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> Most people cannot afford to move. That calculus gets a little different for some folks if the move comes with subsidized universal healthcare and better soc

• toomuchtodo 1y ago
  If you can’t change their mind, and you can’t change their vote, and rural voters die faster than urban voters because of lack of access to healthcare services, state universal healthcare is the best we can do until electorate turn over through rural age out can improve political outcomes. Until then, we are held hostage by the irrational and unsophisticated with votes, which is unfortunate but the reality of the situation. It’s exhausting being dragged by low empathy unsophisticated humans frankly, I am personally over it. I was naive about human nature, hard lessons learned.
  • giantg2 1y ago
    "and rural voters die faster than urban voters because of lack of access to healthcare services, state universal healthcare is the best we can do until electorate turn over through rural age out can improve political outcomes." Is there any evidence that universal healthcare would address the facility and physician shortages in rural areas? It won't make much difference if you give people coverage if they still can't exercise that coverage, or just get subpar care in many rural facilities. It seems that many rural hospitals have turned into glorified helipads to transport many patients to bigger cities. For example, the uninsurance rate for urban vs rural is only 1-2%. It seems like that wouldn't explain the larger gaps in health outcomes. It seemsbother factors would be more important.
    • toomuchtodo 1y ago
      Rural hospitals close because they lack funding. When they have funding, they can stay open and continue to retain medical staff. When they close, mortality rates increase. Can I prove universal healthcare would keep these hospitals open? Highly speculative based on what that solution would look like. I can only prove stripping Medicaid funding is going to close them, with the consequences enumerated. https://www.nbcnews.com/news/us-news/rural-hospital-closings-cause-mortality-rates-rise-study-finds-n1048046 https://www.nbcnews.com/news/us-news/rural-hospital-closings... https://www.nber.org/papers/w26182 https://www.nber.org/papers/w26182 https://pmc.ncbi.nlm.nih.gov/articles/PMC9633454/ https://pmc.ncbi.nlm.nih.gov/articles/PMC9633454/ https://ruralhospitals.chqpr.org/ https://ruralhospitals.chqpr.org/ https://www.aha.org/fact-sheets/2025-06-13-rural-hospitals-risk-cuts-medicaid-would-further-threaten-access https://www.aha.org/fact-sheets/2025-06-13-rural-hospitals-r... https://www.kiplinger.com/taxes/medicaid-cuts-and-your-local-hospital https://www.kiplinger.com/taxes/medicaid-cuts-and-your-local...
      • giantg2 1y ago
        Medicaid reimbursement rates tend to be lower than the cost to treat in many instances. Only preserving Medicaid funding will not prevent hospital closures. We already know that with or without Medicaid, rural hospitals continue to close. The only difference is the speed at which they do. The question was about some universal system preventing rural deaths. If the coverage difference is only 1-2%, then coverage doesn't seem to be the driver. If it's a provider and facility shortage, then we would need some strategy to address the provider shortage, even if we assume we can fix the facility issue by providing higher reimbursement rates or grants.