Rural areas need more health options, public included

By Niel Ritchie

Now that Tom Harkin, D-Iowa, chairs the Senate Committee on Health, Education, Labor and Pensions, Iowa has a true champion for health-care reform. But the best news for residents in rural states across the nation came when he vowed that comprehensive reform would pass this year with a strong public option.

Health care in rural areas lags major cities. According to the National Rural Health Association, rural residents are twice as likely to die from injury, receive less treatment for chronic disease and report lower rates of overall health.

Many Iowans are affected by these trends, as the U.S. Department of Health and Human Services reported this year:

l More than three-quarters of insured Iowans are covered by one company; premium rates statewide have soared 88 percent since 2000.

l 65,524 employers statewide are small businesses, accounting for 76 percent of all jobs, yet less than 4 in 10 can afford to provide health coverage.

l More than 70 percent of Iowa's uninsured are in families with at least one full-time worker.

l Despite skyrocketing costs, Iowans' health ranks only “average.”

Although they talk a good game about protecting Americans' rights, those fighting hardest against reform are more about personal gain. Between 2000 and 2007, profits of the nation's 10 largest health insurance companies soared 428 percent while millions more fell into the vast pool of uninsured. Campaign finance reports reveal that in the first six months of this year alone, the health-care sector gave $11.4 million in contributions to federal lawmakers now working against the people they were elected to serve.

Wendell Potter understands. While heading corporate communications for Cigna in the 1990s, he was tasked with killing the Clinton administration's health-care plan, devising many of the scariest myths also shouted at town halls this summer. After seeing the catastrophic results of his work, he blew the whistle and now serves as senior fellow for health care with the Wisconsin-based Center for Media and Democracy.

“What insurance companies do to manipulate public opinion is to tell lies and throw off misleading information; fear-mongering is a big part of their strategy,” he told me.

Nearly everyone agrees that reining in health-care costs and industry profits is critical. But that alone won't cure all our ills. Sen. Harkin is right: Only a strong public option can overcome too few options in rural areas.

Niel Ritchie is executive director of the League of Rural Voters, a Minnesota-based non-profit dedicated to strengthening rural communities nationwide (www.leagueof

ruralvoters.org).