Inherent Problems in the Pittsburg Metropolitan Statistical Area

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The map representing the Pittsburg Metropolitan Statistical Area (MSA) found on page 460 of our textbook provides some idea of inherent problems associated with urbanization and its encroachment upon the differing jurisdictions existing within all MSAs. While each local government may have specific issues that differ from other districts within an MSA, they also share problems as well. Noted on the map is that the Pittsburg MSA abuts the state of Ohio, however, what is not pointed out by the authors is that both the Wheeling and Steubenville-Weirton MSAs, located in the southeastern portion of Ohio and southwestern border of Pennsylvania, segue into West Virginia (Ohio Metropolitan Statistical Areas). This may give some idea concerning inherent problems, such as the example provided in the text related to Tennessee’s Memphis Regional Medical Center (“The Med”), where there exists no contingency for Medicaid reimbursements for healthcare services provided to residents living in Arkansas who are part of the same MSA (Smith, Greenblatt and Mariani 459). The problem described at the end of the paragraph above appears to be inherent to MSAs “Because these metropolitan areas span not just county but also state and even national borders, it is incredibly difficult to exercise any form of centralized planning over their growth and operation.” (Smith, Greenblatt and Mariani 462). Precedent appears to remain none existent to address the dilemma faced by The Med, where Medicaid reimbursements across state borders continue to be a contentious issue; and the proposition of incorporating those areas in Arkansas served by the hospital remains untenable because MSAs, as regions sharing essential services in this case, are not constitutionally... ... middle of paper ... ... today, it would be highly improbable that any movement attempting to consolidate geographic and political boundaries, as well as public services within those boundaries would be met with earnest bipartisan consideration, or by those having a vested interest in maintaining the status quo. Works Cited Bovbjerg, Randall R., Joshua M. Weiner and Michael Houseman. "State and Federal Roles in Healthcare: Rationales for Allocating Responsibilities." Federalism and Health Policy. Eds. John Holahan, Alan Weil and Joshua M. Weiner. Washington D.C.: Urban Institute, 2003. 25-57. Print. Smith, Kevin B., Alan Greenblatt, and Michele Mariani. Governing States and Localities. Third ed. Washington, D.C.: CQ, 2011. Print. "Ohio Metropolitan Statistical Areas (MSAs)." Workforce Development. Stark County. Web. 02 May 2012. .

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