How Will the New Health Care Impact Rural?
[imgbelt img= Steph-Larsen530.jpg]Rural youth speak out at the National Rural Assembly in St. Paul, MN.
11:45 a.m., June 29
Broadband advocates connect over common concerns
The most widely discussed issue in broadband talk today is the impending AT&T/T-Mobile merger, and sentiments at the Assembly are decicively negative. There is concern over the creation of monopoly – e.g., decreased consumer choice – and over the possibility of wireless dominance over wired access.
Though the market is moving toward this end, participants in this morning’s breakout session insist that many of the opportunities that internet access opens to rural areas are contingent on wired service. Central to this debate is the issue of net neutrality.
The Rural Broadband Policy Group has published a letter denouncing the merger, which teh group intends to send to policy-makers in Washington.
Obama Administration’s Affordable Care Act in Rural
“People are just freaked out” about the new national health care reform care legislation, said a woman from Virginia. People are talking about death panels and whether “government will make us buy broccoli.”
But what’s in the bill for smaller communities? A sample:
• The act sets us Area Health Education Centers, which will help steer rural people into health care jobs. The idea is that it will be easier to train and keep rural residents in health care professions rather than try to convince city dwellers that they need to transfer to much smaller towns.
• The bill will fund the National Health Care Service Corps, another program aimed at encouraging health care workers to locate in underserved areas.
• The bill sets up a rural residency program. Most residencies (for doctors) are in cities, where doctors “learn how to do urban medicine,” explained Steph Larsen, who is with the Center for Rural Affairs. This new program will set up residencies for doctors who want to learn to do rural medicine.
(Yes, the medicine is the same, rural and urban. But rural docs needs to have a broader array of skills.)
• The law has a 10% incentive payment for doctors who do primary care in underserved areas.
• The bill has increased funding for community health centers.
One area that could have an impact on rural businesses is the creation of health insurance marketplaces. These marketplaces will make it easier for people and businesses to choose among health insurance providers.
This could undercut local insurance brokers, who are particularly active in rural communities.
11:00 a.m., June 29
Rural Philathropy ~ An Insider Approach
With all the talk about economic development – both domestic and international – it’s easy to get confused. What, after all, is the difference between rural development philanthropy (RDP) and traditional community philanthropy? It was only in the past couple decades that philanthropy became an organized industry in the first place.
The first breakout session on rural philanthropy is meant to help us answer these questions. It is a “comprehensive approach” that does not depend on an “outside funding stream,” said John Molinaro, co-director of the Aspen Institute Community Strategies Group.
Rural communities, which constitute one half of communities around the world and 20% nationally, certainly warrant development efforts. These communities are often rich in natural resources but poor economically, due to the outside control of resource production and refinement – often by large corporations that “strip mine” (literally and figuratively) these areas without consideration for the population’s wellbeing and sustainability.
Rural philanthropic efforts have often been managed in the same way with one-size-fits-all solutions, said Molinaro. He champions the idea that the key to sustainable, inclusive, forward-thinking development is Rural Development Philanthropy. This approach facilitates a ground-up, community-led approach that has the promotion of wellbeing for all community members built into its definition.
Check back this afternoon for updates on the second rural philanthropy session.
“Let’s Make It Real”
Maybe it’s corny to say that young people “are the future,” but it seems true in rural America.
Demographer Ken Johnson began the Wednesday morning session with a report from the U.S. Census. Rural population grew in the last ten years, but at a far slower pace than in the cities.
But there were indications that where there was some economic opportunity, young people were moving back to rural counties. (In retirement counties, for example, both older people AND younger adults are moving in, for example.)
The consensus among the panelists responding to Johnson’s report was that young people must now be considered “assets,” not only for the rural economy but for local cultures. “Young people want to stay with us,” said Kim Phinney with YouthBuild USA. “They are our ultimate wealth creation.”
(Phinney was less excited about the Obama administration’s relatively new council on “community solutions,” a White House group created without a single member from rural America. Phinney noted that the new group concluded that its number one priority was “disconnected youth.” Phinney noted that there was a lot of disconnection going on.)
Chuck Fluharty, with the Rural Policy Research Institute, said there were two points rural Americans should agree on. The first is that “the future of rural America is young champions.” The second is that “culture matters.”
Fluharty said he had hopes for the new White House council on rural America. Four working groups have been formed in the White House, Fluharty said. Some are meeting today. Cabinet secretaries will go out into rural communities this summer.
The key, Fluharty said, would be for rural Americans to push. “The issue is, let’s make it real,” Fluharty said. “And this assembly has something to say about it.”
“New Trends in Birth, Death, and Movement: America’s Future in Education, Youth Development, and Diversity”
Kenneth Johnson of the Carsey Institute talked a lot about demographics, and had plenty of fresh data to back up his claims.
Rural America grows in two ways, he said, citing the birth-to-death ratios and migration, both domestic and foreign immigration. This dual process leads, he said, to “diverse patterns of population change.”
Perhaps most shocking, Johnson reported that there are 750 non-metropolitan counties – that’s 36% of all rural counties — where more people die than are born. There are “four funerals for every baptism” in certain Minnesota counties, Johnson said, quoting a friend.
Johnson called the current influx of middle-aged and elderly adults into rural communities, a trend coupled with an outflow of adolescents and young adults, “a perfect storm.”
But the “biggest story coming out of Census 2010,” Johnson said, “not just for rural America but for all of America,” is the growing diversity of the nation’s population from children to seniors.
“America is changing from the bottom up, from the youngest to the oldest,” he said; 46% of the population under 18 years of age is minority.
Johnson added that poverty is “one more kind of diversity that rural America has.”
Once the stage was opened up to roundtable talk among the invited speakers, Kim Phinney of YouthBuild USA criticized President Obama’s rural policies, which take as their first priority so-called “disconnected youth.” Phinney sees the policies as themselves disconnected.
But “what on earth are we going to do about [these problems]?” Brian Dabson asked.
The answer, said Delia Perez and the Llano Grande Center, is education. Phinney added that we need an “asset-based approach” regarding our young people, who are our “ultimate [form] wealth creation.”
“We will have completely missed the boat” with economic development policies, Phinney said, if we do not focus efforts on youths.
A different approach: “Culture and values are at the heart” of rural America’s opportunities, said Peter Morris of the National Congress of American Indians. The opportunity to take advantage of collaboration with Native nations, he says, is crucial to building an inclusive and prosperous nation.
8:45am, June 29
Good morning, Rural Assembly
The 300 participants in the 2011 National Rural Assembly are gathered again into the Minnesota Ballroom, where last night’s speeches were set, orating the outset Day Two.
Talks this morning include St. Paul Mayor Christopher Coleman, who continued yesterday’s themes of connectedness and cooperation. “If we keep on hitting ourselves against each other,” he said, “we’re not going to get very far.”
Coleman urged participants to “inform us on urban boards like Minneapolis and St. Paul,” saying, “I hope we [in cities and rural areas] start to understand each other.”
Daily Yonder’s Bill Bishop, Alex Bloedel and Shawn Poynter
covered the three days of the National Rural Assembly in St. Paul, MN, a
gathering of 300 rural advocates and national leaders June 28-30. Check the
following links for all the posts from Tuesday, Wednesday morning, Wednesday afternoon, and from Thursday morning here and here.
Also, Center for Rural Strategies has compiled a library of
up-to-date materials on rural transportation, youth, broadband, native
nations, education, environmental justice, and more. Find those papers here.