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.

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Health & Wealth Update
11:30 am
Wed December 14, 2011

Telemedicine: Adventures in time and space

The cover of Radio News magazine, April, 1924. These days, telemedicine is no longer a sci-fi "maybe." In rural America, more and more doctors and patients are connecting via live video.
nih.gov

In April 1924, Radio News Magazine ran a splashy futuristic cover story: "The Radio Doctor – Maybe!" Kids sit around a new-fangled doohickey and say "ahhh" for a distant doctor on  a video screen. In this weekly Health & Wealth update, the future is now! Telemedicine is expanding to rural hospitals across the country.

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Health & Wealth Blog
3:45 pm
Mon December 12, 2011

Versus urban areas, rural Missouri has poorer health, fewer doctors

According to the Missouri Hospital Association, some 500,000 additional people will enroll in health insurance between now and 2019. That's expected to put some serious strain on the rural health system. Click through for more graphics.
Lydia Mulvany KBIA

Health is generally poorer in rural Missouri compared to urban areas, yet there is a distinct shortage of primary care physicians in rural Missouri. KBIA’s Jacob Fenston has reported that the shortage is only expected to worsen over the next ten years as the elderly population expands.

This graphic shows some of these inequalities--click through for more detail.  Created by Lydia Mulvany.

Health & Wealth Update
7:02 am
Wed December 7, 2011

World AIDS Day marks 30 years

World AIDS Day was December 1. In Columbia, residents held a candle-light vigil at the corner of College and Broadway.
Jacob Fenston KBIA

This year marks a grim birthday: it was thirty years ago that the first AIDS victims were officially diagnosed. Though the rate of new HIV infections in the US has stabilized in recent years, the percentage of those in rural areas has been on the rise. In this weekly Health & Wealth update, World AIDS Day.

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Health & Wealth Report
7:30 am
Tue December 6, 2011

Growing doctors in rural Missouri

Dr. Dale Essmeyer shows Milan High student Kaylee Michael how to take blood pressure.
Jacob Fenston KBIA

In rural Missouri, there are roughly half as many primary care doctors per person, compared to urban parts of the state.  That's a problem, when you consider that rural residents are also older (about three years, on average) and poorer (about five percent more live in poverty). In this Health & Wealth report, small towns in Missouri are facing the shortage by "growing their own" doctors and nurses, starting as early as middle school.

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Health & Wealth Blog
9:31 am
Mon December 5, 2011

Time to sign up for Medicare

Medicare open enrollment ends December 7.
medicare.gov

For seniors and people with disabilities, now's the time to sign up for or review Medicare coverage. This year, Medicare's open enrollment period ends a lot earlier than usual. 

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Health & Wealth Update
9:35 am
Wed November 30, 2011

Rural post offices hoping for a break

Old-timey post office boxes in Arrow Rock hearken back to a time before Facebook, when snail-mail was king.
Austin Fax KBIA

The US Postal Service is hemorrhaging money – over the past year, it lost more than $5 billion. To staunch the negative cash flow, the postmaster general is looking at closing nearly 3,700 post offices – the vast majority in rural America. In this week's Health & Wealth update, KBIA's Austin Fax checks in to some very small towns where post offices may be on the chopping block.

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Health & Wealth Update
7:56 am
Wed November 23, 2011

Rural women diagnosed later

Faustine Williams

Women in rural Missouri are more likely to be diagnosed with breast cancer at a late stage than women in urban or suburban counties. In this weekly Health & Wealth update, the urban / rural disparity in breast cancer detection. 

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Health & Wealth Blog
8:23 am
Mon November 21, 2011

Should Medical School Be Free?

Peter Bach is a doctor at Memorial Sloan-Kettering Cancer Center in New York.
mskcc.org

Heck yeah!! So should lunch. But two researchers say making medical school free could send more young doctors into primary care and rural practice, thus solving one of the big challenges facing health care today. And they've got a way to pay for it too.

