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.

World AIDS Day marks 30 years

Dec 7, 2011
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.

Growing doctors in rural Missouri

Dec 6, 2011
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.

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. 

Rural post offices hoping for a break

Nov 30, 2011
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.

Rural women diagnosed later

Nov 23, 2011
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. 

Should Medical School Be Free?

Nov 21, 2011
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.

Missouri Health Premiums Below National Average

Nov 18, 2011

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.

It's Rural Health Day!

Nov 17, 2011
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.

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.

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.

Senators Get an Earful on Health Reform

Nov 11, 2011
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."

Audrain Voters Plump for Public Health

Nov 9, 2011
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.

Political Points vs. Sound Policy?

Nov 4, 2011
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.

Full Interview with Lt. Governor Kinder

Nov 3, 2011
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."

Health Reform Moves Toward the Supreme Court

Nov 2, 2011
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. 

Paying for Quality, Not Quantity

Oct 28, 2011
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.

States to Pick Up Medicaid Costs

Oct 27, 2011
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.

New Providers Could Fill Gap in Rural Dental Care

Oct 27, 2011
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.

Report Says Health Reform Will Provide Financial Boost

Oct 26, 2011
Affordable Care Act
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. 

Missouri's Rural Doctor Shortage

Oct 24, 2011
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. 

Missouri Is First in Line for New Medicaid Money

Oct 21, 2011
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. 

Reporter's Notebook: Running in Joplin

Oct 14, 2011
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. 

Lawmaker Seeks New 'Family Consent' Law

Oct 6, 2011
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.

Rural Hospitals Face Medicare Cuts

Oct 3, 2011
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.

Insurance Premiums Hit Record High

Sep 27, 2011

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.

ACLU Targets Camdenton Over LGBT Sites

Sep 26, 2011
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.

Agriculture Secretary on Rural Jobs

Sep 22, 2011
USDA

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 Care Exchanges Spark Clash

Sep 16, 2011

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.

USDA Commits $14 Million to Rural Jobs

Sep 14, 2011

Agriculture secretary Tom Vilsack announced $14 million in new funding Wednesday to help stimulate rural job growth. Small businesses across the country will get money, including a tiny airport in southern Missouri.

Health Reform Targets Health Literacy

Sep 13, 2011
Jacob Fenston / KBIA

Nearly one million more Americans were without health insurance in 2010, compared with the year before. That’s according to new Census numbers released Tuesday, which also show the Midwest has one of the lowest rates of uninsured in the nation. But even for people who have health insurance, understanding a doctor’s orders can be an obstacle to getting good care.

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