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Let’s double the number of Doctors for Rural America

yonkman


I find that rural voters can be pretty progressive on certain issues. It just depends on how you talk about it and how you position your approach. This short blog is not about changing policy.  It is about talking to the rural voter about healthcare in language that is meaningful and impactful.


The Issue


One of the biggest issues in rural America is that there are not enough doctors. And I experienced that when I moved back to the family farm.  Without using my connections, leverage, or resources, it took me over a year to find a primary care physician who fit. The issues were legion are enough to fill an entire separate article. And it can take 4 to 6 months to secure an appointment with a specialist.


From time to time I float the idea with rural voters that there is a simple way to double the number of doctors. This piques people’s interest as the doctor scarcity issue affects nearly everyone.  It is also the reason many people are loathe to expand coverage – adding to the number of insureds without increasing the number of doctors will make it even harder to find doctors and to secure appointments.


When asked how I would do this, I point out that doctors in the U.S. spend up to 60% of their time on insurance matters, including billing and collection costs, rather than doctoring. If we went to simply one insurer we would eliminate that waste. That could double the number of Doctor hours available to patients, which for all practical purposes is doubling the number of doctors in all specialties. 


This is met with enthusiastic support. I often get asked why no one has thought of this before.


The Backstory


Winston Churchill’s most insightful comment about the United States was “You can always count on the Americans to do the right thing – after they have exhausted all other options.”  We are there on health care.  One way or another, we will eventually get to single-payer healthcare. It is simply a matter of time. 


The reason every country in the G20 (except for the United States) and every country in the OECD 34 (except for the United States and Mexico) has single payer health care:  It works.  It is one thing that government does well.  The United States spends twice the amount on health care per capita than the next highest country, yet achieves generally worse outcomes.  Studies suggest the US would save nearly $2 trillion over 10 years after implementation of single payer healthcare.


There are dozens of reasons for this, but one crucial drag on our system is that a US doctor spends an inordinate amount of his or her time navigating and justifying treatment with multiple insurance companies, each with its own rules, protocols and forms. (Not to mention the time that employers spend negotiating plans and navigating the same labyrinth).  A Canadian doctor often spends ten times fewer hours doing this.


Marketing Universal Health Care to Rural Americans


Democrats attempted to market healthcare to voters by pitching tactics and not strategy.  Up to this point Democrats have tried to sell “Universal Healthcare,” “Single Payer Healthcare,” and “Medicare for All.”  It didn’t work and Democrats have generally given up on the issue at this time.


The buzzwords used by Democrats were fraught with problems. First, to many people they sound like socialism when pitched as an end in and of itself.  Second, it sounds like Democrats are going to allow 20% more people into the system without increasing the number of doctors, which will make it even harder for people to get a doctor’s appointment. And third it sounds very expensive.  This is a no go strategy.


On the other hand, proposing to double the number of doctors while eliminating waste is a win-win strategy. In one fell swoop, is clear to the voter where the waste is, why it would increase the number of Doctor hours, how even with more people covered, there would still be enough doctor hours to go around, and why even with more people covered, it would still be less expensive.


There is enthusiastic support for this approach. It is simply an approach to the topic that resonates with the rural voter. And if Republicans argue that doubling the number of doctors is inaccurate, and that it’s really only 25%, that is a great argument to have. Or that you’re not really doubling the number of doctors but simply doubling the number of Doctor hours. Again, a great place to be having a discussion.


Talking Points for Democrats


Universal health care is no longer being actively promoted by Democrats.  Yet this is the time to start planting the seeds of an approach to health care that will actually address the doctor shortage for rural voters.  It sets up Democrats to having more in their policy agenda than just Obamacare. 


It is also a terrific example of the danger of eliminating the rural voice from national politics.  There is no staff dedicated to rural outreach in the White House, even though the rural vote represents at least 25% of the Electoral College vote. Rural voters are intuitively aware of this.


This is a problem.  When there is no voice at the table, you can’t know what you don’t know.

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Win in 2024 Reclaim the Rural Vote by Mark Yonkman

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Tel: 231-878-5161

Stakes for the 2024 election could not be higher. The future of our democracy is on the ballot. But Democrats won’t win if they can’t speak effectively to the rural voter.


President Obama proved it can be done in the modern era.   We can do it again.


I’ve had the unique opportunity to experience both sides of the urban-rural divide. Growing up on my family’s farm in Michigan and spending my professional career as an attorney in urban settings has given me the ability to understand and appreciate both perspectives.


My goal is to help Democratic campaigns to effectively reach and persuade the rural voter and to help them consciously build a rural function into their campaign staff to reach this under-represented minority. I’m pleased to make myself available as a resource to support political campaigns in the all-important rural homesteaded states.

Mark W. Yonkman
Democratic Operative's Handbook

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