Senate Proceeding 07-07-09 on Jul 7th, 2009 :: 4:04:00 to 4:12:45
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4:03:45 to 4:04:08( Edit History Discussion )

John Barrasso: justify that effort. i thank the preside yield the floor. i thank senator sessions, who i see waiting for a turn to and senator barrasso waiting for his turn to speak, for their courtesy in allowing me the extra time. i yield the the presiding officer: the senator from wyoming.

4:04:00 to 4:12:45( Edit History Discussion )
Speech By: John Barrasso

4:04:09 to 4:04:30( Edit History Discussion )

John Barrasso: many barrasso: thamr. barrasso: thank you, madam president. madam president, i ask unanimous consent to speak for up minutes in morning business and then recognize senator sessions when i finish. the presiding officer: without objection. mr. barrasso: thank you, madam president. madam president, most everyone knows i'm an orthopedic surgeon. in wyoming, many people refer to me as wyoming's doctor. that's because for over two decades, folks have invited me into their homes with television

4:04:31 to 4:04:51( Edit History Discussion )

John Barrasso: health reports, radio health reports, where i give people information that they can use to stay healthy and to keep down the costs of their medical care. and i end each of these te saying, here in wyoming, i'm dr. john barrasso, helping you care for yourself." this is also my philosophy for

4:04:52 to 4:05:12( Edit History Discussion )

John Barrasso: government: helping people help themselves. as medical director of the wyoming heth fairs, i worked to give people all around the cowboy state access to lifesaving preventive blood tests and low-cost medical screenings.my goal is always to encourage famies to eat right, to exercise, to manage chronic

4:05:13 to 4:05:33( Edit History Discussion )

John Barrasso: diseases, ando stop smoking. because prevention is one of the keys to a long and a happy and a healthy life. as i travel home every weekend, i hear the concerns people have about health care and the cost of care. they're concerned about the specific costs of their medical care and thousand affects them and their family -- and how it affects them and their family budget.

4:05:34 to 4:05:55( Edit History Discussion )

John Barrasso: many families -- many families -- across wyoming and this country worry that they will lose the health care coverage that they currently have. others can't afford insurance today. that's what's wrong with our health care system. that is what we need to fix. now, i know from firsthand experience that doing nothing is simply not an option.

4:05:56 to 4:06:17( Edit History Discussion )

John Barrasso: we must be careful, we must be thoughtful, and we must be deliberate about the changes that we make. health care is a very complex and it's an intensely personal issue. it deserves a national debate, a serious, open and transparent national debate. i welcome the opportunity to

4:06:18 to 4:06:38( Edit History Discussion )

John Barrasso: talk about the concerns of people living longer and needing more care and more advanced care. the concerns to care are affordable care, access to care and high-quality care. well, in the midst of this debate, we cannot stand for rural americans to be left behind.

4:06:39 to 4:06:59( Edit History Discussion )

John Barrasso: they need access to high-quality care, affordable health care just like everybody else. when first came to the senate, i promised the people of wyoming that i would fight each and every day to protect and to modernize our rural health care delivery system. i committed to do my part to strengthen our rural hospitals, our rural health clinics and our community health centers.

4:07:00 to 4:07:20( Edit History Discussion )

John Barrasso: i committed to do my part to increase rural america's access to primary health care services and to aid in the successful recruitment and retention of nurses, nurse practitioners, doctors, physician assistants all across rural and frontier america. madam president, there are obstacles, obstacles faced by

4:07:21 to 4:07:41( Edit History Discussion )

John Barrasso: our hospitals, our clinics and our providers, obstacles that they have to overcome to deliver quality care to all of the families in rural america. and, you know, they end up having to do it in an environment of markedly limited resources. now, the federal government needs to recognize these important differences and then

4:07:42 to 4:08:02( Edit History Discussion )

John Barrasso: respond with the people of i am here not just as their senator but also as a doctor who has practiced medicine fighting on their half. now, recently i joined three of my colleagues to introduce s. 1157, the craig thomas rural hospital and act. well, today, madam president, i

4:08:03 to 4:08:24( Edit History Discussion )

John Barrasso: rise to talk about a different bill, a bill i've introduced alongside my colleague from oregon, senator ron wyden. it is called "the rural health clinic patient access and improvement act." now, this legislation is a great example of what bipartisanship can produce. now, senator wyden, i want to thank you, i want to thank your

4:08:25 to 4:08:45( Edit History Discussion )

John Barrasso: staff for working so hard to collaborate with me on this very important bill. i commend your dedication to he equal access to the high-quality medical care that they deserve. madam president, this legislation strengthens america's 3,500 rural health clinics that serve rural and frontier communities.

