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Pioneer Editorials: Include rural health care in reform effort

As Congress struggles with meaningful health care reform to meet President Obama's timeline, help from other venues will be needed and appreciated.

The announcement Wednesday that hospitals will give up $155 billion over 10 years in expected payments from Medicare and Medicaid is huge. The savings, plus the $80 million pledged last month from pharmaceutical companies, will go a long ways in holding down the bill for health care reform to taxpayers below $1 trillion.

But while hospital groups, notably the American Hospital Association, are making this pledge with the administration, we fear that some institutions which would have government reimbursements reduced could actually put them in even more severe financial problems.

North Country Regional Hospital could well be one of those institutions.

Among the concessions by hospitals, some $50 billion would be saved by cutting payments to hospitals that treat a disproportionate share of uninsured patients. The payments wouldn't be reduced, however, for several years, until the 46 million Americans without insurance get coverage. Supporters believe at that time, there won't be a need for the payments.

Still, hospitals such as NCRH, which are already in the hole in Medicare reimbursements, which don't cover costs as it is now. Add to that lower reimbursements from the state, and the pledge by hospital groups to cut $155 billion looms large for NCRH.

Discussion of a public health care plan to create competition with private insurance carriers could add another $31 billion in losses a year to hospitals, independent analysts say. So again NCRH's bottom line would be affected.

It is well and good to see cooperation and partnerships in health care reform, but we hope that those partnerships do not foster less quality health care and less access to health care in rural areas, such as Bemidji, where it is already hard enough to recruit physicians to serve locally.

Legislation should include waivers and special programs designed to provide the best health care possible to rural residents, as is available to urban residents who live within miles of teaching hospitals, research hospitals and a plethora of specialists.