Republicans pushed their version of a Medicare prescription measure through the House this week. The bill would spend 320 billion dollars over the next ten years to offer seniors a prescription drug benefit. Seniors would pay a monthly premium of about $33, and a yearly deductible, expected to be around $250. The benefit would be administered through private insurers.
The prospect of a drug benefit is heartening to the seniors who form much of Rural America's population. But the availability of private health insurance remains a frustration for many.
However, the situation is not hopeless. A conference in Duluth, Minnesota this week highlighted both the challenge of rural health insurance and some unique solutions.
Part of the reason for the Minnesota Rural Summit is to showcase solutions for common rural problems like distance and low population density. Health care providers have been forced to be innovative on this front. Videophones have been in use since 1995 to reach more remote patients and utilize small nursing staffs. Assisted living coops have been formed to create communities for the elderly in small towns. Some doctors are returning to the practice of making house calls.
While these are all solutions to particular problems, none works if the communities cannot afford health insurance. Many small businesses are unable to handle the hefty overhead of health insurance premiums for their employees, one of the top three reasons potential employees leave rural areas. And businesses of one, such as farms, often do not qualify to be a part of any group coverage plans.
In Minnesota, communities are making strides to change the health insurance situation in rural areas by utilizing a state statute from the 1970s that authorizes purchasing alliances. The alliances bring together whole regions of the state to form a large insurable group. The non-profit entities of at least three to five thousand members allow businesses, church organizations, union members, municipal and county employees, and even businesses of one to be insured.
Liz Quam Berne, Exec. V.P. AMOM: "There's no solution for the farm families and the working uninsured coming from the federal level, there's nothing that's coming from the state level, they've decided they're going to roll up their sleeves and figure it out."
Liz Quam Berne is the executive vice president of Advocates for Marketplace Options for Mainstreet, or AMOM. The group has played a major part in the development of purchasing alliances from helping groups form to advocating legislative action to make purchasing alliances more effective.
Quam Berne: "It's all about keeping the working families in the rural area, it's all about sustaining our healthcare providers, it's all about looking at our healthcare providers as major employers, it's all about having a viable economic region that people want to move to."