4 ms·

Isn't this like 1/2 the appeal of living in rural America though? Way out there, on your own. Fewer creature comforts, more getting stuff done on your own. No

Isn't this like 1/2 the appeal of living in rural America though? Way out there, on your own. Fewer creature comforts, more getting stuff done on your own. No paying the connivence fee associated with cities, having everything nearby but paying double the rent. Yes this sounds like an obscene edge case but it's part of the deal

rtkwe 2y ago
Very few completely eschew the option to get medical services when they decide they need them.
- gruez 2y ago
  The point is that being far away from critical services is part of the rural-urban tradeoff. It's like being upset that there isn't a level 1 trauma center within a 30 minute drive, because you live in the middle of nowhere. Nobody is going to deny the importance of living near a level 1 trauma center, but you kinda signed up for it when you decided to live in the middle of nowhere.
  - fdsseghy 2y ago
    Easy there. Just because you can afford a computer, internet, car and rent doesn’t mean everyone can. A common theme of rural America is getting out if you can.
    - bobthepanda 2y ago
      It costs money to move, and if you don’t have the money I wonder how kind the GP commenter would be to someone fleeing a rural area and living out of their car or a tent in their community.
  - femiagbabiaka 2y ago
    Some people do not decide.
  - s1artibartfast 2y ago
    I think the "you signed up for it" rubs me the wrong way. Particularly when it doesn't have to be that way, wasn't always that way, and there are specific policy choices causing a change. Sure, most places never had a level 1 trauma center, but they did have hospitals, clinics, and pharmacies. Many of these medical institutions are leaving despite increasing population due to changing healthcare economics and policy choices.
  - soco 2y ago
    You signed up for it by deciding to be born in one of the families living there, with no money nor possibilities to move away. Now what? Receive the irony of the well-situated IT workers for it?
sieabahlpark 2y ago
[dead]
throwawaysleep 2y ago
Rural America certainly votes that way. I’d be curious if the people in these counties view this report as more than bashing.
- delichon 2y ago
  There were three doctors here before Obamacare, now zero, same population. So it's very common out here to blame that. Healthcare access in the nearest big city has also cratered. Two week appointments have become six months ... to see a nurse.
  - cogman10 2y ago
    I have a nephew currently going to medical school in Idaho (So by no means prestigious). By the time he's finished the expected tuition costs are $500,000. A big reason you don't see family doctors in the sticks isn't because there aren't people that would love to be a small practice in the middle of nowhere. It's that nobody but a major medical institution can give them enough of a salary that they don't go broke under student debt.
  - mjevans 2y ago
    I'm extremely hopeful that congress will do something crazy like repeal that or otherwise screw things up SO BADLY we, as a country, backlash far enough to socialize the basic human rights. EVERYONE should have healthcare. Just provide and tax to fund. It'd be cheaper than their medical bills, and WAY less headache if they don't have to deal with medical billing <<< THAT is the selling point. Everyone should have retirement... wait that's what social security was supposed to be right? What's the problem *(other than funding it)... Medicine has developed 'old people jails' to turn the elderly into medicine consuming vegetables like some dystopian videogame or movie? Well... socialize that and have the experts figure something out. That's clearly a problem of improperly aligned incentives wound around a bunch of stuff I'd like people of various correct fields to address. Why there aren't people in big cities: Costs too damned much to DO anything here; the rent is WAY too high. (we need to build a LOT, a WHOLE LOT more to catch up to years of not enough housing and slightly less not enough of the other stuff). Why there aren't people in the rural areas: I suspect that though the rent is nicely low, the population density no longer supports the service. PART of that could be addressed by getting everyone on the same service (single payer healthcare), 3000 people sounds like enough for a basic family practice doctor to me. That's seeing ~10 people a day for 300 days out of 365 days a year. However that's about it.
0xbadcafebee 2y ago
