Summersville Regional Medical Center is city owned. It provides great care and it is among the lowest cost hospitals in the U.S. It is a rural medical miracle.

Just what did Sen. Kent Conrad of North Dakota have in mind when he insisted that the health care reform bill in Congress contain provisions for medical co-ops? Chuck Haga of the Grand Forks Herald writes that it is the Wilson Health Planning Cooperative now forming in an 11-county region of western North Dakota (scene above). 

The co-op started in 2002 as residents looked at ways to reduce poverty in the area. “We were a little startled to see how direct the connections were — how poor health leads to poverty, and how poverty leads to poor health," one organizer told Haga. The co-op is named for a family doctor who serviced the area for more than half a century. Dr. Herbert Wilson is on the board of the co-op and he describes a careful process of organization that included 10 open meetings in the region. Haga wrote the organizers learned that people "want the cooperative to be local and self-governing, available to all, affordable and offering high quality care. They want it to cover a broad range of health services, from preventive care to family medicine to hospice care. And they want a diverse makeup to their cooperative, pulling private insurers, the Veterans Administration, the Indian Health Service and other interests together, which they believe would provide efficiencies, cost savings and easier accessibility."

The co-op has designed a "Wilson health card" bearing a picture of the doctor and is now trying to see how it can fit in with federal legislation.

President Obama meets with tribal leaders this coming Thursday. The President should consider treating Indian Country as the 51st state.

The Obama administration is making a health care reform pitch to rural America today. It comes in the form of a report issued by Health and Human Services Secretary Kathleen Sebelius, the former governor of Kansas. The report tells us that one in five Americans who are uninsured live in rural communities — which is to be expected, since one out of five Americans live in rural communities. 

Sebelius said in a conference call today that the "system we have really isn’t working for the 50 million” Americans who live in rural areas, she said, according to the Grand Forks Herald. “A lot of them are self-employed or work for family businesses, including family farms,” Sebelius said, and are disadvantaged by “not many choices and extremely high prices and rules that don’t protect consumers.” 

The Grand Forks paper wrote that the new report states that “millions of rural Americans have limited access to a primary health care provider,” and “with the recent economic downturn, there is potential for an increase in many of these health and access disparities that are already a problem in rural communities....There were only 55 primary care physicians per 100,000 residents in rural areas in 2005, compared with 72 per 100,000 in urban areas. The rate decreases to 36 per 100,000 in isolated, small rural areas. There are nursing shortages as well, with less than half as many nurses per capita in isolated rural sareas than in urban areas.”