[Congressional Record Volume 143, Number 49 (Wednesday, April 23, 1997)]
[Senate]
[Page S3558]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DeWINE:
  S. 637. A bill to amend title XVII of the Social Security Act to 
continue full-time-equivalent resident reimbursement for an additional 
one year under Medicare for direct graduate medical education for 
residents enrolled in combined approved primary care medical residency 
training programs; to the Committee on Finance.


                 The Primary Care Promotion Act of 1997

  Mr. DeWINE. Mr. President, I rise today to introduce the Primary Care 
Promotion Act of 1997. This bill would restore full Federal funding 
under Medicare for graduate medical education for physicians 
specializing in approved combined primary care residency training 
programs. This legislation is needed to refocus the recently issued 
HCFA regulations that reduce the level of Federal funding to graduate 
medical education paid by the Medicare program.
  While HCFA's goals--reducing Medicare spending and placing sensible 
limitations on the number of new specialists trained in this country--
are praiseworthy, we must not lose sight of the fact that we face a 
shortage of primary care physicians, and particularly those who treat 
children.
  The Federal Government has used Medicare dollars effectively to 
support physicians who specialize in care for our seniors. Now, in my 
view, we must make a similar commitment to ensure that medical 
professionals are prepared to meet the health needs of our children. 
Despite what the bulk of our health policy would suggest, the health 
needs of our children are very different from those of their parents 
and grandparents. Children aren't miniature adults, and they need care 
that is tailored to their special needs.
  This legislation would greatly benefit children, because it would 
enable physicians to complete advanced training in combined specialties 
such as internal medicine and pediatrics or emergency medicine and 
pediatrics. A recent survey by the American Boards of Internal Medicine 
and Pediatrics demonstrates the wisdom of this investment: over 70 
percent of the physicians who were trained in the combined specialties 
of internal medicine and pediatrics between 1980 and 1995 currently 
work as primary care providers. Because the health needs of children 
are so varied and so different from those of adults, they often require 
care by physicians who have received specialized training.
  The Primary Care Promotion Act is supported by a wide variety of 
professional medical associations, including pediatricians, specialists 
in internal medicine, children's hospitals, and medical educators. This 
legislation has received bipartisan support in the House of 
Representatives, where it has been introduced by Representative Louise 
Slaughter, and we expect similar support in the Senate.
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