural or distant locations; nevertheless, only 9% of physicians and 16% of nurse practitioners now work in such places (Sharp et al., 2019). Specialists in fields like surgery and obstetrics are in short supply, and so is the number of people who can use their services. In the 1980s, many rural towns lost their only hospital. However, critical access facilities (CAHs) have helped meet part of this need because federal legislation has been passed to safeguard these facilities. Nevertheless, this trend is showing up again because of less money and changes to how Medicare pays, making it hard for many places to get treatment.
Approximately 2,031,229 people in Alabama, or 43.6% of the total population, call rural regions home. Fifty-five of Alabama’s 67 counties are classified as rural, and eight of those counties lack a hospital. Of the 55 outlying counties, 35 do not provide labor and delivery care. Two thousand one hundred sixty people needed primary care doctors in rural areas, compared to 1,250 in metropolitan areas (Sharp et al., 2019). The average response time for emergency services in rural areas is 27.4 minutes, based on the Alabama Department of Public Health website. In 2009, the number of hospital beds capacity in rural Alabama counties per 10,000 population was approximately half of what it was in metropolitan regions.
Economic Impacts of Healthcare Access in Rural America
Over the next decade, the Health and Wellbeing Initiative will track various factors. One effort is keeping tabs on insurance policies and availability across the board for long-term care. Among the intended outcomes are improvements in dental health, long-term medical support, and care for those nearing the end of life. Disparities in healthcare access due to factors including ethnicity, income, disability, age, and geographical location are another focus (Sharp et al., 2019). In addition to gauging the healthcare system’s readiness to treat the newly insured, people in good health will also keep an eye on how the demand for medical professionals shifts in response to innovations in care delivery. Technologies like telemedicine are being put into practice.
Clinical and Public Preventive Services are the objectives relevant to this paper’s topic. According to the SurgeonGeneral.gov website, “evidence-based preventative therapies are beneficial in lowering mortality and impairment and are cost-efficient or even cost-saving (Barnard et al., 2022). “The goal of this approach is to help patients get the clinical preventative treatments they need by connecting them with community initiatives that can help them with things like transportation, child care, and navigating the healthcare system (Sharp et al., 2019). Successful implementation requires that people be aware of and motivated to use these preventative services and that the healthcare system be able to provide them. The National Quality Strategy and the Surgeon General’s Office are working together to improve people’s cardiovascular health as one strategy to achieve this goal (MacKinney et al., 2019). To that end, the National Quality Strategy prioritizes measures that may reduce the risk of cardiovascular problems.
The Role of Major Healthcare Organizations
The Surgeon General’s Office has reported that the majority of Americans who suffer from hypertension or high blood cholesterol are unable to keep their conditions under control. The effort also seeks to reduce financial barriers to accessing preventative care and treatment by modernizing billing processes, promoting team-based care, and reducing the cost of drugs and treatments (Sharp et al., 2019). Implementing community-based preventative services that work in tandem with community resources, such as support groups or neighborhood or home-based programs, is one strategy to bolster access to care in rural regions. For underprivileged communities, the plan recommends establishing care hubs in workplaces and educational institutions (MacKinney et al., 2019). To increase the likelihood of receiving treatment, it is also important for individuals to have access to a primary care practitioner. Having convenient access to care close to one’s place of residence or employment is essential. Better quality treatment at reduced costs is guaranteed when clinicians can work in concert with one another and other healthcare team members.
The government will back these plans by keeping an eye on their effectiveness. By offering clinical preventive care by bolstering hypertension tests and care, they want to cut down. on the number of deaths caused by cardiovascular disease. Promoting knowledge about the Affordable Care Act’s coverage expansions and removing expenses for preventive treatments among doctors and the general public, especially in rural and underserved regions (MacKinney et al., 2019). Patients should have easy and quick access to their health data, which should be kept private. Hence, the adoption of digital medical records is strongly recommended. The government will also improve preventative medicine and complementary and alternative treatment methods.