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Health & Wealth Blog
9:30 am
Fri November 18, 2011

Missouri Health Premiums Below National Average

Missouri families pay close to twenty percent of income on health insurance premiums. If that sounds like a lot, stay away from Mississippi. Families in that state pay the highest percentage of their income toward health insurance: 28 percent. This, according to a new study by the Commonwealth Fund.

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Health & Wealth Blog
12:13 pm
Thu November 17, 2011

It's Rural Health Day!

celebratepowerofrural.org

To celebrate, experts from non-profits and government agencies are holding a live webinar on some of the challenges and rewards of providing health care to rural America.

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Health & Wealth Update
10:03 am
Wed November 16, 2011

One Person's Travelocity is Another's Government Takeover

The left-leaning crowd in St. Louis waved signs as senators listened to over three hours of testimony.
Jacob Fenston KBIA

Backers compare health insurance exchanges to Travelocity or Expedia. Websites where you can quickly compare prices and features to get the best deal. But detractors oppose them as a federal intrusion into the health care market. In this weekly Health & Wealth update, Missourians debate the merits of Obama's health reform law, as state lawmakers try to decide whether to authorize an exchange.

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Health & Wealth Report
9:09 am
Tue November 15, 2011

Six Months After the Storm, Runners in Joplin Get Back on Their Feet

The Joplin Road Runners, after a pre-dawn run.
Jacob Fenston KBIA

Six months ago, an EF5 tornado plowed through the center of Joplin, leaving about one-fifth of the city's population without a home. Now, people are slowly getting back to normal. For some, normal means lacing up the running shoes and hitting the streets.

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Health & Wealth Blog
10:06 am
Fri November 11, 2011

Senators Get an Earful on Health Reform

From front to back: Senators Scott Rupp, Jane Cunningham, Joseph Keaveny, and Jim Lembke.
Jacob Fenston KBIA

Missouri state senators listened to over 3 hours of impassioned testimony on health care reform yesterday. The hearing was supposed to be on the rather mundane question of whether Missouri should set up an online health care exchange starting in 2014, or let the federal government do so. But the hearing quickly became a forum for debating the merits of health reform itself. After the jump, two interviews with senators on the committee: a Democrat representing one of the state's most liberal districts, and a Republican who has been at the forefront of Missouri's pushback against "Obamacare."

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Health & Wealth Update
3:18 pm
Wed November 9, 2011

Audrain Voters Plump for Public Health

Voters came out 60 percent in favor of the health center initiative.
Garrett Bergquist KBIA

Missouri is ranked 50th among the states in funding for public health, spending about one third of the national average. Audrain County spends even less, just $7.90 per person. In this weekly Health & Wealth update, voters in Audrain went to the polls yesterday and approved a new property tax that will keep the county's struggling health department afloat. I spoke with reporter Garrett Bergquist, who has been driving around Audrain talking to voters.

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Health & Wealth Blog
10:12 am
Fri November 4, 2011

Political Points vs. Sound Policy?

Kansas Governor Sam Brownback has long been a critic of health care reform.
governor.ks.gov

Republican lawmakers in red states are in a pickle. The Affordable Care Act requires each state to set up a health care exchange designed to bring down insurance costs for consumers. Republicans want no part of anything related to Obama's health care reform law, which they see as a federal intrusion on states rights. But if state lawmakers don't set up an exchange, the federal government will. In September, Republican senators in Missouri prevented the state from accepting $21 million of federal money to lay the groundwork for an exchange. Next door, the Sunflower State is in a similar quandary, reports Bryan Thompson of Kansas Public Radio.

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Health & Wealth Blog
11:47 am
Thu November 3, 2011

Full Interview with Lt. Governor Kinder

Lt. Governor Peter Kinder.
TeamKinder

Lt. Governor Peter Kinder takes aim at "Obamacare," and Democratic rivals. We discuss his legal challenge to what he calls "the federal health control law," and why he thinks his lawsuit will likely end up before the Supreme Court. We also cover some political turf: Kinder compares his style of leadership with that of Governor Jay Nixon. Missourians, says Kinder, "want a fighter, not someone who will lie down and just take dictation from our federal masters."

