Health & Wealth Desk

When Sarah Scantling went into labor this summer, she had to drive 30 miles and across state lines.

Three years earlier, the only maternity ward where she lives in Pemiscot County, Missouri closed down. Scantling had to choose between a handful of other hospitals in the region between 20 and 70 miles away. She chose to give birth in the hospital in Dyersburg, Tennessee.

For five years now, the Missouri legislature has considered legislation to create a prescription drug monitoring database that would allow pharmacists and physicians to look at their patient's prescription history for signs of misuse of narcotics. And for five years, Missouri pharmacists like Erica Hopkins have watched those efforts fail with disappointment.

Nurse Catherine “Bizz” Grimes moves like her name sounds: at a frenetic pace. She darts across the hall from the prenatal diagnosis clinic at Indiana University Health University Hospital in Indianapolis, sits down at her cubicle, puts on her headset over curly white blonde hair and starts dialing.

$1.25 million.

That’s the size of the bill that could have shuttered the only public hospital in rural Pemiscot County, Missouri in August 2013.

Next year, Blue Cross Blue Shield of Kansas City will leave the individual health care marketplace in Missouri that was set up under the Affordable Care Act. And when it does, about 18,000 patients in 25 western Missouri counties will lose their health insurance. If those enrollees sign on to Healthcare.gov this fall to buy a replacement plan, they may have no options to choose from.

That's because those 25 counties could become "bare."

For the hundreds of rural hospitals struggling to stay in business, health policy decisions made in Washington D.C. this summer could make survival a lot tougher.

Blue Cross Blue Shield of Kansas City announced on Wednesday that it will not offer individual plans on the Affordable Care Act insurance exchanges next year The move will affect about 67,000 people across 30 counties in Missouri and two counties in Kansas

“Through 2016 we have lost more than  $100 million [on ACA plans],” the company’s CEO Danette Wilson said in a release. “This is unsustainable for our company.”

The Affordable Care Act did a lot to expand HIV/AIDS treatment and prevention for people at highest risk for the disease. Many gay men and other men who have sex with men gained health insurance and new infections went down. The estimated number of annual HIV infections in the United States declined 18 percent among gay and bisexual men between 2008 and 2014, according to the Centers for Disease Control and Prevention.

In the current debates over health care, one topic rarely gets mentioned: dental health benefits. That’s because dental health has historically been separated from the rest of medicine. But today, that separation leaves many Americans with no way to prevent or treat debilitating dental health problems.

Author Mary Otto tells the story of the rampant disparities in dental health in the United States and how those play into other disparities of race, class and income in her new book, Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America.

As the outreach counselor for Battle High School in Columbia, Missouri. Dana Harris’s job is connecting students with services when they have mental and emotional troubles such as ADHD, anxiety or depression.

Six years ago, 53-year-old Corla Morgan noticed blisters forming on her neck and back.

“I couldn’t sleep because when I took my shirt off, if my shirt touched my skin, the skin just peeled off,” Morgan says. “I was in really horrible pain.”

Darvin Bentlage says his health insurance plan used to be the same as all the other cattle farmers in Barton County, Mo.: stay healthy until he turned 65, then get on Medicare. But when he turned 50, things did not go according to plan.

“Well, I had a couple issues,” he says.

He’s putting it mildly.

This story has been updated on March 7, 2017.

Missouri State Senator David Sater is looking for ways to reduce the amount of money his state spends on Medicaid, because, as he sees it, “the Medicaid program is eating out lunch right now.”

His idea? To voluntarily cap the amount of Medicaid funding coming from the federal government. 

When Joe Morris had a heart attack last Easter and had to be rushed to the ER, it was the first time he’d been to the doctor in more than 40 years — since high school.

Back home in the small community of Neosho, Mo., Morris needed follow-up care to manage his heart disease and diabetes, but he didn’t have a doctor — or insurance.

Caroline Brown, a sophomore at the University of Missouri got a fever over Thanksgiving break. Soon it became painful to bite down, and her cheek began to swell. A trip to her physician confirmed it – Caroline had the mumps.

“Mumps kind of sounds like this archaic thing,” Brown said. “We get vaccinated for it - it just sounds like something that nobody gets.  So I just didn’t think that it was possible that I would get it.”

Public health is due for an upgrade. That was one take-away of a recent lecture from a 20-plus year veteran of the field, Dr. Anne Schuchat, the principal deputy director for the Centers for Disease Control and Prevention. Public health 3.0 is what the Department of Health and Human Services has named its recent call to action to close significant health gaps - through collaboration across sectors to address systemic issues.

Every morning Pat Wilson walks down the hall from her office in the Julia Goldstein Early Childhood Education Center through the gym and into a part of the building not typically associated with a school nurse: the kitchen.

There, she checks a list—posted on the side of the stainless steel refrigerator—of all the students in the school with a food allergy.

“It’s constantly being updated,” Wilson says.

Dennis Rodgers flips over a bright pink piece of paper and rattles off his choices:  “Attempt resuscitation or do not attempt resuscitation... to do limited intervention or to take no medical intervention… whether to intubate or not to intubate.”

As of the September 30, a relatively unknown herbal supplement called kratom will likely join the ranks of Schedule 1 drugs in the U.S. - alongside drugs like heroin, LSD and marijuana.

This supplement has been traditionally used in Southeast Asia, but has recently gained popularity in the United States as a way to manage opioid withdrawal or chronic pain without the use of prescription medications.

Researchers and people using the herb decry the DEA’s move to criminalize it, which they say will stall research and deprive many Americans of a presumably harmless substitute to stronger prescription painkillers.