The Scramble to Save Rural Health Care From DOGE

Northern Maine is home to some of America's poorest - but it ranks high on national measures of health. Hospital programs visit more patients in their homes where they can be more comfortable and receive everything they need, which in turn reduces medical costs.

To address the food insecurity problem among its low-income students, Columbia University launched Swipes, a meal sharing app in which students with a surplus of “meal swipes” could donate them to students in need. But when that app struggled to function and roll out properly, Columbia looked downtown to New York University, where student Jon Chin launched a similarly purposed but more effectively designed app, Share Meals. So far, the app has enabled over a thousand meal donations, and is hoping to work with Columbia to share its code and expand its donor services.

Clarke County School District in Georgia has 21 public schools that all offer free meals to students, regardless of their financial needs. This is facilitated through a federally-funded program, so even though poverty rates are high in the area, local residents are not footing the bill. While there are still some challenges implementing the program, in general it is received well and allows students to focus on their work and well-being instead of being distracted by hunger.

The Children Living With Cancer Foundation organizes dance parties for children with cancer, to provide them with a sense of joy, encouragement, and community during times of need. The nonprofit also organizes community events and donations and works with local pharmacies to get patients the medicines they need at subsidized rates. So far, the Foundation has supported 300 childhood cancer patients and their families.

The United Kingdom's health-care system – which has been lauded as one of the most equitable models for care – is built around a government agency that decides "which treatments are worth covering, and for whom." Although the measures used to determine these recommendations are controversial and the agency doesn't always sustain public trust in their decisions, the overall outcome has increased both social solidarity and life expectancy.

Milan’s tampone sospeso or “suspended test” initiative provides rapid COVID-19 tests to stop the spread of the virus. The initiative sets up in highly visible public areas of Milan and is based on a model of mutual support where everyone pays what they can. It is run with the help of over 50 volunteers and Medicina Solidale, a group of medical professionals who provide free medical advice to those who can’t afford to access care. The project has raised 24,000 euros from 436 donors, which has enabled them to administer rapid antigenic swabs to more than 3000 people.

The Hounslow council sent £20 vouchers to every household to help the local economy recover from the COVID-19 pandemic. Households had about two months to spend the voucher, which could purchase products or services at a range of businesses from cafes and cinemas to retailers and laundromats. Retailers can use an app to scan the vouchers and eventually redeem them for payments.

Drug Aid Africa sources unused, unaltered drugs from people who don’t need them anymore and distributes them to people who do need them but can’t afford or access them. Drug Aid Africa provides free routine medications for conditions like sickle-cell anemia, as well as antimalarials, antibiotics and frequent visits to communities where they provide healthcare support and supplies. So far, the organization's efforts have helped more than 10,000 people.

A pair of doctors are working to make healthcare more accessible and affordable by training area hospitals to use new technology, like ultrasound devices, to detect non-communicable diseases. Through their newly established non-communicable disease clinic staffed with personnel trained to provide more precise medical care, about 1,100 patients have been cared for.

Birth in Color's doulas are filling the maternity care gap as rural labor and delivery rooms close, disproportionately impacting people of color. Doulas provide physical, emotional and informational support before, during and after childbirth, and advocate on the mother’s behalf. Doula care leads to improved birth outcomes and lower rates of C-sections, and in April 2022 doula services were added under the state’s Medicaid program.