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Health & Wealth Update
6:10 pm
Wed November 2, 2011

Health Reform Moves Toward the Supreme Court

ltgov.mo.gov

Missourians have never been in love with health reform. A year ago, Missouri was the first to pass a state law prohibiting an individual insurance mandate. It was a largely symbolic rejection of the Affordable Care Act, but now, more serious obstacles are looming. Missouri Lieutenant Governor Peter Kinder is one of dozens of officials from around the country challenging "Obamacare" in the courts.

In this weekly Health & Wealth update, the Affordable Care Act moves toward the U.S. Supreme Court. 

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Health & Wealth Blog
6:53 pm
Fri October 28, 2011

Paying for Quality, Not Quantity

Harold Miller is president and CEO of the Network for Regional Healthcare Improvement and the executive director of the national Center for Healthcare Quality and Payment Reform.
futurestrategies.org

In the United States, we pay a lot more for our health care than other wealthy countries, but we are no healthier.  Missourians actually pay even more per capita than the U.S. average, and are even less healthy. (Missouri is ranked 39th in the nation in overall health, and we are the 9th most obese state.) A big part of the problem is the way we pay for health care, according to Harold Miller, executive director of the Center for Healthcare Quality and Payment Reform.

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Health & Wealth Blog
4:02 pm
Thu October 27, 2011

States to Pick Up Medicaid Costs

Total Medicaid spending growth (dark blue) compared to state spending (light blue). In 2009 and 2010 state spending fell sharply as federal stimulus money came to the rescue. Now the reverse is happening.
kff.org

During the Great Recession, as the ranks of poor and unemployed swelled, enrollment in Medicaid shot up, growing by 7.8 percent in 2009. At the same time, state tax revenues collapsed by nearly 17 percent. States couldn't afford to pay their share of Medicaid costs, and Congress came to the rescue with the Recovery Act, boosting federal Medicaid funding by around $103 billion. But the recovery dollars ran out in June, and now states are facing the biggest yearly increase in Medicaid costs in history, according to projections by the Kaiser Family Foundation. Missouri already spends over a quarter of the state budget on Medicaid.

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Health & Wealth Blog
10:41 am
Thu October 27, 2011

New Providers Could Fill Gap in Rural Dental Care

Part of the dental shortage is that few dentists accept Medicaid. In Kansas, it's 25 percent, compared with 90 percent of physicians.
kansasdental.com

Able to clean teeth, like a hygienist, but also fill cavities like a dentist. If you've never heard of a registered dental practitioner, it's probably because they are only legal in two states, Alaska and Minnesota. Like nurse practitioners, these mid-level providers are aimed at helping underserved rural areas.

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Health & Wealth Blog
5:34 pm
Wed October 26, 2011

Report Says Health Reform Will Provide Financial Boost

President Obama signs the Affordable Care Act, March 23, 2010.
whitehouse.gov whitehouse.gov

In 2019, the average Missouri family will be $1,471 richer. That’s how much the average family will save on health care each year once Obama’s reform law takes full effect, according to a new study by Families USA, a pro-reform group. 

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Health & Wealth Report
5:59 pm
Mon October 24, 2011

Missouri's Rural Doctor Shortage

Dr. David Hill on his ranch outside Southwest City, Mo.
Jacob Fenston KBIA

There’s a doctor shortage in rural America. This is not news – just the opposite – it’s been going on for ages. Even old Doc Adams, the country doctor in “Gunsmoke,” was constantly overworked. In one episode, when he finally gets a vacation, he’s kidnapped by outlaws in need of his services. Present-day Missouri ain’t Dodge City, Kansas. But many rural doctors are still overstretched. 

