Rural Health Care – Do Rural Areas Have to Accept Lower Quality or Availability of Health Care?

I am defined as a senior citizen. I live and work in a rural area. Yet, our firm operates and competes around the globe. The county in which I live is half the area of the state of New Jersey – the most densely populated state in the United States and the state I relocated from. The population of Kittitas County is less than 40,000 people compared to approximately 4.5 million people in a comparative area of New Jersey. New Jersey is the home of many pharmaceutical companies and the general region has some of the finest health and medical care available, whereas in our rural county in Washington State there are neither pharmaceutical companies nor great health care.


There is great health care in Seattle, but to access this great health care requires a trip of more than 100 miles (140 km) over a mountain pass. The debate here is not just affordable health care – a national passion at the current time – it is more personal in rural areas. It is whether we have any access to any quality health and medical care period. So, with trepidation, I enter the debate.


Not surprisingly, the OECD (Organization for Economic Co-operation and Development) reported in their “OECD Health Data 2009” that health care spending in the US per person was $7,290 and average life expectancy was slightly greater than 78 years. France spent approximately half as much per person and had an average life expectancy of 81 years, and Japan spent one third as much as the US on average and has an average life expectancy of slightly less than 83 years.

This news is discouraging for me. The US medical system, despite much criticism, is widely admired for its astonishing advancements, but even Switzerland spends only two thirds of the US per capita expenditures, and their health care is equally admired. The high cost of US medical care is due to our fee-for-service concept which leads to innovation because the service is available for anyone that can pay. The real national debate is over the nearly 50 million people who are not covered by medical insurance for a variety reasons and the growing cost of existing health services such as “Medicare,” which is causing the national debt to soar. (Also, I must acknowledge the national debt is soaring in addition because of the government efforts to counter the global recession this year.)


So why am I bothered about the health care debate? Because in rural America, the problem is wider than in urban and suburban America. In our area, there is a community operated and funded hospital within ten miles of us, but only basic services are available. As the average age of County residents increases (along with my my medical care needs) I worry more and more about whether I will have to return to New Jersey, where I lived for nearly 40 years. I think not! I am of the baby boom generation. I can and do, as I have said, offer my services internationally. I am unwilling to give up my quality of life here in Cle Elum, Washington.

I offer the following solution to keeping the best attributes of private health care combined with local initiatives which can serve as a broad model for rural areas such as ours.


We have established a philanthropic organization funded by the citizens of the community and government sources. We “facilitate” the availability of quality health services through our community efforts and a partnership we have established with one of the largest private medical centers in Seattle.

Through a combination of donor funding and the entrepreneurial efforts of the local residents, we are building a local, private medical center as a part of working to create a quality rural health care system. The Medical Center will use innovative techniques, such as, “Tele-Stroke,” whereby a patient accesses the latest heart diagnostic technologies at the medical center (for which we have provided CAPEX and OPEX funding) through Internet communications with the Emergency Room at the Medical Center. Thus, the patient is getting the same medical care as available in Seattle!

We are also matching the medical needs of the rural area with services that were not available before our efforts. The concept builds upon the willingness of the local population to provide for themselves and the willingness of a private medical center to fill a niche without the huge bureaucracy - we both make out. The private medical center does not have to charge “city rates” and we receive quality health care at a cost that most rural residents can afford.

The “health care debate” nationally can rage on, but in this rural community we have begun to solve our problem. We can both afford quality health care and have ready access to it. Our successful efforts may offer insights to others on how to solve many current problems as we continue our national health care debate.