Public Health Scene

The fact that this country's health policy is crafted in the urban setting of Washington D.C. is both a symbolic and concrete example of how rural America can be left out of reform discussions, says SPH professor Ira Moscovice.

As director of the Upper Midwest Rural Health Research Center, Moscovice has highlighted how reform measures have failed to consider the rural health care context. For instance, proposals that seek to expand coverage have not accounted for the longstanding access issues faced by those living in rural areas. And higher government reimbursements for large, often urban-based providers who invest in robust health information technology put smaller rural-based providers at a disadvantage. Moscovice's team released a series of reports on these issues at the request of the Health Resources and Services Administration, one of the largest agencies in the U.S. Department of Health and Human Services.

"Rural heath care shouldn't be an afterthought," says Moscovice. "We want to make sure the 20 to 25 percent of Americans who live in rural settings aren't left behind."