Health & Wealth Desk

Wednesday mornings during Morning Edition, and Wednesday afternoon during All Things Considered

KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. Reporter Katie Hiler produces a short weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri.

Joel Sager
Joel Sager

A little known part of the U.S. Department of Agriculture’s Rural Development agency is one of the main sources of mortgage credit to low-income families in rural America.

Alan Cleaver / flickr

The Affordable Care Act’s online insurance marketplace has its problems, but the service also has potential to help improve rural health. Jon M. Bailey, the director of rural research and analysis at the Center for Rural Affairs, went as far as putting it this way:

“The new health insurance marketplaces were practically created for rural people.”

Compiled by Kelsey Proud, St. Louis Public Radio / Flickr

Starting on October 1, Missourians will be able to shop for health insurance through a new online marketplace. It’s one of the biggest changes in health insurance coverage under the federal Affordable Care Act.

But there’s still a lot of confusion about how the exchanges will work.

St. Louis Public Radio's Véronique LaCapra spoke with the Missouri Foundation for Health’s Ryan Barker to try to get some answers. Here's an excerpt from their conversation.

How will Missourians access the new health insurance options?

My Farm Roots: Providing from the land

Sep 25, 2013

This is an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

My Farm Roots: Always a farmer

Sep 18, 2013

This is an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

In 1986, Becky Doyle was helping her husband run the family’s hog farming operation. She also had a sidelight business of marketing gift baskets made from Illinois products. But that wasn’t enough: Doyle decided she would make a run for the Illinois House.

My Farm Roots: Looking back fondly

Sep 4, 2013

 

This is an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

More than once while I was listening to Paul Horel's stories about farm life in Iowa, I felt like I was at a family reunion. With his glasses and balding head, mild Midwestern accent, and talk about plowing and politics, he could easily have been my uncle.  

This is an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

Amy Konishi says when her obituary is written it’ll read, “All she knew was work.”

My Farm Roots: Wings

Aug 21, 2013

This is an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

Kelly Hagler, 25, is among the millions of young people who have left rural communities for the bright lights of the city, in this case Chicago.

But Hagler has not left completely.

Here’s what she told us last year when we asked people to share their “My Farm Roots” stories through the Harvest Network:

“The drought and fear of not making contract yields, mixed with the pressure of new house expenses, is aging my already Old Man,” she wrote. “It's also so strange to be detached from them. It's something that few other non-farming families have to deal with: The guilt of leaving behind older parents to work the farm, all because you're trying to make your own living where more opportunities exist.”

Harum Helmy / KBIA News

This week for the show, I went to the Missouri State Fair and all you’re getting is this audio postcard.

First, I talked to Marlys Peck, who, along with her family, has been selling corn dogs at the fair for more than 41 years. Every year, Peck and her parents spend the state-fair week under the same tree near the historic Womens Building. 

Harum Helmy / KBIA News

Walk into Columbia’s Museum of Art and Archaeology between now and Aug. 11, and you’ll find some pretty intense, large-scale woodcut prints depicting rural Missouri life staring back at you.

In one print, naked women straddle a monster truck. Another depicts a brother and sister getting married to each other. One print has an entire town going berserk with excitement over the opening of a fast-food chain restaurant, and in another, customers at a shop try on a used denture... and put it back on the shelf. 

Luke Runyon / Harvest Public Media

 This is an installment of the 2013 edition of My Farm RootsHarvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.
  

Trent Johnson didn’t grow up on a farm, but he was always enamored with the cowboy lifestyle.

My Farm Roots: A song in her heart

Jul 24, 2013
Bill Wheelhouse / Harvest Public Media

This is an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

Jackie Dougan Jackson keeps a pretty thorough log of her life. The 85-year-old retired college professor lives in Springfield, Ill., and has lived there for more than 40 years. However, she has devoted a lot of time to her first 22 years, when she lived on a family farm near Beloit, Wisc.

Jackson has written a couple of books of what she calls “creative nonfiction,” which she calls the “Round Barn” series, based on a distinctive feature on the family farmstead.  In those books she relates tales from the farm life of her childhood, from her “grama’s” depression to tall tales told at the dinner table.

“I feel as if I’m a native Turtle Township, (Wis.,) person,” Jackson said. “I began collecting stories (about the farm) actively in 1967, I have them in handwriting and transcribed.  I’ve been writing about farming in Wisconsin from 1900-1972”.

