Rural America Needs Medicare for All Now

Barb Kalbach

Rural America is facing a health care emergency – and Medicare for All is the answer.

Hospitals in rural Iowa, where I live, are closing or teetering on the brink of closure at an alarming rate. Over a hundred have shut down since 2005, and hundreds more are on life support. In some counties, they no longer deliver babies.

Long-term care facilities are vanishing all across rural America, or being bought up by large corporations who care more about profit than the care of our loved ones.

I know firsthand – I’m a registered nurse, and a lifelong Iowan from the country. I’ve kept a close eye on where we’ve been with health care, and where we appear to be headed. The future does not look bright if we stay on our current failed path.

Medicaid expansion was supposed to improve access to care. But the opposite happened in Iowa when we passed this in 2013, then handed the entire program over to private, for-profit Managed Care Organizations. What we got in return was less care, more services denied, facilities shuttered, and lives lost to corporate greed.

My local hospital has had to hire someone full-time just to submit, resubmit, and resubmit again claims to these private companies – and we’re still waiting on claims we filed over a year ago to be processed.

But even without the privatization of Medicaid, our rural areas would still face a health care emergency: Privatization just hastened what was already happening. That’s because the current for-profit healthcare system in this country is an extractive industry, that sucks both wealth and life out of communities, especially in rural areas.

Rural hospitals, local nursing homes and care facilities are the lifeblood of small towns all across the heartland. We’re watching farming communities and small towns wither away, as the countryside empties out, as our health declines. All because of allegiance to the almighty dollar.

Only a system that puts the wellbeing of all people above enriching a few will deliver the care we need, where and when we need it, and keep our rural communities alive and vibrant.

The Medicare for All Act of 2019 offers us an opportunity to fix much of what’s wrong with American health care. Instead of allowing private corporations free rein to decide who has access to care and how much they must pay, this bill puts healthcare decisions back where they belong: in the hands of patients and their care providers, and the financing back into public hands.

Under this act, introduced by Rep. Pramila Jayapal of Washington State, all aspects of our healthcare will be covered. This includes, but isn’t limited to, medical, dental, vision, hearing, prescription drugs, mental health, addiction treatment and much more.

Perhaps most importantly for Iowa and all rural communities, Medicare for All covers long-term and in-home care as well. This is a blessing to our families, especially those whose needs most often go unseen and unmet by an industry currently dominated by profit: the elderly and people with disabilities. Long-term and in-home care allows people to stay near their families or in their homes, near loved ones and rooted in the communities we’ve come to call home.

For this, and so many other reasons – we’ll actually spend less, and get far better coverage – Medicare for All is the prescription America and our rural communities need.

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