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Outside the Garden of Eden: Rural Values and Healthcare Reform

Published online by Cambridge University Press:  29 July 2009

Kate H. Brown
Kate H. Brown
Affiliation:
Assistant Director of the Center for Health Policy and Ethics, Creighton University, Omaha, Nebraska
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Extract

It should surprise no one familiar with the problems in rural healthcare that 87% of a randomly selected sample of Nebraskans recently called for either fundamental or complete change of the healthcare system. Rural communities in the United, States have been hard hit by the rising cost of healthcare at a time of economic and demographic decline. Unable to sustain operating costs and personnel needs, rural hospitals and medical, practices have been forced to close their doors at an, alarming rate.

Furthermore, rural patients are decreasingly able to afford what services are available to them. Most must purchase insurance privately because they are unlikely to be insured through employment. Therefore, they pay dearly because they are not eligible for corporate rates and because insurance companies use experience instead of community rating to assess risk.

Type
Special Section: Cross-cultural Perspectives in Healthcare Ethics
Information
Cambridge Quarterly of Healthcare Ethics , Volume 3 , Issue 3 , Summer 1994 , pp. 329 - 337
Copyright
Copyright © Cambridge University Press 1994

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References

Notes

1. Kerrey, R. 66% of Nebraskans support Kerrey USA; Kerrey sees poll as support for reform, says public is ready to debate details. Press release. 1991 June 25. Hickman-Brown Research.Google Scholar

2. Office of Technology Assessment. Health Care in Rural America (OTA publication No. OTA–H–434). Washington, D.C.: Government Printing Office, 1990.Google Scholar

3. American Hospital Association. 1990 Closure Report: A Statistical Profile. Chicago: AHA, 1991.Google Scholar

4. This largely results from the prevalence of self-employment or employment in businesses not offering coverage to workers and/or dependents in rural areas. Comer, J, Mueller, K. Correlates of health insurance coverage: evidence from the Midwest. Journal of Health Care for the Poor and Underserved 1992; 3(2): 305–20.CrossRefGoogle ScholarPubMed

5. Dorr, R. Health care on the farm. Omaha World Herald 1993 04. 6:1, 11.Google Scholar

6. Similar contextual features were observed to influence rural physicians' perception of justice. Jecker, N, Berg, A. Allocating medical resources in rural America: alternative perceptions of justice. Social Science and Medicine 1992; 34(5): 467–74.CrossRefGoogle ScholarPubMed

7. de Tocqueville, A. Democracy in America [trans, by Lawrence, G.]. New York: Doubleday Anchor Books, 1969: 510Google Scholar. Quoted in Bellah, R et al. , Habits of the Heart. Berkeley: University of California Press, 1985: 37.Google Scholar

8. Brown, K. Connected independence: a paradox of rural health. Journal of Rural Community Psychology 1990; 2(1): 51–64.Google Scholar

9. White, J. Money Makes Us Relatives: Women's Labor in Urban Turkey. Austin: University of Texas Press, 1994 (in press)Google Scholar. This system of exchange is further described.

10. This tendency to limit altruism within one's social group was also observed by Gans: “Their generosity does not always extend to groups or classes of people, particularly those of lower status and darker skin.” Gans, HJ. Middle American Individualism: The Future of Liberal Democracy. New York: The Free Press, 1988: 5.Google Scholar

11. Comparing U.S. Census Bureau data. U.S. Bureau of Census. 1980 Census of Population Subject Reports Place of Work (PC80–2–6E). Washington, D.C.: Government Printing Office, 1984Google Scholar. U.S. Bureau of Census. 1990 Census of Population and Housing: Summary Social, Economic, and Housing Characteristics: Nebraska (1990CPH–5–29). Washington, D.C.: Government Printing Office, 1992.Google Scholar

12. Wuthnow, R. Acts of Compassion. Princeton, New Jersey: Princeton University Press, 1991.Google Scholar