> Rural family doctors can and do still deliver babies in the absence of ob-gyns. But the proportion of generalist doctors willing and trained to do so has been declining for decades. Many family physicians I met while touring rural areas as part of a Brookings and American Enterprise Institute commission on rural life cited liability risks as the motivator of their retreat from maternity care. Adverse birth outcomes are among the most common claims against physicians in medical-malpractice lawsuits, and awarded judgments can be very high, which inflates the liability-insurance premiums that doctors must pay. In addition, in places with few ob-gyns, a generalist is more likely to have to handle high-risk cases without expert help.
Simple Idea: Very sharply limit lawsuits against medical professionals and organizations who are acting as "last ditch" providers of essential care.
toomuchtodo•27m ago
This simply removes liability without reducing objective risk, the solution imho is to incentivize people of reproductive age who intend to carry a child to move to urban areas where services are and will continue to be available, as the current trajectory is a continued decline in medical services as rural America continues to evaporate.
From the piece:
> Further, only 4 percent of the country’s ob-gyns practice in rural areas, which is where 10 percent of women ages 15 to 49 live. And that proportion is likely to fall even more because many new entrants to the field are not willing to do a residency or start a practice in states that restrict abortion, many of which are more rural.
> An even greater challenge will be the massive cuts to Medicaid within the One Big Beautiful Bill Act, many of which Congress set to go into effect after this fall’s elections. Medicaid covers more than 40 percent of American births overall and an even higher proportion in rural areas. More generally, the program is crucial to the financial viability of many rural hospitals, such that even if the cuts didn’t touch pregnant women at all, they could still deprive women of care by producing more rural-hospital closures. As an inducement to get votes from conservative rural congressional members, the OBBBA included a $50 billion Rural Health Transformation Fund, but this is substantially less money than the Medicaid cuts will total across rural America.
Rural America is too far into the gravity well to reach escape trajectory of a positive outcome. There is no will to spend today what it would cost to fix this (ie provide sufficient funding to maintain rural healthcare services and systems at a reasonable baseline for the local rural healthcare consumer base), and over time, the cost will only continue to rise.
bell-cot•1h ago
Simple Idea: Very sharply limit lawsuits against medical professionals and organizations who are acting as "last ditch" providers of essential care.
toomuchtodo•27m ago
From the piece:
> Further, only 4 percent of the country’s ob-gyns practice in rural areas, which is where 10 percent of women ages 15 to 49 live. And that proportion is likely to fall even more because many new entrants to the field are not willing to do a residency or start a practice in states that restrict abortion, many of which are more rural.
> An even greater challenge will be the massive cuts to Medicaid within the One Big Beautiful Bill Act, many of which Congress set to go into effect after this fall’s elections. Medicaid covers more than 40 percent of American births overall and an even higher proportion in rural areas. More generally, the program is crucial to the financial viability of many rural hospitals, such that even if the cuts didn’t touch pregnant women at all, they could still deprive women of care by producing more rural-hospital closures. As an inducement to get votes from conservative rural congressional members, the OBBBA included a $50 billion Rural Health Transformation Fund, but this is substantially less money than the Medicaid cuts will total across rural America.
Rural America is too far into the gravity well to reach escape trajectory of a positive outcome. There is no will to spend today what it would cost to fix this (ie provide sufficient funding to maintain rural healthcare services and systems at a reasonable baseline for the local rural healthcare consumer base), and over time, the cost will only continue to rise.
(think in systems)