Proposed Policy Improvements
Local and state governments may assist by improving access to clinical preventive care via expanding programs like Medicaid and the Children’s Health Insurance Program (CHIP) and the providers that work with them (MacKinney et al., 2019). Work with local institutions, including churches, schools, companies, and healthcare providers, to assess the healthcare needs of underprivileged communities. Another option is to gradually enroll people in health insurance by lowering barriers to enrollment (Kozhimannil & Henning-Smith, 2018). The program’s intended outcome is for those at risk of developing diabetes to adopt better lifestyle habits, such as eating more healthily, exercising regularly, and changing harmful habits (Barnard et al., 2022). Each participant is given a local pharmacist to help them manage their disease and take their medications as prescribed.
Policy to Address Unemployment
High unemployment, limited access to the internet and computers, a lack of mobility, an inability to pay insurance premiums, and a lack of healthcare literacy all contribute to a lack of access to treatment in rural parts of western Alabama. Tombigbee Healthcare Authority (THA) offers solutions to this problem by providing citizens with various healthcare alternatives, including community getaccess to preventative treatments in schools, churches, and community centers (Kozhimannil & Henning-Smith, 2018). Prescription medications are made available to those in the Delta Rural Access Program (DRAP) at risk for chronic health issues. Some of the many programs that DRAP promotes and gets rural people to sign up for our health insurance classes to prevent high blood pressure, case management solutions, health education, screenings, and pharmacy help.
Socioeconomic Support for Policy Change
The proportion of respondents who said they eat healthily almost doubled. Now that they know they can enroll people in healthcare with the support of local churches, DRAP will keep at it because a large proportion of the population already regularly attends religious services. The first step in ensuring that more people obtain ongoing and preventative care services is to increase the number of people with access to health insurance.
Those who live in rural areas are disproportionately represented in areas that lack adequate access to medical care. Low-income people in urban and rural areas were deterred from seeking medical attention because of the high out-of-pocket expense of treatment (Cromer, Wofford, & Wyant, 2019). Those who qualified for Medicaid had lower out-of-pocket medical expenses because of the expansion. This research highlights the positive aspects of the expansion, particularly for individuals living in rural regions, and how it has the potential to reduce health inequalities in such places. The analysis also reveals that low-income people would be hit hard in locations where healthcare is scarce if the ACA were removed.
The usage and expense of care between the two cohorts were investigated using a two-stage modeling strategy (Statz & Termuhlen, 2020). Healthcare expenses were higher for this group because they were less likely to seek treatment, had fewer prescriptions, and paid more out of pocket for those services. The research found that low-income people, particularly African-Americans living in rural areas, in states that did not expand Medicaid fared worse than their counterparts in states that did expand Medicaid on many health-related measures (Kozhimannil & Henning-Smith, 2018). This research lends credence to the idea that expanding Medicaid coverage to these people would be very helpful.
Value Proposition from the Policy Change
Rural communities face far greater challenges due to the high cost of care. The lack of doctors and hospitals is a contributing factor. This is because the current residents set the price of treatment, leaving insurance companies with little choice but to comply (Statz & Termuhlen, 2020). Those who work in rural regions are more likely to be blue-collar employees, who earn less but often have access to health insurance via their employer. The ACA’s Medicaid expansion and Health Insurance Marketplace helped increase access to healthcare for all Americans, including those living in rural communities. Unfortunately, the Supreme Court ruled in 2012 that states could choose whether or not to expand Medicaid, and several states have yet to do so, leaving thousands of people without coverage who would otherwise have had it (Statz & Termuhlen, 2020). According to the Kaiser Family Foundation, nearly two-thirds of rural America’s uninsured population resides in states that have not expanded Medicaid.
