The Consequences of Strategic Intervention: Providing Health Care for Rural America

The National Conference will continue its examination of regional strategic interventions, in which medical school departments partner with communities and agencies to increase the primary care workforce and the availability of health care for rural America.

Baretta Casey, MD

Even if NO health care reform proposal passes in the near future, it is still a public policy issue that has to be addressed. If one looks at the entire history of federal policy development in the area of “primary care” (a term the “feds” promoted), going back to the beginning of World War II, there have been key decisions as well as “non-decisions” that in historical perspective can be considered as importantly consequential.

Whatever was to happen to the health care system was to be (1) something or (2) nothing. Either “change” or “no change” would have consequences for physician supply, the underserved and uninsured (which should be considered different concepts), rural health care access, care of the healthy, sick and frail elderly, care of children, and public health issues.

If health care reform should end up a compromise that takes in features that neither the reform advocates nor status quo advocates had considered (e.g., non-profit cooperatives, or triggers that base more extensive government intervention on the number of health care plans available in an area), there will need to be more work done (clean-up legislation, regulation promulgation, and, of course, implementation of the reforms by all the entities concerned).

Preceding a series of presentations on regional issues, a roundtable panel will discuss the issue. Participants will include Doctor Baretta Casey of the University of Kentucky and Robert Maudlin of the Spokane Family Medicine Residency.

Dr Casey is associated with the University of Kentucky’s rural center located in the Appalachian town of Hazard.

Robert Maudlin, Pharm. D.

Dr Maudlin has been a pioneer in establishing physician residency programs in private practices in very small communities in Eastern Washington and elsewhere in the University of Washington’s WWAMI program, an initiative that links medical school admissions and physician residency programs to underserved communities in the States of Washington, Wyoming, Alaska, Montana and Idaho.

Additionally, he has consulted throughout the United States on programs that create strategic linkages between educational institutions with rural communities.