The health care issues in rural New York are at a critical juncture at a time when the economy of many communities is failing or on the brink of collapse. The rural health care crisis and upstate economic crisis are tightly interrelated, and the solution to both may lie in considering them together.
The problem is due to the physical distances and the aging demographics. Rural residents are older, poorer and sicker and more than 30 percent live alone. This makes them more vulnerable to timely access to routine and emergency care. Delaying treatment results in more advanced disease and worse outcomes.
Currently, there are a half million uninsured rural residents. This number increases every year as private insurance is less available, farm families have less access to employer-based insurance and Medicaid is less accessible.
Many upstate hospitals are on the brink of collapse. They have significant manpower shortages, because they are unable to attract physicians, nurses, mental health and emergency workers. Furthermore, every time a health care professional leaves a rural community, there is an additional loss of approximately $100,000 to the local economy.
The impact of the crisis on large and small businesses has been devastating. Large businesses with yearly premium increases of 15 percent are non-competitive in the marketplace. Small businesses cannot afford to provide health care for their employees and their families, so they cannot effectively recruit talented people.
Medicaid has been strangling county budgets throughout the state. But there are real solutions. We can deliver care across large distances with new technology. In Kansas, tele-health is connecting rural residents with providers. Tele-video programs train providers and help in diagnoses and disease management. In Utah, tele-pharmacy links pharmacies in remote locations helping residents get access to prescription drugs. Distance online learning can attract nursing students, allowing them to stay close to home while earning their degree. We can provide incentives for medical students and residents from our SUNY schools and hospitals to practice in rural counties.
Health care is one of the state's largest employers with both direct and indirect jobs accounting for billions of dollars in wages and benefits to the economy. One out of every 10 upstate workers is in health care and 13 percent of the private sector jobs in this state are health care. Health care workers and employers pay millions in taxes further supporting economic growth.
For every 100 health care jobs, there are 35 additional jobs added to the local community. Good health care attracts new employers, a highly educated work force, young families, millions in federal funding and provides good jobs. Health care is essential for the growth of new businesses and for the prosperity of established ones.
Investment in rural health care is good medicine, both for the health of state residents and for the ailing upstate economy.
Jon R. Cohen, M.D., is chief medical officer of North Shore-Long Island Jewish Health System.