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U.S. Senate Panel on Challenges of Providing Rural Health Care

Testimony by Dr. Deborah Richter
C-SPAN, September 26, 2018

U.S. Sen. Bernie Sanders (I-Vt.) heard testimony Tuesday afternoon from Dr. Deborah Richter of Cambridge, Vt. during a Senate roundtable discussion focused on the costs and availability of health care in rural America.

Sanders invited Richter, who works in primary care and addiction medicine in rural areas of Vermont, to testify before the Senate Subcommittee on Primary Health and Retirement Security. Richter told the senators she sees “the inadequacies of our health care system every day.”

Richter said the problems with our nation’s health care system “are magnified in rural America” since patients are “older, sicker and poorer.” “This is particularly true of the impact of the opioid epidemic which started in rural America,” she said.

Recent studies show rural Americans, compared to those in urban areas are disproportionately more likely to suffer premature death from heart disease, cancer, stroke and many chronic diseases. Deaths among rural Americans from opioid overdoses, vehicle crashes and other accidents are about 50 percent higher than those among people living in urban areas, the studies state.

“When we are looking to reduce health care costs now and in the future, we must first address the primary care shortage,” Richter said. “Primary care represents most of the medical office visits in any one year. In a nutshell, primary care is most of the care to most of the people most of the time. Yet, we represent less than eight percent of total costs.”

During the discussion, Sanders emphasized that a Medicare-for-all system would provide better and more affordable health care than our current system, including in rural America.

“As a physician who has practiced in the U.S. health care system for the past 30 years, I would say that in my experience, unless we address the system as a whole we will not solve any of the pressing problems in health care. We need to regard health care as a public good and make it accessible to all. We have wonderful health professionals and hospitals in this country. We are spending enough money,” Richter said. “We need a program of expanded Medicare for all Americans.”

https://www.c-span.org...