You're really stretching by assuming rural Americans have the option of living somewhere else. I live in a relatively small town (~3000, though it's much bigger than other towns nearby). Most people here have never gone more than 100 miles from town. They have shit jobs (when they get them), live below the poverty line, have poor education. There is no transportation but rotted-out 20-year-old trucks or whatever $500 used car you could find in a nearby town. Their families have lived here their whole lives. They have no savings, no retirement, usually no health insurance. This isn't "an appeal" or "a deal" they took, like they decided it would be cute to live a libertarian dream in the sticks. They have no other choice. This is what being poor is: a lack of options and no recourse. Rural people who aren't poor still live there because... it's their home. You don't just decide move away from your family, friends, support structure, and entire way of life, because you want easier access to a pharmacy. Expecting people to just put up with pharmacy deserts or move, is a pretty hostile and careless position. It would be like expecting city people to get mugged every so often because that's the price you pay for wanting to have a pharmacy nearby. These things shouldn't be expectations, they are problems to be solved, as in most other developed nations they largely are solved. We're the freaks for putting up with ridiculous amounts of crime, death, inconvenience, and needless expense.
- deleted 2y ago
  [deleted]
- WarOnPrivacy 2y ago
  > Rural people who aren't poor still live there because... it's their home. You don't just decide move away from your family, friends, support structure, and entire way of life, because you want easier access to a pharmacy. It absolutely is all of that. It's also the money. $10k in flames is the low end of an interstate move. Supporting yourself and arranging all the pieces (ex:training) into a job that pays the bills - maybe quadruple that. Maybe more. And all of that assumes luck.
  - relaxing 2y ago
    Who said anything about an interstate move?
WeylandYutani 2y ago
I remember a documentary on China and apparently they let people study medicine for free if they play Medicine Woman Quinn in the boonies for a few years in exchange.
- bgnn 2y ago
  If you study medicine in Turkey, at a public or private university, you have to do up to 3 years of mandatory but paid service in a place government assigns you in order to obtain your diploma. This is how you can get rather good healtchcare coverage accross the country. You need to do this once more if you do a specialization.
cogman10 2y ago
I grew up in a fairly rural community. Every common service has basically collapsed. The town I lived in had a grocery store, full service station, restaurant, hardware store, and even a bowling alley. Those are all completely gone. This was in a town with about 300 people. How the collapse happened is actually pretty simple. As suppliers slowly consolidated they started raising prices for smaller business as somewhat of a "go away, you're annoying to deal with" policy. It's simply far easier to sell 1000 items to walmart than it is to sell 10 items to 100 different stores. That in turn collapsed businesses in the town as you could literally go to the walmart a 45 minute drive away and get things for half the price. Medicine is mostly due to privatization of education and consolidation of medical offices. There are simply limits to how many students medical schools can take and as a result they've simply continued to raise tuition prices to try and limit demand. That has put huge debt burdens on new doctors which makes working in rural locations particularly unappealing (they can't afford the salary a doctor needs to afford the debt they've taken on). 15 minutes from my hometown, there's a medical center that used to employ about 10 doctors when I was a kid. Now it's mostly staffed by 1 or 2 nurses with a doctor that comes in 3 times a week. Where they used to have to tools and equipment to handle most medical needs, now they are effectively just a stabilization location while patients wait for life flight to take them to one of the more major medical locations. I personally blame weak anti-trust enforcement and mass privatization and deregulation for the current state of things in rural America. These communities are dying because they have no capital power. That causes them to be steam rolled by basically everyone. Big business has wrecked that part of america.
- cogman10 2y ago
  Oh, and one more thing I'll add. I can't move to my hometown anymore because housing prices have gotten insane. I could probably build for cheaper than it costs to buy an existing home. Why is this? Because a bunch of "get rich quick" scammers have purchased all the vacant homes and turned them into air-bnbs while they wait and hope to flip the properties to someone else. My hometown is not some sort of "vacation destination". I highly doubt anyone is ever renting a single one of those homes. Yet here we are, with people sitting on property that used to be the homes of my childhood friends leaving them vacant or with a sale price that's double or triple what it should be for the location.
s1artibartfast 2y ago
Not really, it doesn't have to be a binary, and wasn't always that way, and doesnt have to be this way.

