The continuing rural health care problem

Map of primary care physicians per county

The Texas Tribune's map of primary care physicians per county

There are many aspects to the challenges people face with health care. The shortage of health care in rural areas in Texas has been repeatedly discussed but the problem is far from being solved. Emily Ramshaw of the Texas Tribune has done a multi-part series on the health care crisis in rural Texas.  In part 1 of story she points out that 63 Texas counties have no hospitals while 27 counties have no primary care physicians and 16 having only one. [Part 2 of the series looks at emergency care. Part 3 looks at the politics of the solution and part 4 looks at the recruitment of doctors.]

The math is simple. Many areas of the state are losing population while health care is becoming more specialized and expensive. There aren’t enough people in these sparsely populated areas to make a medical practice profitable and to pay for the increasingly expensive technology doctors rely on today. Today, medical care goes to where the people are and the town doctor isn’t going to show up at your front door with his little black bag.

The state has already created some programs to encourage doctors to set up their practices in under-served areas. Legislators from rural areas complain it’s harder to gain more support because  they’re increasingly outnumbered by representatives of urban and suburban areas. However, it would be difficult in any scenario to defend more subsidies for rural health care without running into complaints about socialized medicine.

The rural health care problem is another example of the clash between the traditions of Texas and the state’s future. As much as we relish our rural heritage and the image of the wide-open Texans plains, the wide open spaces of Texas may the worst place to get sick as frontier doctors disappear more quickly than the frontier.


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