Healthcare Crisis Stifling Rural Independence

by: Natasha Chart

Fri Jun 12, 2009 at 08:00

Nice to know that when it's people, instead of banks, whose health is at risk, the federal government becomes inordinately worried about how much things cost. I've positively run out of sarcasm on the subject.

Though our current system also has a significant cost, it's just that the public pays it, as Chris wrote last month. And when they're not paying it in dollars, it's coming out of their health, their time and their independence.

Rural areas have additional concerns, aside from the difficulty of keeping a high enough population of medical professionals. As Debra Eschemeyer put it to me over email, link added:

"I gathered a group of young farmers and farm workers together a few months ago and guess what the number one issue was: HEALTHCARE. One mishap on the farm and you are in debt for LIFE. Not to mention pre-existing conditions ... forget finding any insurance company to cover you then.

"Why do so many farmers work two jobs? Answer: health care. Why can't we get more people to farm? Answer: who wants to work two jobs their whole life!"

The rural employment situation poses other problems.

Natasha Chart :: Healthcare Crisis Stifling Rural Independence
In areas where there aren't much in the way of jobs, people who want to stay in their homes will try to make a living farming. Not so easy.

Take chicken farming as an example. Grist's Suzi Parker explains how the highly consolidated, monopolistic chicken industry works*:

... "These companies seek rural areas where unemployment, or underemployment, is high and people are desperate for ways to stay on the farm," says Aloma Dew, a Sierra Club organizer in Kentucky. "They assume that poor, country people will not organize or speak up, and that they will be ignorant of the impacts on their health and quality of life."

The companies provide local growers, who work under contract, with chicks, feed, medicine, and transportation. Growers take care of the rest, investing hundreds of thousands of dollars in construction, maintenance, and labor costs. When the company requires upgrades, the costs fall to the growers. The massive amounts of manure, too, are their responsibility. (In Arkansas alone, chicken farms produce an amount of waste each day equal to that produced by 8 million people.)

Payment is results-oriented, based on measures like total weight gain of the flock. It's a system, says the United Food and Commercial Workers, that leaves 71 percent of growers earning below poverty-level wages. ...

If you want to switch professions at that point, you can't. You owe too much on the loans for the single-purpose chicken houses that you had to put your own house up as collateral for. And the chicken companies only enter into one year contracts, even if you had to get a 10, 20 or 30 year loan to pay for the facilities.

Want to sell your chickens to someone else? Too bad. The companies have effective geographic monopolies, no employer-employee responsibilities towards you, and if they terminate your contract, you're done.

Similar stories abound throughout the agricultural sector. Yet, like everywhere else, the large corporations who profit the most off of rural poverty and scarce opportunity spend a lot of money to convince people of things that go against their own interests. Eschemeyer continues:

"Another point is that we have trouble reaching farmers with our message...why?...the fact that American Farm Bureau really is an insurance company that made its way into the minds and pockets of farmers through health insurance.

"Yet they have a stock portfolio that reads like a who's who of agribusiness giants: Archer Daniels Midland, ConAgra, Monsanto, Phillip-Morris, Dupont, Novartis and Dow AND they lobby for every anti-family farmer legislation possible."

If you either can't or don't want to farm, well, hope and pray that a prison opens up nearby, that you live near a university or state capital, or a WalMart didn't eat all the local small businesses. And good luck finding a job with health coverage.

Adding insult to economic injury, rural areas tend to have even fewer health coverage options than those in more densely populated regions, making rural health insurance options almost as exploitive as the chicken industry.

Steph Larsen, a healthcare organizer at the Center for Rural Affairs puts the problem in perspective:

... Small businesses, entrepreneurs and self-employed workers are the lifeblood of rural communities. Without health reform that works for them, the economies of our rural communities will continue to suffer. Yet our rural states are some of the most consolidated in the country.

In Vermont (pdf) for example, where 62% of the population lives in rural communities, two companies control 90% of the market share of health insurance. Montana's (pdf) rural population is 46% of its total population, and one insurance company has 75% of the market. Iowa (pdf) has 1.1 million people in rural areas, and 80% of the insurance market is controlled by the top 2 insurers.

