Subsidies to work in rural areas - thoughts?

[midjd]

I thought this was a very interesting article (and proposed solution) to what seems to be a growing problem.

I'm not totally sure if I agree with the idea of subsidies to practice in rural areas, but our state is one in which most of the population is concentrated in a few areas. The program I manage has about 60 contractors across the state, and it is extremely difficult to find attorneys to serve the more rural areas (meanwhile I have local attorneys coming out of my ears). 

OTOH the profession gets enough flak as it is without receiving "handouts" - and with 45% of new graduates unable to find a job in the legal industry, it seems like the easy solution would be to just move. But how easy is it?

MARTIN, S.D. — Rural Americans are increasingly without lawyers even as lawschool graduates are increasingly without jobs. Just 2 percent of small law practices are in rural areas, where nearly a fifth of the country lives, recent data show.

Here in Bennett County, which is situated between Indian reservations on theNebraska border, Fredric Cozad is retiring after 64 years of property litigation, school board disputes, tax cases and homicides with no one to take his place.When he hung out his shingle he was one of half a dozen lawyers here. Now thereis not a working attorney for 120 miles.

“A hospital will not last long with no doctors, and a courthouse and judicial system with no lawyers faces the same grim future,” South Dakota’s chief justice, David E. Gilbertson, said. “We face the very real possibility of whole sections of this state being without access to legal services.”

In South Dakota, 65 percent of the lawyers live in four urban areas. In Georgia, 70 percent are in the Atlanta area. In Arizona, 94 percent are in thetwo largest counties, and in Texas, 83 percent are around Houston, Dallas,Austin and San Antonio. Last summer, the American Bar Association called on federal, state and local governments to stem the decline of lawyers in rural areas.

Last month, South Dakota became the first state to heed the call. It passed a law that offers lawyers an annual subsidy to live and work in rural areas, like the national one that doctors, nurses, and dentists have had for decades.

The new law to lure lawyers passed partly because it requires the ruralcounties and the bar association to contribute to the subsidy before the statepays. Mr. Kraft said the law seemed good, but he worried about finding themoney for his county’s share and rental properties for young lawyers.

The new law, which will go into effect in June, requires a five-year commitment from the applicant and sets up a pilot program of up to 16 participants. They will receive an annual subsidy of $12,000, 90 percent of thecost of a year at the University of South Dakota Law School.

This compares with a 40-year-old federal medical program, the National Health Service Corps, which offers up to $60,000 in tax-free loan repayment for two years of service in underservedareas and up to $140,000 for five years of service. The program consists of nearly 10,000 medical, dental and mental health professionals serving 10.4 million people, almost half in rural communities.

A spokesman for the federal program said research had shown that residents who train in rural settings are two to three times more likely than urban graduates to practice in rural areas.

“The health care model is unbelievably subsidized, and while I favor finding some version of it for legal needs, it is never going to be ratcheted up tothat level,” Professor Wilkins of Harvard said. “We should think more about public-private partnerships and loosening up some of the restrictions on law practice without junking them all. What we need now is experimentation, like what is happening in South Dakota.”

www.nytimes.com/2013/04/09/us/subsidy-seen-as-a-way-to-fill-a-need-for-rural-lawyers.html?_r=0

[milee]

Guess it's no more ridiculous than the subsidies to rural areas for mail, phone, doctors, roads, etc. 

IMHO, it's a bad idea.  If people choose to live in rural areas, that's fine but it doesn't make much sense to me for others to subsidize that choice.  Seems like another government program that is well-intentioned but ends up perpetuating the problems it's meant to solve.  Maybe if we stop artificially propping these dying areas up then people will either move to where the jobs and services are or determine the best way to grow the local economy.  As it is, we just keep alive a dying way of life and trap future generations into inescapable geographic poverty.  Yay.

[midjd]

First, kudos for being able to read through my terrible formatting (apparently you can't c/p from NYT and use quotes)!

You do raise a good point. It's almost a chicken-and-egg situation - on one hand, you don't want people to be half a day's drive from medical or legal services, especially in an emergency. On the other hand, at some point, wouldn't that spur them to move closer to civilization?

I do think the way SD is doing it - requiring the rural counties and bar associations to pony up before state funding gets involved - is better than just writing a check. Gives them a little bit of skin in the game.

[Deleted]

Who wants to be a country solicitor?

[Deleted]

Milee,

I don't think there's a problem with a lot folks moving TO these areas. In the cases that I'm aware of there's a real problem with getting services to the Native Americans who are living on the reservation. Since "we" put them there I think there's an obligation for us to provide services to them.

That said, I'd like to see some real statistics on how well the rural medical program is working, not just anecdotal evidence that doctors that train in a rural area stay in a rural area...