Jackson’ family owned both a dairy farm, starting in 1911, and then got into growing seed corn when hybrid corn was developed in the 1930s.

Along with saving stories from the past, she keeps items from the past as well. She is glad to show you a milk bottle and a milk cap from Dougan’s Dairy, her father’s early-century operation, which eventually closed as home delivery phased out.  She can also display a bag of Dougan’s Hybrid Corn from the old days when seed corn was groundbreaking ag technology. 

pinprick / FLICKR

 Update: Gov. Jay Nixon signed SB 262 into law on Friday, July 12. 

A bill that was pushed by the state's insurance agents association could create a barrier in getting Missourians enrolled in time for the new online health insurance marketplace  one of the key parts of the health care reform law.

Casey Fleser / Flickr

This week, a sweet story from a library in Oregon County, just north of the Missouri-Arkansas state line.  

Rachel Reynolds Luster is the librarian at the cozy, one-room library in Myrtle, Missouri:  population around 150. There’s one gas station and a small post office, but no grocery store or bank.

Upon reporting to work on day one, she realized there was going to be one major challenge: there were hardly any modern books.

hospital room
Fotos GOVBA / flicker

  Compared to their urban counterparts, rural hospitals serve a population that tends to be older, sicker, uninsured and have less income. Rural hospitals provide a lot of uncompensated care and run on more narrow profit margins.

To stay open, these hospitals depend on special federal designations that give them a higher rate of reimbursements from Medicare and Medicaid. For example, when a hospital designated as a critical access hospital, Medicare reimbursements can make up to a third of its entire revenue

Abbie Fentress Swanson/Harvest Public Media

This story is part of the 2013 edition of My Farm Roots, a series from KBIA Radio's partner Harvest Public Media that chronicles Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

Missouri's lax regulations on meth-lab cleanup

May 29, 2013
Leah Shafer / Flikr

 


   Missouri’s meth problem is no secret. In 2012, the Show-Me State has the highest number of meth-lab seizure in the country.  But beyond the busts — Missouri has no statewide regulation on what to do with former meth labs. 

On AMC’s ‘Breaking Bad,’ meth cooks prepare a batch in a trailer in the desert or a dirty and  abandoned house. But this image of secrecy and seclusion isn’t always true. Timothy Sigmund is a real estate attorney from Jefferson City. He says many meth labs aren’t where pop culture might suggest they are.

“Apartment buildings, nicer homes,” Sigmund says. “It can be happening in many different places, and it doesn’t matter. It’s not that it’s some run-down shack in the middle of the woods.”

 

This week on KBIA’s talk show Intersection, host Ryan Famuliner sat down with State Sen. Kurt Schaefer (R-Columbia), Rep. Caleb Rowden (R-Columbia) and Rep. Chris Kelly (D-Columbia) to discuss the legislative session that ended on Friday. One of the main things on the show’s agenda was, of course, Medicaid expansion – or lack thereof.

Famuliner asked the panelists why the expansion failed to pass. 

Kellie Kotraba / KBIA News

  

With the Missouri legislative session ending on Friday and a Republican supermajority that still won't budge, the hope to expand Medicaid in Missouri is pretty much dead for FY 2014.

It's so dead that perhaps the only thing that could bring it back to life is, well, interfaith prayers for a miracle.

jfcherry / Flickr

Many Missourians will likely need help navigating the Affordable Care Act's new health insurance marketplace that's set to go online by Oct. 1, but one analyst says there might not be enough time or federal funding to train those who can help.

Harum Helmy / KBIA News

This week on the show, we're hearing from Francine Robison and D.J. Fry, two out of the more than 20 cowboy poets and musicians who performed at the 15th Annual Missouri Cowboy Poetry and Music Festival. 

Harum Helmy / KBIA News

If you think all cowboys are of the rugged, silent and stoic Marlboro Man type – think again. Some cowboys write poetry.  

Every year since 1998, for a weekend in April, a group of cowboy poets Missouri and its surrounding states gather in Mountain View, Mo., near West Plains. They spend three days in town, usually from Friday to Wednesday, giving poetry performances, playing folk songs, telling classic cowboy stories. The gathering, also known as the Missouri Cowboy Poetry and Music Festival, is one of the largest of its kind in the Midwest. 

