Rural hospitals were at the center of various negotiations and compromises made yesterday in Congress. The big topic, of course, is health care reform. The Democratic Blue Dog Coalition has been demanding more for rural hospitals. The Post notes that Blue Dogs are "from largely rural districts" who have enough votes to stop health care legislation from passing through the House Energy and Commerce Committee.  The Washington Post explains: 

Rural health-care providers generally receive less in Medicare reimbursements than their urban counterparts, and delinking the public plan from Medicare was considered critical for conservative Democrats. "We have saved America's rural hospitals from closure," said  Rep. Mike Ross (D-Ark.), a Blue Dog leader on the committee. 

Meanwhile, Post business columnist Steve Pearlstein has a recommendation for the Dogs: "If they really want to solve the doctor shortage in their home states, for example, they could propose a small tax on all hospital services and use the money to provide free education to all medical students -- in exchange for a few years of service in underserved communities." 

Rep. Mike Ross (above), a Blue Dog Democrat from rural Arkansas, comes from a town where many of his constituents can't afford health care. "Yet Ross stands ready to try to block passage of a House bill that, its supporters say, would provide exactly what Arkansas needs: guaranteed insurance and a wider choice of coverage at competitive prices," write Eric Pianin and Ann Carrns with Kaiser Health News. The two writers go to Prescott, Arkansas, to explore what they say is a "conundrum": that even though many Blue Dog voters would benefit from the health care bill now in the House, Blue Dog representatives oppose it "because they say it’s too costly and doesn’t solve other health care problems in their mostly rural districts."

Ross has said that unless changes are made, they'll vote against the bill in the House Energy and Commerce Committee. "What we’re talking about is containing the cost, slowing the rate of growth of health care down where it can grow at the rate of inflation,” Ross said in an interview, “because if we don’t, it’s going to bankrupt this country.” 

In Prescott, in southwest Arkansas, the reporters find that the "economy is taking a toll on health care...." Twenty percent of Prescott's residents don't have insurance, and premiums have risen by 80 percent since 2000. There's need and suspicion there. Hospitals have closed in rural Arkansas because of low reimbursement rates, which is one of Ross's concerns. “You know, it’s easy to provide everybody a shiny new insurance card,” he said. “But what’s important here is they actually have access to a doctor once they get the insurance card.” 

Nick Reding went to Oelwein, Iowa, to write a book about meth. What he produced, at its heart, is a story about how a small town can survive the worst.

What's the cheapest route to health care reform? Staffing "continuity care homes" in places now medically underserved, writes Dr. Robert Bowman.