What Can We Do to Address the Worst Issues Southerners Face?

Last week, we covered the healthcare issues facing the southeast, and increasing the number of providers may solve many of those issues.

The Affordable Care Act sought to improve healthcare in the US through expanding coverage across the nation to families in need. It was a noble idea, but not a silver bullet for the south’s premature mortality problem that is causing the US to fall short in international comparisons.

While expanding coverage sounded like a good idea, the issues in the south can’t be boiled down to financial problems. Most citizens in states like Arkansas and Mississippi live in rural areas; 90 percent of counties in each state are designated as “provider shortage areas” by the federal government, meaning there are fewer than 100 providers per 100,000 patients.

When you put that together, a complicated narrative starts to arise that provides a significant barrier to adequate primary care. In “provider shortage areas, patients maye drive an hour or more to see a physician, so they may only be seeing a doctor when they have serious problems. Primary care, instead of serving as a regular doctor, is in effect a practice that deals in untreated chronic conditions more than the acute conditions primary care physicians are trained to treat — a very costly distinction.

So, not only are patients’ conditions less manageable than if they had been treated early on, they cost the healthcare system much more, sapping resources from others in need. This is true financially, as well as temporally. If physicians are tied up with extremely sick patients, the few patients that are willing to make the drive for routine illness may have a hard time getting an appointment. Therefore, the problem is compounded and the few providers that exist in any given rural area are able to do less work than their colleagues in metropolitan areas.

Even if these patients had insurance, they’d have a hard time receiving treatment — a problem that the Obama administration had initially sought to cure with rural health centers and accountable care organizations. But the ACA was incomplete when it was passed, and too many uncertain concessions were taken for granted. The administration chose coverage over access in hopes they’d get a chance to go back to the drawing board later.

Sadly, we already know how the story ended.