4:08:46 to 4:09:07( Edit History Discussion )

John Barrasso: rural health clinics are a highly valued medical provider in communities all across this country. in wyoming, we have rural health clinics located in communities that many people have never heard of, bags, wyoming, glennrock, hewitt, lovell, hughland bow, and themopolis.

4:09:08 to 4:09:28( Edit History Discussion )

John Barrasso: these clinics me sure that patients have access to primary care as close to home as humanly possible. now, that's not always a chance in wyoming. to give a snap shop of the landscape, we have only 20 hospitals and 18 rural health clinics spread over 100,000 square miles, remarkably large distances, vast distances,

4:09:29 to 4:09:49( Edit History Discussion )

John Barrasso: complex medical cases and increased demand for technology, for advanced medical care. the rural health care system, madam esident, is certainly not one-size-fits-all. well, let me explain what this rural health clinic patient access and improvement act actually does. first, the rural health clinics currently receive an

4:09:50 to 4:10:13( Edit History Discussion )

John Barrasso: all-inclusive payment rate which is capped at $76. that payment has not been adjusted except for inflation since 1988, and we all know that medical inflation has gone up at a much greater rate than the regur inflation. so this bill addresses this problem by raising the rural

4:10:14 to 4:10:35( Edit History Discussion )

John Barrasso: health clinic cap from $76 to $92. rural health clinics are a examinee component of the rural health dliferry system and we need to -- delivery system and we need to make sure that there is fair pay for patients who are taken care facilities. we also need to give them enough flexibility to meet their community's health care needs. now, additionally, this measure

4:10:36 to 4:10:57( Edit History Discussion )

John Barrasso: would establish a new quality reporting program for rural health clinics. three years ago, congress required the centers for medicare and medicaid to create a physician quality reporting system. this program offers bonus payments to doctors quality measures on medicare services. the quality incentive program is linked to the medicar physician

4:10:58 to 4:11:19( Edit History Discussion )

John Barrasso: fee schedule. rural health clinics, though, are not paid using the physician fee schedule. so if congress really wants to pay doctors based not on volume but on the quality of care, then it is important to rember that the one-size-fits-all approach will not work here.

4:11:20 to 4:11:41( Edit History Discussion )

John Barrasso: that's why this bill ensures that a comparable quality incentive is available to rural health care providers. now, third, the rural health clinic patient access and improvem provider retention demonstration project. it's a five-state project that's going to study the extent to which a medical professional can be encouraged, enticed to

4:11:42 to 4:12:03( Edit History Discussion )

John Barrasso: practice in an underserved rural and frontier area. the states would be given grants to help physicians and physician asstants and nurse practioners and certified nurse midwives to help them pay a small portion of their medical liability c now, i believe these incentives will help dw more providers, especially those who deliver babies to work in an underserved

4:12:04 to 4:12:24( Edit History Discussion )

John Barrasso: area because their malpractice insurance is the same whether they deliver one baby or a hundred. but in these small areas, there aren't that marriage penalty babiemany babies beingborn this year. so the cost, while it's the same for their malpractice insurance, has to be distributed over a fewer number of patients. so this is an incentive to help encourage them to practice in these underserved areas.

4:12:25 to 4:12:45( Edit History Discussion )

John Barrasso: madam president, wyoming has too few primary care providers for theithe population that we must serve, and i know mstate is not alo. this bill that senator wyden and i have introduced reflects our commitment to ensure rural americans have access to high-quality health care services. i strongly encourage all of my colleagues with an interest in