Government Can’t Deliver to Rural Areas In Frugal Times

By SAM URETSKY

Rural resentment is a real phenomena, and its political implications are significant, On Jan. 26, Paul Krugman’s column in the New York Times was headed “Can Anything Be Done to Assuage Rural Rage?” It’s commonly believed that rural resentment is fueled by beliefs that rural areas are ignored by policymakers, don’t get their fair share of resources and are disrespected by “city folks.” This has led to a shift, not only to the right, but into deep MAGA. To make things worse – well things are getting worse.

Professor Krugman makes a good case that there have been many efforts to provide services to rural areas. “The truth is that ever since the New Deal rural America has received special treatment from policymakers. It’s not just farm subsidies, which ballooned under Donald Trump to the point where they accounted for around 40% of total farm income. Rural America also benefits from special programs that support housing, utilities and business in general.”

The problem, in large part, is due to the costs of providing services to areas of low population density. This includes mail service where the postal carrier has to drive over a mile to each recipient, when compared to delivering the mail in a high-rise apartment building, or even a suburban development where the houses are 11 feet apart. It affects high-speed internet access which has become as essential as basic telephone service, and grocery deliveries. There’s no question that the government is trying, but it’s faced with the same cost challenges that keep private corporations from serving low density areas.

But in addition to these services, there has been a pattern of closures of rural hospitals. A list of hospitals that have shut their doors in 2023 includes:

• Fairview Regional Hospital in Hot Springs, Arkansas (100 beds);
• Mountain View Regional Medical Center in Jasper, Texas (100 beds);
• Parkview Community Hospital in Lufkin, Texas (100 beds);
• Regional Medical Center of Orangeburg-Calhoun in Orangeburg, South Carolina (100 beds);
• Southeast Georgia Health System in Sylvania, Georgia (100 beds);
• Southeast Missouri Hospital in Cape Girardeau, Missouri (100 beds);
• Union Hospital in Moundsville, West Virginia (100 beds),

This follows 10 hospitals of similar size that closed the previous year. The reasons for closing are usually financial, since Medicaid payments don’t cover the costs of care, and have caused the closing of major medical centers in New York City and other large cities as well. A shortage of medical personnel in rural areas has also been a problem.

But the lack of health care facilities in low population areas is being exacerbated by the closing of regional airports. These airports provided a way to get patients to the major medical centers, and without them the people may be forced to drive for hours, not to get to a hospital, but just to an airport needed to get to a major center. A partial list includes:

• Big Spring Municipal Airport in Big Spring, Texas;
• Roswell Municipal Airport in Roswell, New Mexico;
• Lake Charles Regional Airport in Lake Charles, Louisiana;
• Elko Regional Airport in Elko, Nevada;
• Casper/Natrona County International Airport in Casper, Wyoming;
• Cheyenne Regional Airport in Cheyenne, Wyoming.

The closed airports have a devastating effect on the areas they service. The regions become increasingly isolated, far from the goods and services needed for modern life. The airlines blame a shortage of personnel, but the effect of these closings harms the regional economy because there are fewer jobs. The people who live in these areas may have to drive longer distances on roads that are increasingly congested by other people faced with the same problems. To make things worse, closing of an airport reduces the value of homes.

There are proposals of course – but all of them involve increased expenses. Although the representatives of the areas with closed airports, all Republicans, voted in favor of increasing the national debt, they still favored other strictures including cuts in the social safety net, that would hurt their constituents.

Rural rage, rural resentment, appears to be in large part due to the feeling that the coastal elites don’t care about the needs of low-density areas – and so they vote for the false populism of the MAGA crowd. It’s possible that the truth could make them free, but it’s hard to deliver the message to regions which lack 5G internet and newspapers.

Sam Uretsky is a writer and pharmacist living in Louisville, Ky. Email sdu01@outlook.com.

From The Progressive Populist, June 15, 2023

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