J. Wellington Wimpy, the gluttonous, portly, ne’er-do-well moocher in the old Popeye comic strip, gained immortality with his plaint, “I will gladly pay you Tuesday, sir, for a hamburger today.”

For Wimpy, of course, Tuesday never came. A lesser-known line was: “I’d like to invite you over to my house for a duck dinner — you bring the ducks.”

For however much the health care reform legislation could mean to rural communities, among the most underserved by the nation’s medical system, it’s much like Wimpy’s cadging for burgers: no bucks to back up the promises.

The legislation, embroiled in much wrangling and controversy over its insurance coverage requirements and costs, nonetheless contains a number of scantly publicized provisions that could benefit rural America, according to an analysis by the Center for Rural Affairs, “Health Care Reform, What’s In It?”

The law “provides numerous opportunities for rural areas to increase all medical professions, to stabilize their medical delivery systems, and potential to aid the economies of many rural communities, as new and improved medical facilities and more health care professionals … afford more jobs, more income and more economic opportunity,” the report notes.

“Access issues are serious health challenges in most of rural America,” says Jon Bailey, the center’s research director. Most rural communities and many of their citizens suffer from severe shortages of health care providers and work force, as well as “an economically fragile health care delivery system,” he notes.

“For rural families, businesses, and communities, there is much to gain from health care reform … and much to lose if government fails to properly implement, or Congress fails to adequately fund, the provisions most crucial to improving rural health care access.”

The National Center for Rural Health Works at Oklahoma State University has found that just one full-time rural primary care physician generates, on average, about $1.5 million in revenue and nearly $1 million in payroll, and creates or helps create 23 jobs in the community.

But back to Wimpy and his hamburger today for the promise of payment another day.

“While the access provisions in the law are of great potential benefit to rural America, the key word is ‘potential,’” Bailey says. “Many of the provisions … are long-term strategies that will not immediately alleviate rural access challenges. Further, a weakness of the law is that most of its rural access provisions are not funded.

“The law only gives Congress authorization to appropriate funds … and without funding, these provisions are nice words in the federal law books, leaving much of rural America in the same weak health care access spot.

“Like much of the act, the provisions concerning access are a nice start — but rural citizens and policymakers must make sure they go beyond a nice start to truly benefit rural families and communities.”

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