Pennsylvania has one of the most diversified populations of all the states, and it is important that all its citizens, wherever they live, have access to needed medical care.

We have large cities, metropolitan areas, farms, small towns, and scattered villages, and communities throughout the commonwealth are being tested by some sobering facts: Our population is decreasing, job growth is limited by a shrinking work force, and state government is having a hard time figuring out how to provide services within the existing tax structure. So we must support all the things that keep our state competitive and healthy.

One of the things that makes our state a strong economic force is our rural population. Pennsylvania, despite its reputation as an industrial "rust belt" state with large urban development, is among the states with the highest number of rural residents, right up there with Texas and North Carolina. One in every four Pennsylvanians lives in a rural area.

So state and national policymakers should want to see our rural residents thrive, and that includes ensuring that rural hospitals survive, especially when they serve low- and moderate-income families, many on Medicaid.

Unfortunately, such families could be harmed by a plan in Washington to end or limit the 340B Drug Pricing Program, part of the Public Health Service Act of 1992 that helps rural and inner-city safety-net hospitals obtain discounted drugs for patients. Under 340B, the savings from these drugs allows hospitals to provide medical care to underserved populations. With about 20 percent of the population of Pennsylvania's rural areas over age 65 and getting older, it underlines the importance of this needed program.

Who would want to end these important discounts? Big pharmaceutical companies. I am not arguing that they should not make a profit based on all the good they do for our health, their research into new drugs, and their packaging and distribution activities. But I believe that trying to limit or stop 340B is going too far.

If we want to ensure that all parts of the commonwealth flourish economically — cities, suburbs, farms, small towns, and villages — we must continue the programs that sustain us. To ensure the health of residents from Pennsylvania's inner cities to its small rural enclaves, 340B must be retained.

Look at a map of Pennsylvania that shows the 48 hospitals using 340B. As one hospital spokesman says, "It is a huge swath of our state." These hospitals are in our most rural and most urban areas — in 30 of our 67 counties. These hospitals provide 62 percent of the uncompensated care for the needy.

In today's divided political world, plenty of people believe there are too many federal programs that cost too much, and many others want more programs or even more taxes. But we can all agree that when a federal program demonstrably accomplishes its goals for an efficient expenditure of funds, it should be maintained and protected for the benefit of its recipients. That kind of program makes us all, as a state, stronger.

Earl Baker is a former state senator and Chester County commissioner.