Some rural communities concerned reform provisions could hurt Medicare services

Newspapers in Alaska and Washington state explore how health reform provisions might affect Medicare services in rural areas, while a Colorado newspaper looks at one senator's efforts to increase the number of doctors in rural areas.

Anchorage Daily News: "The bill passed by the U.S. House Nov. 7 could make it harder especially for older Alaskans on Medicare to get in to see doctors -- and it could hurt Alaska's economy if Alaskans have to pay more taxes for medical care but get less back, says Mark Foster, a contract consultant for the Institute for Social and Economic Research, an arm of the University of Alaska Anchorage. He analyzed the House bill, and has some observations about the Senate bill that's center stage now, but can't tell yet how the Senate version would affect most Alaskans. ... Foster believes Alaskans who use Medicare ... will be harmed if the House bill prevails. Many seniors already can't find primary-care doctors who will accept Medicare because it pays doctors below Alaska market rates, and even below the rates paid by the joint federal-state Medicaid insurance available to low-income people. ... If Medicaid is expanded, more Alaskans would be eligible for the government-paid insurance. But Foster says such expansion, and the House proposal to establish a new government-sponsored insurance program called the public option, would likely drive up medical care costs in Alaska" (Shinohara, 12/10). 

The (Spokane, Wash.) Spokesman Review: "In Washington and Idaho, where providers have long complained Medicare fails to cover their expenses, making them hesitant to take more Medicare patients, the bill's potential effects are uncertain. Republicans from the states say the bill will make the problem worse. But others argue provisions in the bill that reward efficient care, along with higher reimbursements for primary care physicians, will remedy the problem. A report released last month by the chief actuary of the Centers for Medicare and Medicaid, which administers the two government insurance programs, predicted that the $500 billion reduction in total Medicare spending in the House bill could result in reduced access to care and benefits" (Barker, 12/11).

The Durango (Colo.) Herald: "With the moment of truth at hand for the Senate's health-care bill, U.S. Sen. Mark Udall is trying to get two amendments added he says would help rural areas. ... Udall's amendments would set up a training program to recruit doctors from rural areas to attend medical school, then send them back to their hometowns. Most rural counties in Colorado have doctor shortages, Udall said. His second amendment would set aside for rural areas a portion of the $10 billion in grants for groups that promote healthful lifestyles" (Hanel, 12/11).