- The Washington Times - Sunday, September 6, 2009

MOUND BAYOU, Miss. | The segregated Mississippi Delta was no place for a black person to get sick in the 1940s.

Black doctors, and even some white ones, would treat black patients, but hospital beds were few and far between. Into that gap stepped the Taborian Hospital, built by a black fraternal order in Mound Bayou, a town incorporated in 1887 by former slaves, to provide care the farmhands, entrepreneurs and professionals couldn’t get elsewhere.

The hospital was an early adopter of prepaid services — annual dues of $8.40 entitled an adult to hospital care and burial benefits, while the fee for a child was $1.20 per year. It was the precursor to what eventually became the modern system of health insurance.

Taborian Hospital shut its doors more than two decades ago, and Mound Bayou now sits in the heart of an area with some of the nation’s lowest rates of health insurance coverage. In fact, Nielsen Claritas, a demographic research firm, says fewer households are insured in the Greenville metropolitan area, right next door to Mound Bayou along the state’s western border with Arkansas, than anywhere else in the country.

The root causes of the shortfall are simple: Bad economic times, coupled with the traditional agriculture-based economy, mean many businesses here simply don’t offer coverage to their workers.

The solutions, however, are not as easy to pinpoint.

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It’s the new segregation, though one that this time breaks down along the lines of health care coverage, not race. But the tradition of Taborian Hospital also lives on in the doctors who reach out to uninsured patients, and in the clinics that have sprung up here and throughout the country tailored specifically to those who don’t have health coverage.

As Congress and the country grapple with how to overhaul the nation’s medical care system and extend health insurance coverage to everyone, that same debate is taking place in the Mississippi Delta, where its effects are most acute.

DELTA WOES

It’s a running joke that Mississippi ranks near the lowest of all the states on just about every bad list — from education to obesity to quality of life. But people here say the untold story is that if you took the Delta population out of those calculations, the rest of Mississippi would probably jump up to middle of the national pack.

To illustrate that point, Delta doctors tick off some of the health problems where their region is among the nation’s worst-off, including high infant mortality rates; low birth weight; soaring rates for diabetes, hypertension and stroke; and high incidence of stage three and four breast cancer in women.

Dr. Aaron Shirley, a doctor who has pioneered trying to extend health coverage to the uninsured, says some of those problems are a direct result of lack of insurance.

For example, low-income women generally can’t sign up for Medicaid until they are actually pregnant. That delay means prenatal care starts later, which translates into lower birth weights and a higher chance of medical complications early in life.

Sitting in a cluttered office at the Jackson Medical Mall, an innovative project Dr. Shirley started to help make health care more accessible, he said the government was to blame for failing to sign up those who are eligible for Medicaid, even though Mississippi gets more federal matching money for each of its own Medicaid dollars spent than any other state.

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