Harum Helmy / KBIA News

At only 17 cents per cigarette pack, Missouri has the lowest tax for tobacco in the U.S. In 2012, Missouri voters said no to increasing that tax to 90 cents per pack. Missouri is also one of 14 states that don't have some sort of a statewide ban on smoking in non-hospitality workplaces, and/or restaurants, and/or bars. All of this adds up to the Show-Me State's top spot as the freest state in the nation when it comes to tobacco. 

But since 2007, about two dozen municipalities in Missouri have enacted a comprehensive smoking ban in all workplaces, including restaurants and bars. This Monday, rural Washington, Mo., joins that list. The City Council voted to pass the ordinance to ban smoking back in January. 

Images of Money / Flickr

The uphill congressional battle to expand Medicaid in Missouri is making rural hospitals that serve areas with high poverty levels really, really nervous. KSMU's Jennifer Davidson has the story.

IntelFreePress / Flickr

  Almost gone are the days when physicians collect your medical records in yellow manila folders stacked ceiling-high behind the nurses’ counter.

More and more medical professionals in the U.S. are using an electronic health records system to do things like store patient data, call up medical records and even prescribe medications. A Department of Health and Human Services survey found that in 2011, 35 percent of all U.S. hospitals have adopted an electronic health records system. It's a pretty rapid growthin 2009, only 16 percent of U.S. hospitals use the system.

Many of these electronic systems are so handy they even have decision-making software—a tool that helps physicians make treatment recommendations and diagnoses.

“The idea is that a physician can open one up and maybe use one to diagnose whether a patient has appendicitis and decide whether they want to operate,” said Victoria Shaffer, an MU psychologist who studies the decision-making side of the electronic health records system.

Not all patients like this high-tech diagnoses tool, though.

Missouri Capitol
File Photo / KBIA

Missouri’s Republican-led House on Tuesday struck down Democrats’ attempts to include Medicaid expansion in the state’s budget.

If that scenario sounds familiar to you, it’s because these rejections have happened a few times before. On Feb. 25, two House committees rejected Rep. Jake Hummel’s (D-St. Louis) bill to expand Medicaid under the terms of the Affordable Care Act. On March 14, the Senate Appropriations committee voted down the Senate Democrats’ version of the expansion bill.

Rep. Jay Barnes (R-Jefferson City) was in one of the committees that struck down Rep. Hummel's Medicaid expansion proposal. Barnes has since introduced his own version of the expansion -- outlined in House Bill 700

Every week, KBIA's Health & Wealth Desk curates the week's most interesting (or so we think) articles and reports on rural health, wealth and society issues. 

Rural post offices in crisis

Libby Burns / KBIA

This is the second in a two-part discussion about health literacy and the healthcare reform.  

Not knowing what the online health insurance marketplace looks like might be problematic for Missourians. 

As part of the Affordable Care Act, Missouri’s uninsured can choose to buy insurance from the state’s health exchange come October. The exchange is an online marketplace where anyone who isn’t already insured will be able to compare and purchase private insurance plans. Some uninsured Missourians would be eligible for help with the cost, too.  

Missouri has missed the deadline to create its own marketplace or start a state-federal partnership. So, the federal government is setting it up. The problem is, even though the marketplace is supposed to be open for enrollment in about six months, no one knows what it looks like yet.

“We’re losing time that could be useful in helping people understand and prepare [for the exchange],” said Catina O’Leary, the director of Health Literacy Missouri, a nonprofit group that’s working to make health care topics more understandable for Missourians. “It would be really great if we could manage people’s expectations and start training on what they’re going to need to know.”

But here's what we know so far: 

Every Friday, KBIA’s Health and Wealth Desk curates the week’s most interesting (or so we think) articles and reports on rural health, wealth and society issues.

Osteopathic Physicians: An Answer To Rural Health Care Needs?

It’s no secret the U.S. is facing a shortage of primary care physicians – especially in rural areas, which is home to some 20 percent of all Americans, but only has 9 percent of all physicians. Compared to specialized medicine such as surgery and cardiology, primary care does not pay as well – and the average student loan debt for med school graduates is $161,290. Only about 24 percent of MD graduates lean to primary care. That’s not the case with recent osteopathic medicine graduates, though.  

Harum Helmy / KBIA News

On this week's Health and Wealth Update, the first part of a discussion about health literacy and the healthcare reform. 

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