Six weeks ago visitors to the farm gate were urged to take care of their health. Diet and exercise and other common sense suggestions were made. But all of that was predicated on the assumption that you have a doctor nearby to help you monitor your health. While there are many who are going to ignore the New Year’s offering, there are probably just as many or more who have no opportunity to check up on their health because of the shortage of medical care in rural America. While this issue is not going to increase your revenue or reduce your production cost, it is an issue that affects you, impacts tens of thousands of your brethren, and is part of the Farm Bill. If the health of your farming community is a concern because the closest medical clinic is too far away, it should be a concern to all in farming. You might be next.

Rural health has a voice in the Farm Bill, and in the 2002 edition it was addressed in Rural Development, Food and Nutrition, and Food Safety. However, the infrastructure issues are in the Rural Development Title, which was $2.6 billion. The political winds favor an increase in that area for 2007. Rural Development can provide money for hospital construction and connections for telemedicine, which links doctors with patients at a distance. (So you don’t have to turn your head and cough really loud!)

Rural health and other rural issues are monitored by the Rural Policy Research Institute at the University of Missouri in cooperation with the USDA and other Land Grant institutions, which say rural Americans are not getting their share of federally-funded programs because of structural issues. In cooperation with the National Rural Health Association, RUPRI Director Chuck Fluharty says, “Federal payments into rural areas tend to be to individuals (Social Security, welfare payments, etc.) whereas a greater proportion of funds for urban areas support infrastructure development (federal revenue sharing, mass transit, etc.). Federal payments per capita into rural counties average $200 less than to urban counties. Individual transfer payments are of value to the individual but don’t help meet community needs.” Farm commodity payments can pump a lot of cash to farmers and landowners, but that has increased land values without increasing economic development in rural areas according to the Kansas City Federal Reserve Bank.

While commodity program funds may not be helping build the rural health infrastructure, the USDA Rural Development programs can provide funding for a variety of resources. “Rural Development Programs are highly utilized in many states. They provide a small amount of grant funding for hospital and clinic construction, and leverage much more through loan guarantees and interest rate subsidies. They help fund construction of a range of related health facilities including wellness centers, emergency medical services (EMS), and long-term care centers. Development funds support telemedicine development and a range of forms of rural economic development. Rural Development programs also have been used to support broadband construction for rural communities.”

RUPRI and the National Rural Health Association call for supporters to assist with a variety of strategies to increase Congressional attention to medical shortages in rural areas and fund solutions in the 2007 Farm Bill. They include:
1) Funds for rural development should be immune from WTO criticism
2) Programs should be funded that will support capital building projects for rural hospitals.
3) Broadband Internet access should not take as long to connect rural communities as the REA did for electricity.
4) Strategies should be created to bolster rural economic development.
5) The Farm Bill should be recognized as “America’s rural policy” and should include a number of programs of benefit to rural America.

Summary:
Diminishing populations in rural areas raise the likelihood of shortages of primary health care, which includes doctors, hospitals, and pharmacies, but the rural health infrastructure is one of the elements of the Farm Bill. Income transfer programs, compliant with the World Trade Organization rules, could be implemented to provide improved rural infrastructure. The Farm Bill may provide public feeding programs in urban areas, but it is also America’s rural policy.