Equality in Plans based on Location

[IhvGasDoYou56]

Please bear with me because I have Parkinson's and write, text slowly. I have lived all over the United States and have found there IS a big Disservice affecting people on Medicare which should BE FIXED ASAP. People who live in or near BIG CITIES - HAVE MANY OPTIONS in Health Insurance plans to choose from. While those living  in Rural or Remote areas HAVE FEW- IF ANY. IF everything else IS THE SAME with recipients, They SHOULD NOT BE PENALIZED or LEFT OUT just because they LIVE in a Remote or Rural Area. Thank you. James D. Hodges

[GailL1]

You are correct @IhvGasDoYou56 - but many times it is not the fault of the health insurer or even the government (i.e. Medicare or CMS).  

Insurers have a very hard time coming up with networks in smaller areas and now that CMS is requiring them to create these network within a specific geographical distance, it is almost impossible to do in certain areas.  

It isn’t just original Medicare over a Medicare Advantage plan either - if there are no provider, no doctors, no specialist, no hospitals or clinics, no imaging or lab facilities, then these just aren’t there.  These things do tend to flock to the places where there is ample population to support them.  The aren’t publically owned - they are there to make a profit - so a private company.

I would be an advocate to limit the over abundance of these things in more populated areas - but that is not gonna force them to take up shop in needed areas.

Telehealth may help some but it is not the cure-all to this problem.  Accountable Care Organizations may also be a help  in bringing networks of medical resources to barren places but here again the distance to link services together sometime is another barrier.  Having alternate type providers like Nurse Practitioners or Physicians Assistances are not the whole solution either - they can only do so much  and they do as much as they can.

Another thing that I read about recently is the Rural Health Transformation Program (RHTP - it will not keep open every rural hospital but it will keep the most geographically important ones functioning, hopefully. In some states, they are transforming these places into a centralized care area that would supply some of the needed medical services to people - but would it be adequate ?  IDK 

The grant money for this Rural Health Transformation Program has just began to flow to the states but I am not sure that there is a restriction that these funds have to go to rural health.  Like other funds, states may be able to use them wherever - 

You know BEFORE we even try to attempt this, it might be best to get MORE providers - from foreign countries or from our education system - so more slots for residency.  Because we have lots of baby boomers but docs are not plentiful - in fact many new beneficiaries are finding it difficult to get an appointment with a new provider because the docs are restricting their practice to the number of Medicare beneficiaries they are taking.   Then there are the number of them that are retiring themselves and just closing their door rather than taking on a new doc that will take over the practice.

A problem - for sure.  I do not know the answer and I do not think anybody else does either - You got any solutions>  

[papawofboo]

There is an answer but no one likes it including me. Don't live in a rural area or a small town.

Several times a year we go back to our hometown. The trip takes us thru several towns and a lot of farmland. The small towns are getting smaller and the rural area is getting farther away from anything. I don't see how they get home before the ice cream melts, much less find a medical office. 

My sister n law lives in a town of around 25/30 thousand. She has to drove a 100 miles to see most specialist  and to have test done. The hospital is broke, if you go there they will try to get you stable then hopefully you are in for a 100 mile ride in an ambulance. 

These are the main reasons we retired in a larger city.

[GailL1]

@papawofboo @IhvGasDoYou56 @SereneSeagull 

So should we nationalize certain health care providers and facilities and force their work in these barren rural health care area?  Seems to be the only way that there is (kind of) adequate supply.

 I guess we could send them out for any needed surgery or treatment not currently in the rural coverage area.

I have always thought that this was the #1 reason why a national health care system would not work here - we are too vast in area and where populations exist - Canada has the same problem with their Territories-   They have some solutions but a hit and miss at best.

CANADA Medical Assoc - Does where I live affect my health care? 

• MOBILE Health Units
• Satellite care
• virtual care

Same ole problems - too bad we are not all the same - sure would end a lot of the problems to be all the same, right?

[papawofboo]

You may be right but some of it is the small town's themselves. My sister n law lives in one of these. For years no medical service would take an advantage plan. Then one year a large medical group bought one of the office's in her town and they took advantage plans. Now the other's are coming around. Down here in the south we have many many small towns. Some of them doesn't have a grocery store, wal-mart and maybe one gas station. Only stands to reason that medical field has fallen into this group.

[SereneSeagull]

Well said @IhvGasDoYou56