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Aging America Rural Retirement Medicare

In this June 19, 2012 photo, Dr. Bruce Stowell examines patient Robert Busch at his office in Grants Pass, Ore. Stowell is among many doctors in rural areas who have capped the numbers of Medicare patients they take due to low reimbursement levels. A nationwide shortage of primary care physicians willing to set up practice in rural areas is making the problem worse. (AP Photo/Jeff Barnard)

Regarding “Missouri gets $5 million to address growing primary care doctor shortage” (Sept. 5): This announcement of the grant to encourage physicians to practice in rural counties fails to mention the Missouri Legislature’s failure to expand Medicaid in Missouri.

Contrary to many assumptions about where Medicaid patients live, about 80% live in rural counties. The eight hospitals that were reported closed have all done so after Medicaid funds were lost. Primary care physicians are reluctant to care for patients without the basic supports available in a hospital. It’s like asking a farmer to plant without a tractor. The drain of physicians from the countryside has been going on for years. Health care planners have a far clearer idea of what it would really take to solve the problem.

Charles Nester • Webster Groves