Of the list of top 10 most consolidated health insurance states, only two - Hawaii and Rhode Island - have a rural population of less than 30% of their total population. ...

Can you say monopoly? I knew you could. Not that anyone gives a damn about enforcing the law anymore.

The short of it is that rural economies are getting an even nastier end of the stick to hold. The farming community, which needs to start attracting young entrepreneurs again and whose help we'll need in order to put the brakes on climate change, is simply being crushed.

So it's no wonder that Karl Rove is writing that opposing a public option needs to be the main priority of the Republican party. He probably knows what a pain point this is for his party's last reliable voting bloc outside the South. If Democrats succeed in lightening these burdens, they may also find that voters they'd previously written off will take another look at them.

A Democratic Party that's serious about ending the Republican lock on rural votes will get serious about the healthcare crisis and they will pass reform that includes, at the least, a public plan with proper cost controls and low-income premium supports.

Of course, they could also do it because it's the right thing and the country needs it badly. Which is crazy talk, I'm sure.

* As referenced in Jill Richardson's excellent upcoming book, whose galley I'm enjoying, Recipe for America: Why Our Food System is Broken and What We Can Do to Fix It.

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Steph Larsen (4.00 / 2)
wrote a must-read post in January: "For healthy food and soil, we need affordable health care for farmers."

No kidding.

Join the Iowa progressive community at Bleeding Heartland.

Yeah (0.00 / 0)
Isn't it amazing how much everything is so inter-dependent? Now only if we could get the boneheads in office to see that.

The one thing that has always bothered me is how much people in these rural areas want and need these reforms, but often vote against their own interests.

[ Parent ]
A lack of faith (4.00 / 4)
I hear that so often that they "vote against their own interest" but as we are seeing with health care and other issues there is lack of faith that either party will vote the interest of the people and not the interest of the corporations.
  If there is not a real health care reform then I doubt the argument can be made that either party will take up the cause of the rural voter.  At least with the "social issues" they can be sure where the politician stands.

[ Parent ]
Good point (0.00 / 0)
You might very well be right about that.

[ Parent ]
Nailed it (4.00 / 2)
I'm tempted to write a book called, "What's the matter with New York?"

Why we let Democrats get away with towing the line on social issues while repeatedly selling us downriver to the temple money changers, I just can't figure.

[ Parent ]
You should! (4.00 / 2)
Honestly what Gibson posted is the crux of our problem - if the democratic party followed through on expectations we WOULD get more of the rural voters supporting the party and these initiatives that they would benefit from.

OpenLeft should lead the way to have an "accountability index" for democrats - a measurement of their progressive voting/support, and a threshold they should stay above before we pull out all stops and primary them.

Time to hold their feet to the coals!

[ Parent ]
It's sad (4.00 / 2)
My local farmer's market is one of the most successful in NC. The farmers are a tight-knit, supportive group and have achieved some national acclaim. But I've repeatedly observed that whenever one of their community is struck with a healthcare calamity, they have to resort to fundraising, pass-the-hat initiatives because of their lack of affordable/effective healthcare. I'm self-employed as well and know all-to-well about the difficulties and costs of finding your family decent, affordable health insurance. But at least my job doesn't expose me to daily contact with sharp objects.

Save Our Schools! March & National Call to Action, July 28-31, 2011 in Washington, DC: http://www.saveourschoolsmarch...

My CSA farmer sells out of Carrboro, although I'm in Pittsboro. (0.00 / 0)
He works, not two, three, but FOUR jobs, all without health insurance.

     And, yes, their food is amazing.  

[ Parent ]
Administration needs to lean on this even more (4.00 / 2)
Health care reform is more pressing than just about any other issue on the plate, including the economy since health care reform will ultimately help the economy as well.

What is frustrating is Obama was willing to make a prime time address about banks and their need for capital and regulation, yet tens of millions of Americans are struggling due to health care costs (with or without coverage) yet it does not seem as pressing.

I guess when you surround yourself with the people who created the mess and profit from the mess it is hard to see the forest for the trees.

Other Problems with Rural Living (0.00 / 0)
You also can't get high-speed Internet, or even a FedEx or UPS drop-off box within a reasonable driving distance, if you live in a rural area, which drastically reduces the possibilities for self-employment.


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