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Health & Wealth Blog
6:25 pm
Fri October 21, 2011

Missouri Is First in Line for New Medicaid Money

Community mental health centers in Missouri.
Missouri Department of Mental Health

For people with chronic conditions, getting Medicaid services can be a confusing, disjointed experience, shuffling from provider to provider. Under a provision of the Affordable Care Act, states can apply for federal money to help coordinate that care. Missouri did just that, and the news came today that the state will be the first to get this kind of funding under the ACA. Missouri’s application was aimed at helping people with chronic mental health issues. 

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Health & Wealth Blog
3:01 pm
Fri October 14, 2011

Reporter's Notebook: Running in Joplin

Relaxing after a long, slow day of running. The race starts in Commerce, Ok., and finishes in Joplin.
Jacob Fenston KBIA

I ran a marathon in Joplin last weekend – the second annual “Mother Road Marathon,” along Route 66. It was hot, there was a head wind, and it was a long slow day. My time was exactly one hour longer than my first marathon six months ago. I didn’t have a good excuse for my slowness – I’ve just been lazy about training. But for locals in Joplin, training for this race was truly challenging. 

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Health & Wealth
5:21 pm
Thu October 6, 2011

Lawmaker Seeks New 'Family Consent' Law

State Representative Bill White wants a "family consent" law in Missouri.
Jacob Fenston KBIA

End-of-life decisions can be wrenching for families. In the early 2000s, the case of Terri Schiavo riveted the nation, as her family battled over whether to remove her feeding tube or keep her on life support. Now, 44 states have so-called “family consent” laws, which help determine which family member should make health care decisions. Missouri is one of the six states with no such law, putting families and doctors in legal limbo. But a bill headed for the Missouri legislature could change that.

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Health & Wealth
3:01 pm
Mon October 3, 2011

Rural Hospitals Face Medicare Cuts

Bill Sexton is CEO of Prairie du Chien Memorial Hospital in Wisconsin.
Jacob Fenston KBIA

Two weeks ago, President Obama told the nation, “Washington has to live within its means.” As Democrats and Republicans continue to scour the federal budget for over a trillion dollars in possible cuts, one group very likely to be affected is rural hospitals in the Midwest and across the nation.

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Health & Wealth
4:20 pm
Tue September 27, 2011

Insurance Premiums Hit Record High

Health care premiums are at a record high – up nine percent since last year. A survey released Tuesday shows the average family is now paying over 15 thousand dollars a year on health care premiums. KBIA’s Jacob Fenston reports the rising costs are affecting Missourians as well.

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Health & Wealth
5:21 pm
Mon September 26, 2011

ACLU Targets Camdenton Over LGBT Sites

Camdenton High School. The school district is at the center of the ACLU's lawsuit over filtering of LGBT web sites.
Jacob Fenston KBIA

At public schools across the nation, internet filters keep students from looking at pornography and other material deemed harmful. It’s required under a federal law passed more than a decade ago. But now, one rural school district in central Missouri is at the heart of a national legal battle over whether schools may use this law to block websites that promote gay rights.

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Health & Wealth
5:21 pm
Thu September 22, 2011

Agriculture Secretary on Rural Jobs

Agriculture Secretary Tom Vilsack.
USDA
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President Obama has been touring the country trying to sell voters on his American Jobs Act. According to the White House, the bill would, if passed, give the state of Missouri $700 million for transportation projects and cut the taxes of 120,000 Missouri businesses. And agriculture secretary Tom Vilsack says that rural areas in particular would benefit from the jobs bill. Vilsack spoke with KBIA’s Jacob Fenston.

Health & Wealth
12:00 am
Fri September 16, 2011

Health Care Exchanges Spark Clash

A Missouri Senate committee heard testimony Thursday on the health care exchanges mandated by the Affordable Care Act. The legislature must either create an exchange or let the federal government do so. Republicans on the committee clashed with Governor Jay Nixon’s administration.

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