Changing Trends in rural America (lake, houses, tractor, land)

[KCZ]

Originally Posted by TabulaRasa

It isn't unreasonable to want basic health care and skilled emergency services. Especially with an aging population.

It's unrealistic to find or develop extremely expensive services in a community of <1000 people that's 1 1/2 hours away from the nearest largest community. Who pays for that?

[Serious Conversation]

Originally Posted by TabulaRasa

It isn't unreasonable to want basic health care and skilled emergency services. Especially with an aging population.

I live adjacent to some very rural, now depopulated counties in southwest Virginia. Decades ago, these counties were coal mining hubs, with jobs and attendant services like hospitals to match. Today, there are very few customers there with traditional insurance, and many of the people those hospitals serve have no insurance at all or on Medicare/Medicaid.

Reimbursement is substandard. Declining patient volumes, poor reimbursement rates, and rising costs are the death knell for rural healthcare. Combine these issues with high rates of opioid/drug/alcohol dependence in the local population and a poor overall quality of life (what doctor wants to live in rural southwest Virginia an hour away from even a chain restaurant like an Applebee's), you end up with a mess.

Most people have absolutely no idea how much money many rural and small town hospitals lose. A small community hospital can lose many millions of dollars per year.

I've always told people who want extremely rural that if you want to be that far out, you're kind of on your own in regard to the available healthcare.

[augiedogie]

Rural areas are not all the same. Rural west Texas is shrinking towns, little to no medical care, very basic shoping, or none, lots of old people as most of the kids moved away. Literally nothing to do, other than kids sports, but watch the wind blow the dust and tumble weeds.

Rural Wis is quite. Small towns are pretty vibrant. Lots of festivals and other planned activities. Lots of sports and Recreation available. Hunting and fishing are popular pasttimes. Good availability of food and most daily supplies. Medical care though is still a problem, which requires a trip to a medium sized city.

[TabulaRasa]

You don't have to run huge, elaborate hospital systems to offer basic medical services in small community health clinics. It's a public health issue. Rural areas of literal third world countries maintain basic health clinics, in places that are so remote they make U.S. rural areas look positively suburban. It's doable.

It is also within reach to operate community mental health clinics. I know, I've worked for them. They don't exist in many locales where they are sorely needed.

[augiedogie]

We lived in a rural town of 5000, about all they could do there is write a perscription. Any treatment required a trip to a good sized town.

[katharsis]

Originally Posted by augiedogie

Rural areas are not all the same. Rural west Texas is shrinking towns, little to no medical care, very basic shoping, or none, lots of old people as most of the kids moved away.

Rural Wis is quite. Small towns are pretty vibrant. Lots of festivals and other planned activities. Lots of sports and Recreation available. Hunting and fishing are popular pasttimes. Good availability of food and most daily supplies. Medical care though is still a problem, which requires a trip to a medium sized city.

Just a thought --

I am wondering if many small rural "tourist-y" places will eventually turn into large and mostly unregulated (unplanned) retirement centers. It seems to me that for those of us who do not like the idea of living in a 55+ planned retirement community, that might be an ideal solution: lots of activities and beautiful scenery that would appeal to tourists in the summer might also provide an ideal retirement all year long.

We are (hopefully) moving to our retirement home in Door County, Wisconsin next year. Door County has a population about 29,000 for the whole county, with town populations ranging from about 200 to about 1,500, except for one "big" town (Sturgeon Bay, pop. about 10,000). Door County booms with tourists in the summer and again in October during peak foliage season, and so it has several major supermarkets and a major medical center, plus Green Bay is only an hour or so away, and it has many festivals and sporting activities throughout the entire year (which is a benefit that you pointed out). The only reason we can think of that Door County is not more popular with retirees is because the winters are long and cold -- but my husband and I enjoy all four seasons.

[Serious Conversation]

Originally Posted by TabulaRasa

You don't have to run huge, elaborate hospital systems to offer basic medical services in small community health clinics. It's a public health issue. Rural areas of literal third world countries maintain basic health clinics, in places that are so remote they make U.S. rural areas look positively suburban. It's doable.

It is also within reach to operate community mental health clinics. I know, I've worked for them. They don't exist in many locales where they are sorely needed.

A third-world style "health clinic" probably is not providing the level of care that even a standard urgent care would, much less a community hospital. Costs and regulatory burdens in a third world country aren't going to be anywhere nearly as high as the US.

Hospitals are mostly chock-full of professional, fairly well-paid personnel. Assuming no subsidies, that's going to be tough to do with declining patient volumes and revenue.

Originally Posted by augiedogie

Rural areas are not all the same. Rural west Texas is shrinking towns, little to no medical care, very basic shoping, or none, lots of old people as most of the kids moved away. Literally nothing to do, other than kids sports, but watch the wind blow the dust and tumble weeds.

Rural Wis is quite. Small towns are pretty vibrant. Lots of festivals and other planned activities. Lots of sports and Recreation available. Hunting and fishing are popular pasttimes. Good availability of food and most daily supplies. Medical care though is still a problem, which requires a trip to a medium sized city.

A lot of that is due to the local culture. Rural Wisconsin was mostly populated by Germans and other industrious people. It's remained mostly of the same ethnicity and without a lot of net in-migration. People are of a similar "tribe," hard workers, etc. It's easy for a place like that to succeed.

I'm from Appalachia. Work ethic here is generally not that good. A lot of smoking and poor lifestyle choices that lead to poor medical outcomes.

[rruff]

Originally Posted by Serious Conversation

A third-world style "health clinic" probably is not providing the level of care that even a standard urgent care would, much less a community hospital. Costs and regulatory burdens in a third world country aren't going to be anywhere nearly as high as the US.

Hospitals are mostly chock-full of professional, fairly well-paid personnel. Assuming no subsidies, that's going to be tough to do with declining patient volumes and revenue.

The solution is in your comment...

Healthcare in the US is over-regulated and over-priced compared to what regular people make and can afford. A good dose of deregulation and competition is indicated.

[MoNative34]

Is the final copy of the paper finished?

[Winterfall8324]

Originally Posted by KCZ

A lot of the complaints here are about a lack of things that aren't normally seen in a rural area anyways. The biggest problem in my rural town is people moving here from a city and then agitating for development and services that drive up our taxes. If you want shopping and services, stay in the city.

This is a brilliant observation.

Development and pushing to make the community more attractive can lead to a loss of its own value.

And it can't compete with the local city/suburb so there is no point trying.