Rural health reform: Small steps

"Navigating health care’s labyrinthRURAL Kentucky, and particularly eastern Kentucky, is poor and relatively unhealthy. The people who live in the hills and hollows of central Appalachia face high rates of diabetes, heart disease, cancer and respiratory illness. Some of the area’s problems are common across America: many rural Kentuckians are uninsured, for example, which discourages them from seeking preventive care. Other hazards are distinct to the area. Walking can be a dangerous form of exercise, with oversize log and coal trucks barrelling down the twisty mountain roads. Some people live without running water, or in homes heated by kerosene. In any of these cases, people could do with a local expert to help them navigate the labyrinthine American health-care system.That is the idea behind Kentucky Homeplace, run by the University of Kentucky. The programme employs about 40 “lay navigators” who work in the poorest parts of Kentucky helping people figure out what they need and how to get it. In one case, Homeplace helped a steelworker who broke his arm on a day off. He had no health insurance to begin with and, after the injury, no income. Homeplace workers negotiated the price of the surgery, and persuaded a hospital to lend a free room. “You can’t let a man go around with his arm broke,” explains Fran Feltner, the director of the programme. ..." (2009-6-11)
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