Health care: A leap of faith; a key player

Monday, June 15, 2009

The president is asking us, especially those of us in rural America, to take a giant leap of faith.

Barack Obama plans to cut the current levels of Medicare and Medicaid spending by up to $300 billion over the next 10 years.

He would pay for it by adopting new technologies, improving the management of chronic disease, and addressing the geographic variations in Medicare spending.


Medicare and Medicaid already reimburse doctors and hospitals 20 to 40 percent less than private insurance rates, and the health care providers raise rates for patients with private insurance.

Recent studies say that amounts to $89 billion more per year, or an extra $1,800 per family that those with private insurance have to pay for those on Medicare and Medicaid.

Making up for the under-reimbursement for Medicare and Medicaid have been a long-term struggle for rural Nebraska hospitals, and the idea of cutting those payments still farther is incredible.

Expecting the mutually exclusive idea of "government efficiency" to make up the difference in time to keep a number of rural hospitals from going out of business is beyond belief.

Judging from the distribution of stimulus funds, what guarantee is there that rural Nebraskans won't be forced back into the old trap of having to travel to Omaha or Denver to receive the latest in medical care?

And, judging from the experience of Europe or Canada, what guarantee do we have that we won't have long waits for rationed health care, especially from specialists?

An ex-Nebraskan now living in Australia compared that country's health care system to America's -- 20 years ago.

Rural America will have to be on its guard to avoid being shortchanged in health care reform.

Sen. Ben Nelson, who made his name in the insurance industry, has been taking heat over his position on public health care after having received contributions from the insurance interests.

But as a long-time champion of rural health care, Nelson, a Democrat, is in a key position to look out for our best interests. Sunday, he spoke out in favor of the idea of cooperative health insurance plans -- appropriate for someone from McCook, home to Sen. George W. Norris, the father of cooperative electricity.

Sen. Nelson has also been a tireless advocate of rural airline service, through programs like Essential Air Service, which many see as a key component to economic development.

It might seem premature, but naming his hometown airport McCook "Ben Nelson" Regional Airport while Nelson is still on the job, advocating service to Southwest Nebraska, is entirely appropriate.

The McCook City Council, considering such an action at tonight's meeting, should give it enthusiastic approval.

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