I think one reason that some unemployed law graduates don't move to rural areas is the issue of paying off their student loans. I know Mid has been working in a job that gives some loan forgiveness. I think working in rural areas could have a similar structure.

[milee]

Apr 9, 2013 10:34:34 GMT -5 @bonnap said:

Milee,

I don't think there's a problem with a lot folks moving TO these areas. In the cases that I'm aware of there's a real problem with getting services to the Native Americans who are living on the reservation. Since "we" put them there I think there's an obligation for us to provide services to them.

Oh, I'm very aware that people aren't moving to those areas.  My post refers to people who are choosing to stay in those areas even though there are no jobs, healthcare, legal services, etc. and the rest of the population needs to subsidize even their basics like mail and phone service.

And yes, 150 years ago, the US government did a horrible thing in moving Native Americans to reservations.  But by subsidizing healthcare and every other thing that is needed to live, we don't correct that wrong; instead, we perpetuate it.  It's been over 100 years since any Native American was forced to live anywhere.  But by handing them scraps to stay on their plot of land, we're gently encouraging them to stay.  If we stop with the subsidies then they would make choices that made more sense in the long term, not just stay where they are because someone is handing them a pittance and it's too scary to try to escape.

When I lived in Phoenix, one of my best friends was Native American and had grown up on a reservation.  Her observations changed how I thought about the issues.  She thinks that by handing Indians (that's her term) subsidies, the government continues to keep them down... and she's contemptuous of the Indians who are willing to trade their future in exchange for a paid for trailer and some government cheese.

[happyhoix]

My post refers to people who are choosing to stay in those areas even though there are no jobs, healthcare, legal services, etc. and the rest of the population needs to subsidize even their basics like mail and phone service.

Umm, I'm not sure what kind of rural areas you're thinking of, but just because an area is rural doesn't mean it's some desolate moonscape with no jobs and with nothing but impoverished locals too stubborn to move. 
 
Your suggestion that people in rural areas ought to move to other more populated areas is not very practical, given that presumably you eat food which presumably came from farms and feed lots and chicken sheds in rural areas.

Unless you would be willing to locate a pig lot behind your subdivision or your kid's school, I think we need to continue to have rural areas.

I live in a rural Georgia area, and my doctor got part of her education paid for in exchange for locating here after graduation. For professions like medicine and the legal field, where the highest paying salaries are tied to the high volume practices, it makes sense to provide subsidies to those types of professionals who will never have the same type of high case loads (and consequently won't have the same earning potential) in the rural areas.

By the way, we have a small industrial park that employees about 1000 people, and a lot of people like me that live here and commute to a city 30 minutes away to work. Plus we have the schools, the retail shops and restaurants, and of course the agricultural community - so we aren't all jobless here. We just don't have the population density the suburbs and cities have.

[resolution]

There is also a lot more to it than if the professional wants to move to a rural area. They have have to consider what opportunities will be offered to their children. 

My husband's parents both moved to teach school in a very rural area in Appalachia with very few employers. They had three kids. Typically what happens in that particular area is that the kids will either move away to go to school and get jobs or they will stay and spend all their time smoking pot and trying to get enough income from odd jobs to cover food. My husband and his brother moved away. His sister left for school and after a few years of teaching she was able to find a position at the local school. However she is trying to move away now because she is 35 and there is no one to date. 

[973beachbum]

This is anecdotal but it might make a point better than I can.  I have a friend who is a lawyer from NJ who moved to a rural area of Texas.  She moved there for family reasons.  When she got there she looked about getting a job or putting out her own shingle.  At first she felt elated to get such a great reception from everyone.  It seemed like they were thrilled to get a lawyer in the area.  It became obvious quickly that there was a reason there weren't any lawyers in that area.  They simply didn't have enough work.  If she took every case that was offered to her for pay she still wouldn't have made more than a 12 year old with a decent paper route.

There were plenty of people who needed free legal help, but very little that were willing and capable of paying for it.  Except for very few people, who really plans on spending their entire life working for free?

[NomoreDramaQ1015]

Most of Nebraska and Iowa is still devoted to farm land.  I'm not sure we can cram industrial feed lots/farms into the bigger cities.  Nor do I think it'd be an entirely good idea to make all the farmer's quit and get "real" jobs.

I haven't looked into state subsidies but I know UNMC pays relocation costs for nurses/doctors/dentists that agree to move to rural areas.  Fact is you're not looking at near the salary you'd get being a specialist in a larger city.  That's a hard decision considering how much debt you get into for medical school 

There is a huge glut of nurses here to the point where the schools are only taking 1-2 new applicants a year.  I don't see any harm in dangling a carrot to encourage them to move where the jobs are.