rtkwe 2y ago

Very few completely eschew the option to get medical services when they decide they need them.

gruez 2y ago
The point is that being far away from critical services is part of the rural-urban tradeoff. It's like being upset that there isn't a level 1 trauma center within a 30 minute drive, because you live in the middle of nowhere. Nobody is going to deny the importance of living near a level 1 trauma center, but you kinda signed up for it when you decided to live in the middle of nowhere.
- fdsseghy 2y ago
  Easy there. Just because you can afford a computer, internet, car and rent doesn’t mean everyone can. A common theme of rural America is getting out if you can.
  - bobthepanda 2y ago
    It costs money to move, and if you don’t have the money I wonder how kind the GP commenter would be to someone fleeing a rural area and living out of their car or a tent in their community.
- femiagbabiaka 2y ago
  Some people do not decide.
- s1artibartfast 2y ago
  I think the "you signed up for it" rubs me the wrong way. Particularly when it doesn't have to be that way, wasn't always that way, and there are specific policy choices causing a change. Sure, most places never had a level 1 trauma center, but they did have hospitals, clinics, and pharmacies. Many of these medical institutions are leaving despite increasing population due to changing healthcare economics and policy choices.
- soco 2y ago
  You signed up for it by deciding to be born in one of the families living there, with no money nor possibilities to move away. Now what? Receive the irony of the well-situated IT workers for it?

sieabahlpark 2y ago

[dead]

throwawaysleep 2y ago

Rural America certainly votes that way. I’d be curious if the people in these counties view this report as more than bashing.

delichon 2y ago
There were three doctors here before Obamacare, now zero, same population. So it's very common out here to blame that. Healthcare access in the nearest big city has also cratered. Two week appointments have become six months ... to see a nurse.
- cogman10 2y ago
  I have a nephew currently going to medical school in Idaho (So by no means prestigious). By the time he's finished the expected tuition costs are $500,000. A big reason you don't see family doctors in the sticks isn't because there aren't people that would love to be a small practice in the middle of nowhere. It's that nobody but a major medical institution can give them enough of a salary that they don't go broke under student debt.
- mjevans 2y ago
  I'm extremely hopeful that congress will do something crazy like repeal that or otherwise screw things up SO BADLY we, as a country, backlash far enough to socialize the basic human rights. EVERYONE should have healthcare. Just provide and tax to fund. It'd be cheaper than their medical bills, and WAY less headache if they don't have to deal with medical billing <<< THAT is the selling point. Everyone should have retirement... wait that's what social security was supposed to be right? What's the problem *(other than funding it)... Medicine has developed 'old people jails' to turn the elderly into medicine consuming vegetables like some dystopian videogame or movie? Well... socialize that and have the experts figure something out. That's clearly a problem of improperly aligned incentives wound around a bunch of stuff I'd like people of various correct fields to address. Why there aren't people in big cities: Costs too damned much to DO anything here; the rent is WAY too high. (we need to build a LOT, a WHOLE LOT more to catch up to years of not enough housing and slightly less not enough of the other stuff). Why there aren't people in the rural areas: I suspect that though the rent is nicely low, the population density no longer supports the service. PART of that could be addressed by getting everyone on the same service (single payer healthcare), 3000 people sounds like enough for a basic family practice doctor to me. That's seeing ~10 people a day for 300 days out of 365 days a year. However that's about it.