Incomes tend to be lower in rural regions than in urban ones. Since insurance rates are often rather high, this places a disproportionate financial burden on those living in rural areas. Roughly a quarter of the non-elderly population in rural areas live in households with incomes below or equal to the federal poverty line. A three-person household in 2014 would have needed $19,790 (Statz & Termuhlen, 2020). The Healthy People project aims to reduce the existing gaps in service delivery that prevent certain people from receiving the treatment they need.
Access to timely emergency medical treatment is also a serious issue for rural residents. The average wait time for rural residents to get medical attention from emergency services is longer than that of their urban counterparts. The inability to go to a doctor’s office might negatively affect recovery since it adds physical and mental strain to the patient (Statz & Termuhlen, 2020). People living in rural areas are more likely to lack healthcare access and no prescription medication coverage.
Call for Action
Healthcare practitioners and patients in rural locations confront more challenges than their metropolitan counterparts. The capacity of rural Americans to enjoy healthy, normal lives is compromised by several variables, including health inequities caused by a lack of education, isolation, poverty, economics, culture, and access to basic medical treatment (Kozhimannil & Henning-Smith, 2018). The situation in rural areas is already dire, and these complicated circumstances make things worse. As reported by the National Conference of State Legislatures in 2017, only 55% of the primary care requirements are satisfied, and there is a shortage of healthcare providers (Statz & Termuhlen, 2020). A lack of access to medical care has far-reaching implications for people’s emotional and social well-being and physical health. People living in rural settings are more likely to have ongoing health issues than those living in other types of communities (Cromer, Wofford, & Wyant, 2019). Health problems such as diabetes, heart disease, adolescent pregnancies, and unnecessary hospitalizations are more prevalent in rural locations. The prevalence of undesirable behaviors like smoking and being overweight is also lower in rural areas. Lack of access to care for those living with chronic conditions in remote places may drive up expenses for individuals, communities, and governments (Cromer, Wofford, & Wyant, 2019). Methods are now being explored to disperse primary care physicians better and guarantee that they have the requisite cultural competence to treat a wide range of patients.
The poverty rate between urban and rural areas affects the health care that respective residents receive. States can assist with the problem of care accessibility in several ways. The lack of healthcare workers in certain regions might be solved by removing restrictions on the scope of practice for clinicians who are not physicians. By 2030, the number of doctors will fall short of the number of patients who need primary care. Healthcare for remote communities might benefit mid-level professionals like registered nurses and physician assistants. State lawmakers should consider whether these professionals have all the legal rights they need to work in their fields. Many people cannot afford health insurance because some states have chosen not to extend their Medicaid programs. Although there is no silver bullet to the accessibility to care problem, state legislators may help by removing obstacles to practice and increasing coverage for those living in disadvantaged areas. Challenges will remain, and lawmakers must find ways to address them to advance the health of their constituents and the nation as a whole.
References
Barnard, M. (2022). Defining and analyzing health system resilience in rural jurisdictions. SpringerLink. Web.
Cromer, K. J., Wofford, L., & Wyant, D. K. (2019). Barriers to Healthcare Access Facing American Indian and Alaska Natives in Rural America. Journal of community health nursing, 36(4), 165–187. Web.
Kozhimannil, K. B., & Henning-Smith, C. (2018). Racism and Health in Rural America. Journal of health care for the poor and underserved, 29(1), 35–43. Web.
Skoufalos, A., Clarke, J. L., Ellis, D. R., Shepard, V. L., & Rula, E. Y. (2017). Rural Aging in America: Proceedings of the 2017 Connectivity Summit. Population Health Management, 20(S2), S-1. Web.
Sharp, T., Weil, J., Snyder, A., Dunn, K., Milbrath, G., McNeill, J., & Gilbert, E. (2019). Partnership integration for rural health resource access. Rural and remote health, 19(4), 5335. Web.
Statz, M., & Termuhlen, P. (2020). Rural Legal Deserts Are a Critical Health Determinant. American journal of public health, 110(10), 1519–1522. Web.