Dec 7, 2019

The urban-rural health care divide is growing

Photo Illustration: Sarah Grillo. Photo: Spencer Platt/Getty Images

All the bad parts of the health care system — poor health, high costs, inadequate access — are worse in rural areas.

The big picture: "This rural disadvantage is unprecedented," said James Kirby, a federal health researcher.

  • Mortality rates are higher in rural areas, and many of those disparities are getting bigger.
  • Women in rural areas are more likely to die from pregnancy-related deaths than urban women. Two-thirds of these deaths are preventable.

Between the lines: Operating a health care practice, especially a hospital, in a rural area is a tough proposition: There aren't many patients, and a large proportion of them are covered by Medicare or Medicaid.

  • More than 100 rural hospitals have closed since 2010, and those still up and running have slashed some services for patients in order to survive, according to one study.
  • It can also be hard to recruit doctors to work in rural areas.

Go deeper:

Go deeper

Deep Dive: The coming health care collision

Illustration: Sarah Grillo/Axios

Health insurance through an employer — the way most Americans get it — costs an annual average of almost $23,000 to cover a family. That's enough to buy a new Volkswagen every year.

The big picture: While those costs keep rising, Americans' life expectancy is falling.

Go deeperArrowDec 7, 2019 - Health

The health care debate we ought to be having

Photo Illustration: Sarah Grillo/Axios. Photos: Scott Eisen/Getty Images and Erik McGregor/LightRocket via Getty Images

Americans worry a lot about how to get and pay for good health care, but the 2020 presidential candidates are barely talking about what's at the root of these problems: Almost every incentive in the U.S. health care system is broken.

Why it matters: President Trump and most of the Democratic field are minimizing the hard conversations with voters about why health care eats up so much of each paycheck and what it would really take to change things.

Health care profits are soaring

Illustration: Sarah Grillo/Axios

Soaring health care costs are bad news for patients and taxpayers, but great news for the very profitable health care industry.

The big picture: The sector has profited heavily in 2019. Expect more of the same in 2020.

Go deeperArrowDec 7, 2019