[thyme4change]

Oh no - I hope I won't have to move to some weird-ass town in Nowheresville, AZ! 

[midjd]

There were plenty of people who needed free legal help, but very little that were willing and capable of paying for it. Except for very few people, who really plans on spending their entire life working for free?

Very good point. If the under-served areas are mainly composed of people who can't afford to pay for legal services when they need them, how much will a $12K/year subsidy help?  It's a little different than the health professional example, since in most cases a good chunk of their pay comes from the insurance company and/or the federal government.

That may be an unfair assumption, but in some counties in this state, the median HH income is <$20K. The COL is low, but not that low. Could be a big reason as to why attorneys are fleeing those areas (here and elsewhere). 

Our pro bono/legal aid services are good, but woefully underfunded, and I don't see them expanding into rural areas without a huge influx of cash.

Still, with only 55% of graduates working in jobs that require a legal degree - there has to be some happy medium.

[milee]

Throwing subsidies at it just serves to conceal the true costs of not only living there but also of the services produced in these areas.

As far as the example about farming, remove the subsidies and let prices rise to the amount that they'd need to rise to cover the costs.  Maybe the true cost of corn is double what it is right now.  Until the subsidies are removed, nobody knows what the real cost is and nobody can make good decisions... such as maybe instead of corn, we eat more ________.  Fill in the blank with an alternate that is less costly or can be raised in the back yard.  Or, maybe - and this is my personal favorite - we stop overeating to the point we're making ourselves sick. 

Subsidies mask and further promote the problems.

[Deleted]

I'm sorry. I couldn't get past the quote where it said that there were four urban areas in South Dakota. I must have a different definition of urban area. I only count two, maybe three if you count the capital, urban areas in the state.

[bookkeeper]

Just because a location is rural does not mean it is "dying"  Farming and tourism are the top two economic drivers in South Dakota.  Farms have gotten bigger and technology now requires fewer people to operate these farms.  Yes, there are fewer people living in rural South Dakota than in the 1960's but look what else has changed since then.  Namely, fax machines and the internet.  It is pretty easy to get the template for a will, LLC, or divorce for a small charge on the credit card.  Also easy to fax what you need to an attorney 100 miles away.

I am from South Dakota.  I grew up in the country and went to high school in a town of 900 residents.  We had one lawyer in town on main street back in the 1970's.  Fast forward to today, you probably have to drive 20 or 30 miles to see an attorney.  I also worked for the SD Judicial System in a past life and my brother in law is a court services officer (probation officer).  The reality of today is that everyone; judges, attorneys, court reporters, plaintiffs and defendants all must travel an hour or more to get the job done. 

The advent of better communication; video conferencing, fax machines and the internet has made the small town attorney a rare find these days.

Travel has improved as well.  No one from that area of the country thinks twice about hopping in the car for 2 hours to get to a shopping mall.  They should not be too surprised if they have to travel that far for legal help.

[bookkeeper]

South Dakota's urban areas include Sioux Falls, Rapid City, Aberdeen, Pierre, Brookings, Watertown, the entire Northern Black Hills area  and North Sioux City.

Many smaller towns surrounding these 7 larger cities serve as bedroom communities with cheaper housing.  Think of it as urban with a 20 mile green space in the middle. 

[happyhoix]

Apr 9, 2013 12:57:31 GMT -5 milee said:

Throwing subsidies at it just serves to conceal the true costs of not only living there but also of the services produced in these areas.

As far as the example about farming, remove the subsidies and let prices rise to the amount that they'd need to rise to cover the costs.  Maybe the true cost of corn is double what it is right now.  Until the subsidies are removed, nobody knows what the real cost is and nobody can make good decisions... such as maybe instead of corn, we eat more ________.  Fill in the blank with an alternate that is less costly or can be raised in the back yard.  Or, maybe - and this is my personal favorite - we stop overeating to the point we're making ourselves sick. 

Subsidies mask and further promote the problems.

Sure, sounds reasonable. We should put up fences around the cities and suburbs and turn the rest of the country into one big federal park.

In these bad economic times, it sure it won't be a problem to let bread and milk quadruple in costs.

If you have a kid, you could always get a goat to provide the milk, that would also be a green way to keep your grass cut, and I'm sure there aren't any problems with letting kids drink raw, unpasturized goat milk.

Then you could turn your front yard into a wheat field so you can mill your own flour and make your own bread.

Sounds fabulous, I don't know why we haven't all started growing our own food before. I certainly think it would drastically reduce the number fatties we have running around, buying up their cheap bread and milk made in those crappy rural areas.