Better days seen for rural health care: Cabinet secretary says changes would bring benefits


Rural areas stand to gain from health care reform by getting more choices for coverage at better prices, Health and Human Services Secretary Kathleen Sebelius said Tuesday.

Sebelius, formerly the governor of Kansas, said rural areas are currently the most underinsured in the United States.

"The system we have really isn't working for the nearly 50 million people" living in rural areas, she said.

Sebelius spoke to reporters as part of the Obama administration's campaign to drum up support for health care legislation being written in the House and Senate.

The administration also released a summary of facts about rural health care, showing:

--One in five of the nation's uninsured -- about 8.5 million people -- live in rural areas.

--Rural residents are more likely to have chronic health conditions such as heart disease and diabetes.

--There were only 55 primary care physicians per 100,000 residents in rural areas in 2005, compared with 72 per 100,000 in urban areas.

Sebelius and U.S. Sen. Kay Hagan, a North Carolina Democrat, said health care reform legislation would create "exchanges" on which rural residents could purchase coverage from a selection of companies that could not deny coverage to people because of pre-existing conditions. The House and Senate bills also are expected to include a "public option," that is, a government health care plan that would be offered along with the private plans.

Sebelius said the legislation also would invest more money in programs aimed at luring physicians to underserved areas. Hagan said the legislation would "improve the quality, accessibility and affordability" of health care in rural areas.

But Oklahoma lawmakers say the bill's mandate that small businesses provide health care insurance for employees or pay a tax would cripple the main employers in many small areas. Under the House bill, businesses with an annual payroll of more than $750,000 would have to pay an 8 percent payroll tax if they didn't provide coverage.

Rep. Dan Boren, D-Muskogee, whose eastern Oklahoma district is largely rural, called the tax a "fine" and said it would be punitive. And he said many small business employees likely would wind up buying insurance from the proposed public plan that would compete with private carriers. That, he said, would ultimately lead to government-run health care for all.

Rep. Mary Fallin, R-Oklahoma City, said last week that more than half of Oklahoma workers are employed by small businesses and that "penalizing small businesses, especially during a time of high unemployment, will make job loss worse."

But Sebelius said small businesses would get tax credits based on their payrolls.

And she said farmers and others who purchase coverage for themselves would get the benefit of more choices in health care plans. To see more of The Oklahoman, or to subscribe to the newspaper, go to http://www.newsok.com. Copyright (c) 2009, The Oklahoman, Oklahoma City Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.


Copyright (C) 2009, The Oklahoman, Oklahoma City

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