0xbadcafebee 2y ago

You're really stretching by assuming rural Americans have the option of living somewhere else. I live in a relatively small town (~3000, though it's much bigger than other towns nearby). Most people here have never gone more than 100 miles from town. They have shit jobs (when they get them), live below the poverty line, have poor education. There is no transportation but rotted-out 20-year-old trucks or whatever $500 used car you could find in a nearby town. Their families have lived here their whole lives. They have no savings, no retirement, usually no health insurance. This isn't "an appeal" or "a deal" they took, like they decided it would be cute to live a libertarian dream in the sticks. They have no other choice. This is what being poor is: a lack of options and no recourse. Rural people who aren't poor still live there because... it's their home. You don't just decide move away from your family, friends, support structure, and entire way of life, because you want easier access to a pharmacy. Expecting people to just put up with pharmacy deserts or move, is a pretty hostile and careless position. It would be like expecting city people to get mugged every so often because that's the price you pay for wanting to have a pharmacy nearby. These things shouldn't be expectations, they are problems to be solved, as in most other developed nations they largely are solved. We're the freaks for putting up with ridiculous amounts of crime, death, inconvenience, and needless expense.

deleted 2y ago
[deleted]
WarOnPrivacy 2y ago
> Rural people who aren't poor still live there because... it's their home. You don't just decide move away from your family, friends, support structure, and entire way of life, because you want easier access to a pharmacy. It absolutely is all of that. It's also the money. $10k in flames is the low end of an interstate move. Supporting yourself and arranging all the pieces (ex:training) into a job that pays the bills - maybe quadruple that. Maybe more. And all of that assumes luck.
- relaxing 2y ago
  Who said anything about an interstate move?

WeylandYutani 2y ago

I remember a documentary on China and apparently they let people study medicine for free if they play Medicine Woman Quinn in the boonies for a few years in exchange.

bgnn 2y ago
If you study medicine in Turkey, at a public or private university, you have to do up to 3 years of mandatory but paid service in a place government assigns you in order to obtain your diploma. This is how you can get rather good healtchcare coverage accross the country. You need to do this once more if you do a specialization.

cogman10 2y ago

I grew up in a fairly rural community. Every common service has basically collapsed. The town I lived in had a grocery store, full service station, restaurant, hardware store, and even a bowling alley. Those are all completely gone. This was in a town with about 300 people. How the collapse happened is actually pretty simple. As suppliers slowly consolidated they started raising prices for smaller business as somewhat of a "go away, you're annoying to deal with" policy. It's simply far easier to sell 1000 items to walmart than it is to sell 10 items to 100 different stores. That in turn collapsed businesses in the town as you could literally go to the walmart a 45 minute drive away and get things for half the price. Medicine is mostly due to privatization of education and consolidation of medical offices. There are simply limits to how many students medical schools can take and as a result they've simply continued to raise tuition prices to try and limit demand. That has put huge debt burdens on new doctors which makes working in rural locations particularly unappealing (they can't afford the salary a doctor needs to afford the debt they've taken on). 15 minutes from my hometown, there's a medical center that used to employ about 10 doctors when I was a kid. Now it's mostly staffed by 1 or 2 nurses with a doctor that comes in 3 times a week. Where they used to have to tools and equipment to handle most medical needs, now they are effectively just a stabilization location while patients wait for life flight to take them to one of the more major medical locations. I personally blame weak anti-trust enforcement and mass privatization and deregulation for the current state of things in rural America. These communities are dying because they have no capital power. That causes them to be steam rolled by basically everyone. Big business has wrecked that part of america.

cogman10 2y ago
Oh, and one more thing I'll add. I can't move to my hometown anymore because housing prices have gotten insane. I could probably build for cheaper than it costs to buy an existing home. Why is this? Because a bunch of "get rich quick" scammers have purchased all the vacant homes and turned them into air-bnbs while they wait and hope to flip the properties to someone else. My hometown is not some sort of "vacation destination". I highly doubt anyone is ever renting a single one of those homes. Yet here we are, with people sitting on property that used to be the homes of my childhood friends leaving them vacant or with a sale price that's double or triple what it should be for the location.

s1artibartfast 2y ago

Not really, it doesn't have to be a binary, and wasn't always that way, and doesnt have to be this way.