Oct 23, 2019

A growing emergency medical services problem in rural America

A paramedic prepares an ambulance for upcoming calls in Evergreen, Colorado. Phot: Kathryn Scott/The Denver Post via Getty Images

Ambulance services are closing in record numbers across rural America after failing to make ends meet, leaving 60 million Americans at risk of having no help in a medical emergency, NBC News reports.

The big picture: Some states are giving money to emergency medical services, but experts say it's not enough to solve the problem.

Between the lines: This is partially a staffing issue — which also drives the rural doctor shortage.

  • Rural areas tend to be populated with older, sicker and lower-income people than urban areas.
  • Not only does this create an unmet demand for health care services, but it also means there aren't many people in the community to serve — often on a volunteer basis — as emergency medical personnel.

The issue is compounded by rural hospital closures. Ambulances have to transport patients farther than they did before.

  • Since EMS programs are reimbursed per call, longer drives means less calls and thus less revenue.

Go deeper: The plight of America's rural health care

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Rural Americans can't catch a break

Data: CDC; Chart: Andrew Witherspoon/Axios

Preventable diseases are deadlier in rural America than in urban areas, a new CDC report says.

The big picture: More than 46 million Americans live in rural areas, and the system often works against them in nearly every dimension of care.

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Why cities lose high-stakes elections

Illustration: Sarah Grillo/Axios

The rural-urban divide is the defining split in American elections, and that often disadvantages cities, even though they have more voters.

Why it matters: With Democrats clustered in cities and Republicans spread out among exurbs, suburbs are now critical battlegrounds. For example, Democrats swept Virginia's elections Tuesday night thanks in part to suburban voters.

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Health insurers are eating higher medical costs

Data: Company filings; Chart: Naema Ahmed/Axios

Almost all of the major health insurance companies are spending more on medical care this year than they have in the past.

The big picture: Rising prices and more services for some sicker patients are among the many reasons why this is happening. That uptick in spending has freaked out Wall Street, even though insurers are still quite profitable.

Go deeperArrowNov 7, 2019