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Low Medicare payments are forcing Utah's rural doctors and hospitals out of business, Republican congressional candidate Dean Bristow told top Health and Human Services Department officials Monday.

Naturally, he also says that having a doctor in the House - namely himself, a urologist, in the House of Representatives - might help bring needed attention to such problems and help get them solved."I'm not screaming for the doctors. The people will suffer. The elderly are having a tougher time finding doctors to treat them, and the situaion will only make it worse," the 3rd District candidate said. "Thinking about this issue is one of the main reasons I decided to run."

Bristow gave examples of Medicare reimbursement rates that are too low to allow rural hospitals to survive. They are paid much less than urban hospitals, even if the two are near each other - such as the "urban" hospital where Bristow works in Payson compared with the nearby "rural" hospital in Nephi.

For example, Medicare will pay an urban hospital in Utah $3,217 to treat a patient suffering from heart attack - but will pay a rural hospital only $2,601.

"The rates are lower for rural hospitals because they theoretically have lower overhead. But their overhead is actually higher because they can't buy in quantity like larger hospitals," he said.

"Urban hospitals are barely able to stay in operation at the above rates . . . Most rural hospitals are losing money, largely because of the low rate of Medicare reimbursement."

Bristow gave that message in a private meeting to HHS Assistant Secretary James O. Mason, who oversees Medicare. Mason is also the former director of the Utah Health Department.