[Congressional Record Volume 150, Number 18 (Thursday, February 12, 2004)]
[Senate]
[Pages S1291-S1292]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REID (for himself, Mrs. Lincoln, and Mr. Breaux):
  S. 2075. A bill to amend title III of the Public Health Service Act 
to include each year of fellowship training in geriatric medicine or 
geriatric psychiatry as a year of obligated service under the National 
Health Corps Loan Repayment Program; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. REID. Mr. President, as our Nation's 76 million Baby Boomers near 
retirement age, the number of Americans over age 65 will double to 70 
million--one-fifth of the population. Americans older than 85 represent 
the fastest growing segment of this population and membership in this 
once exclusive demographic group is projected to grow from four million 
Americans today to an estimated 19 million by 2050.
  Unfortunately, our health care system is ill prepared to handle the 
strain of this enormous senior population, largely because we have a 
critical shortage of geriatricians. Fewer than 9,000 geriatricians 
practice in the U.S., far below the 20,000 or more needed to 
effectively care for the Nation's booming population of seniors. 
Ironically, the number of geriatricians is expected to shrink as many 
of these doctors retire at the same time baby boomers start qualifying 
for Medicare in large numbers.
  America must plan for the burdens the baby boomers demographic shift 
will place on our health care system and health care providers. Our 
first step is ensuring the country has an adequate number of well-
trained geriatricians.
  I first introduced legislation to address the national shortage of 
geriatricians during the 105th Congress. While I am encouraged that 
greater attention has been focused on this issue, little has been 
accomplished to improve the shortage of geriatricians.
  Today, I am re-introducing legislation that will encourage more 
doctors to become certified in geriatrics. The Geriatricians Loan 
Forgiveness Act would forgive $20,000 of education debt incurred by 
medical students for each year of advanced training required to obtain 
a certificate of added qualifications in geriatric medicine or 
psychiatry.
  Geriatric medicine is the foundation of a comprehensive health plan 
for our most vulnerable seniors. Geriatrics, by focusing on assessment 
and care coordination, promotes preventive care and improves patients' 
quality of life by allowing them greater independence and eliminating 
unnecessary and costly trips to the hospital or institutions. But this 
kind of specialized care is complicated and demanding. Many doctors 
inclined to study and practice geriatric medicine are dissuaded from 
doing so because treating the elderly takes more time and carries 
financial disincentives for doctors.
  Medical training takes time, so we need to lay the groundwork now to 
have enough qualified geriatricians in place in ten years from now. 
This legislation is a commonsense approach and cost-effective 
investment. We must take these steps today to meet our needs for 
tomorrow.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2075

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Geriatricians Loan 
     Forgiveness Act of 2004''.

     SEC. 2. NATIONAL HEALTH SERVICE CORPS LOAN REPAYMENT PROGRAM.

       (a) In General.--Section 338B(g) of the Public Health 
     Service Act (42 U.S.C. 254l-1(g)) is amended by adding at the 
     end the following:
       ``(5) Obligated service.--
       ``(A) In general.--For purposes of this section, each year 
     of training in geriatric medicine or geriatric psychiatry 
     that is required in order to obtain a certificate of added 
     qualification in geriatric medicine or geriatric psychiatry 
     shall be deemed to be a year of obligated service.
       ``(B) Limitations.--
       ``(i) Payments.--Notwithstanding
     the first sentence of paragraph (2)(A), for the year of 
     obligated service described in subparagraph (A), the 
     Secretary may pay up to $20,000 on behalf of the individual 
     for loans described in paragraph (1).
       ``(ii) Individuals.--The number of fellowship years in 
     geriatric medicine or geriatric psychiatry that are deemed to 
     be a year of obligated service under this section shall not 
     exceed 400 in any calendar year.''.
       (b) Effective Date.--
       (1) In general.--The amendment made by subsection (a) shall 
     apply to applications submitted to the Secretary of Health 
     and Human Services under section 338B of the Public Health 
     Service Act (42 U.S.C. 254l-1) on or after 1 year after the 
     date of enactment of this Act.
       (2) First year of program.--For the period beginning on the 
     date of enactment of this Act and ending on December 31 of 
     the

[[Page S1292]]

     calendar year in which such enactment occurs, the Secretary 
     of Health and Human Services shall ratably reduce the maximum 
     number of fellowship years in geriatric medicine or geriatric 
     psychiatry that may be deemed to be a year of obligated 
     service under section 338B(g)(5)(B)(ii) of the Public Health 
     Service Act (42 U.S.C. 254l-1(g)(5)(B)(ii)) (as added by 
     subsection (a)) to reflect the portion of the year that the 
     amendment made by subsection (a) is in effect.
                                 ______