Iowa Congressman Jim Nussle has sent a warning to the White House. Nussle says President Bush will not get his support if Medicare reform does not include changes in the way rural hospitals and doctors are paid for providing care to seniors. Medicare reimbursement in rural America is well below what’s paid to urban health care institutions. Managers of the federal program say it’s cheaper to provide health care in rural areas, but Nussle says that’s not right, as equipment costs are identical, and it can sometimes cost more to lure a qualified health care worker to a rural area. Iowa has the eighth best health care delivery system in the country, but ranks 48th among the 50 states in Medicare reimbursement rates. Nussle, a republican from Manchester, is the new chairman of the House Budget Committee and is involved in behind the scenes negotiations on a variety of issues.
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