INSURANCE ACCESS: Some Farmers Feeling the Pinch

      "[M]ost farmers and ranchers strangled by the sour farm economy" in the Midwest are finding that health insurance is one of the first things to go in their struggle to make ends meet. AP/Newsday reports that insurance companies often charge self-employed farmers much higher premiums than workers in employer-based programs. Also, farmers are often ineligible for government-subsidized health care because even though they may have a failing farm, their machinery is counted as a liquid asset. Some farmers also complain that government assistance is "tailored to urban lifestyles" and excludes needy farm families. A recent survey of 82 farmers and ranchers by Lutheran Disaster Response and Lutheran Social Services of North Dakota found that 26 dropped their health insurance because they couldn't afford it. "If you have four or five bad years and you tighten the belt every time, health insurance gets to be one of the things," said Sandra Thums, a rural specialist with the organization. Jim Long, chief executive of West River Regional Medical Center in Hettinger, ND, said that as a result, "patients have begun to skip important preventive care like mammograms, prostate screening and physicals." In response, doctors "sometimes do not charge for treatment and hand out medicine free." Long said, "Our amount of uncompensated care is continuing to increase at significant rates. Sometimes we take ridiculous payment plans, like $10 a month on a bill that would take 30 years to pay off. In some cases, we don't get paid at all." AP/Newsday reports that legislation attached to the Omnibus Budget Reconciliation Act signed by President Clinton last fall may help self-employed farmers by allowing them to deduct 60% of their medical costs, up from 45% currently (4/8).