Fixing Montana’s rural health-care crisis

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Montana is Big Sky Country. Rangelands, forests, and farmer’s fields spread between our towns and cities. Rural life is at the core of our identity as a state and as a people. Yet, as our country expands and moves forward, in many ways too many Montana communities are stuck facing huge hurdles accessing quality healthc are.

52 of the 56 counties in Montana are faced with shortages in primary care, with nine of those counties having no doctors at all. One of the first things they teach you as an EMT is the importance of the “golden hour” following a traumatic injury. Access to health care can mean life or death for rural communities.

Recognizing this lack of access, I started up a small business with my family to provide in-home health care to patients in Western Montana. I found that not only did communities just outside of Kalispell or Missoula lack doctors, but they barely had the necessary health care infrastructure to ensure the elderly could stay in their homes, or that people with chronic conditions could effectively be treated.

As a Montana state lawmaker, I have seen firsthand how important health-care facilities are for the economies of our rural communities. Part of the reason I decided to run for office at 32 years old was the necessity of continuing Montana’s Medicaid expansion program. We were able to continue health-care coverage for nearly 100,000 Montanans and pump over $500 million into our state economy each year. But, what equally earned my vote was the necessity of keeping our critical access rural hospitals open.

About 65% of Montanans are located in rural areas. Our state also has the second largest Congressional seat in the country. Yet, we continue to elect congressmen that put partisan politics before their constituents. When they undermine our health insurance market, when they side with Big Pharma, they contribute to our rural health crisis. As a former EMT, health care small-business owner, and state lawmaker, I have spent my adult life fighting for Montanans’ access to quality healthcare. But, there is more work to do in D.C.

We must start building flexible delivery systems for rural communities instead of forcing a “one-size-fits-all” approach. We must work with rural communities to implement more Alternative-Payment Models (APM) like Value-Based Purchasing (VBP), and expand Global Payment Systems (GPS) to help hospitals cut on overhead costs and incentivize preventative care. We must support the rural MOMS Act to ensure the same outcomes for rural families as for urban ones. We need to train and empower more homegrown healthcare professionals to live and work in our rural communities. From social workers to family practitioners to nurses to rural care organizations, all would be helped by increased Medicare reimbursement rates.

Montana needs a representative in federal government to fight for resources to train the next generation of rural healthcare providers in our state. We also need to utilize technology to increase patient access by equipping more health professionals with telemedicine services.

As the debate continues on how we best reform our broken healthcare system we cannot forget our rural communities. As Montana’s next Congressman I will not put party politics ahead of what should be our biggest focus - ensuring quality and affordable healthcare for all.

—State Rep. Tom Winter, D-Missoula, is a candidate for Montana’s U.S. House seat

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