As healthcare reform moves into the sausage factory phase, I remain convinced that healthcare reform is imperative for the health of Alabamians almost more so than most Americans and that Alabamians are the least likely to appreciate the urgency and the effort.

I don’t know how many of our citizens are aware that government pays for 45% of healthcare costs (through Medicare, Medicaid and other programs). If they were, they would perhaps appreciate that President Obama rightly feels that we as taxpayers should be getting value for our tax dollar. That is why his principles (outlined at focus on universal coverage, coverage portability, prevention of illness, and reduction in medical errors and waste.

 Our Senator, appearing on Fox News Sunday, bemoaned the efforts of the Democrats to dismantle the “the best healthcare system the worls has ever know”. I wonder if he is aware that the average age of primary care physicians in Alabama (overwhelmingly the type of physician practicing in rural areas) is 50, and some counties have fewer than 3 physicians for the entire county. Eight counties have no hospital at all.

Delays in care are common throughout our state. Trauma deaths, the best predictor of care availability, are twice as high in rural Alabama than in the US as a whole. Obstetrical care is unavailable in 33 of the 55 rural counties. Life expectancy in rural Alabama is 3 years below that of the United States overall, a difference that can be directly attributed to lack of access to health care. See the Alabama Department of Public Health website for further details on the state of medical care in rural Alabama.

On the hope side, we graduated 4 new Family Physicians at the Admiral Semmes last night. Unlike previous years, where the graduates were going to practice Emergency Medicine or Urgent Care, this year the graduates were entering the practice of Family Medicine. In addition, we had 6 “Interns” complete their first year of training, at least one of whom will practice in rural Alabama. Maybe the glass is half full.Residents