The biggest problem with Obamacare in Trump country is not the well publicized lack of insurance providers.
Trump country tends to be more rural with far more millionaires because miners, farmers and oil field workers tend to make more money than the average worker so the deductibles, co-pays and so on are less of a problem for Trump voters than Hillary voters.
The Invisible Elephant in the room is the lack of MDs, PAs and RNs in rural America because of Student debt. Since at least WWI and probably earlier the military has been providing ex post facto student debt relief to Doctors, Nurses, Dentists and so on. Also medical and related schools are on a scholarship list for enlisted men. But student loans are based on nominal, not real, wages. Nominal medical wages are lower in rural areas creating a severe shortage of medical care and 100 mile plus trips to get something better than a volunteer fireman with limited EMS training in an emergency.
Is there any chance of this problem being addressed, which has become much worse under Obamacare regulatory burden?
I see your point but I think the logic is faulty.
In an area with an abundance of well off folks why the heck would they have applied for subsidized Obamacare and would they have qualified?
In my "modest" world I have helped my poor neighbors sign up for Obamacare. They were largely angry they had to pay anything for health insurance preferring to live dangerously and risk being a medical freeloader if illness struck while they were uninsured.
Me of a 98 MarkVIII and 97 Oldsmobile and 68 Mustang, I am not check to check but I am not a millionaire. I also have had some form of non-Obama care insurance. Choices on the marketplace never really affected me in my "wealthy" state.
So, I propose the lack of subsidized choices do not affect the people you are talking about one bit.
True but the lack of caregivers do. Ocare contained regulations that prevented/hindered the establishment or expansion of doctor run hospitals and clinics.
Interesting.
OK. So there are "enough" insurance providers in each state. I would prefer more competition myself, but I have choices here.
The problem is a lack of doctor's offices. In Missouri this problem seems to be based on a lack of motivated students. Maybe not rural Idaho where patient density is lower.
My observations are:
-Comically enough my ~40 year old Nurse Practicioner who I liked drove a Mercedes and lived in some giant house in an old school good neighborhood.
-I didn't go to the office for a few years and was reassigned to a 40 something doctor there. The man drives a tiny German hotrod, or at least did a couple years ago and talks about golf.
-Since then I have been hitting up Walgreens and Urgent Care's when I feel ill and want to know if I am just a wimp or in need of anti-biotics. These folks I don't know well at all. I don't see as many uber nice cars at these places though.
My idea based on these and other doctors I see, is doctor's make more money than most folks and apparently live well enough after paying off their medical school debt.
So my theory is Obamacare may have made it a little more difficult but there are other factors at play since the doctors around here who are 10 years removed from Medical School all seem pretty well off:
-Some would be doctors are scared out of medical school by the debt load they are sure to take on vs uncertainty they are any good.
-A good number of smart folks can make good money doing things besides being a doctor these days.
-There are many college degrees which don't require any classes more difficult than a year of Spanish and some Algebra where if you show up and are awake you can pass. Why learn to study for a difficult one?
-Education itself is too darned expensive making it difficult for someone from a poor family to get an M.D. Not impossible, but difficult.
-There is a cultural problem where "edumacation" is looked down upon. To me it is an Archie Bunker / Al Bundy / Homer Simpson glorification issue I first noticed in the aftermath of W's fuzzy math statement.
Then, quite simply there is the capitalistic problem of why the heck would I want to be a specialized doctor in the middle of nowhere where I have xx number of possible patients when I can go to the metropolis of Kansas City and have xx,xxx possible patients. There are not as many mattress stores in rural Idaho as in the suburbs of St Louis also. Do you know the number of people who drive 100 miles to get to a furniture store in the outer suburbs of St Louis?
