[Congressional Record Volume 150, Number 130 (Monday, October 11, 2004)]
[Senate]
[Pages S11271-S11274]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
IMPROVING ACCESS TO PHYSICIANS IN MEDICALLY UNDERSERVED AREAS
Mr. SESSIONS. I ask unanimous consent that the Senate proceed to the
immediate consideration of Calendar No. 775, S. 2302.
The PRESIDING OFFICER. The clerk will report the bill by title.
The assistant legislative clerk read as follows:
A bill (S. 2302) to improve access to physicians in
medically underserved areas.
There being no objection, the Senate proceeded to consider the bill
which had been reported from the Committee on the Judiciary, with an
amendment to strike all after the enacting clause and insert in lieu
thereof the following:
[Strike the part in black brackets and insert in lieu thereof the
part printed in italic.]
S. 2302
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
[SECTION 1. WAIVER OF FOREIGN COUNTRY RESIDENCE REQUIREMENT
WITH RESPECT TO INTERNATIONAL MEDICAL
GRADUATES.
[(a) Extension of Deadline.--Section 220(c) of the
Immigration and Nationality Technical Corrections Act of 1994
(8 U.S.C. 1182 note) (as amended by section 11018 of Public
Law 107-273) is amended by striking ``2004.'' and inserting
``2009.''.
[(b) Designation of Health Professional Shortage Areas by
State Agencies.--Section 214(l)(1)(D) of the Immigration and
Nationality Act (8 U.S.C. 1184(l)(1)(D)) is amended--
[[Page S11272]]
[(1) by striking ``professionals,'' and inserting
``professionals or in other shortage locations specified by a
State department of public health (or its equivalent),''; and
[(2) by striking ``in a geographic area designated by the
Secretary.'' and inserting ``in such a geographic area or
other shortage location.''.
[(c) Exemption From H-1B Numerical Limitations.--Section
214(l)(2)(A) of the Immigration and Nationality Act (8 U.S.C.
1184(l)(2)(A)) is amended by adding at the end the following:
``The numerical limitations contained in subsection (g)(1)(A)
shall not apply to any alien whose status is changed under
the preceding sentence, if the alien obtained a waiver of the
2-year foreign residence requirement upon a request by an
interested State agency.''.]
SECTION 1. MODIFICATION OF VISA REQUIREMENTS WITH RESPECT TO
INTERNATIONAL MEDICAL GRADUATES.
(a) Extension of Deadline.--
(1) In general.--Section 220(c) of the Immigration and
Nationality Technical Corrections Act of 1994 (8 U.S.C. 1182
note) (as amended by section 11018 of Public Law 107-273) is
amended by striking ``2004.'' and inserting ``2006.''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect as if enacted on May 31, 2004.
(b) Exemption From H-1B Numerical Limitations.--Section
214(l)(2)(A) of the Immigration and Nationality Act (8 U.S.C.
1184(l)(2)(A)) is amended by adding at the end the following:
``The numerical limitations contained in subsection (g)(1)(A)
shall not apply to any alien whose status is changed under
the preceding sentence, if the alien obtained a waiver of the
2-year foreign residence requirement upon a request by an
interested Federal agency or an interested State agency.''.
(c) Limitation on Medical Practice Areas.--Section
214(l)(1)(D) of the Immigration and Nationality Act (8 U.S.C.
1184(l)(1)(D)) is amended by striking ``agrees to practice
medicine'' and inserting ``agrees to practice primary care or
specialty medicine''.
(d) Exemptions.--Section 214(l)(1)(D) of the Immigration
and Nationality Act (8 U.S.C. 1184(l)(1)(D)) is further
amended--
(1) by striking ``except that,'' and all that follows and
inserting ``except that--''; and
(2) by adding at the end the following:
``(i) in the case of a request by the Department of
Veterans Affairs, the alien shall not be required to practice
medicine in a geographic area designated by the Secretary;
``(ii) in the case of a request by an interested State
agency, the head of such State agency determines that the
alien is to practice medicine under such agreement in a
facility that serves patients who reside in one or more
geographic areas so designated by the Secretary of Health and
Human Services (without regard to whether such facility is
located within such a designated geographic area), and the
grant of such waiver would not cause the number of the
waivers granted on behalf of aliens for such State for a
fiscal year (within the limitation in subparagraph (B)) in
accordance with the conditions of this clause to exceed 5;
and
``(iii) in the case of a request by an interested Federal
agency or by an interested State agency for a waiver for an
alien who agrees to practice specialty medicine in a facility
located in a geographic area so designated by the Secretary
of Health and Human Services, the request shall demonstrate,
based on criteria established by such agency, that there is a
shortage of health care professionals able to provide
services in the appropriate medical specialty to the patients
who will be served by the alien.''.
Mr. SESSIONS. I ask unanimous consent that the committee substitute
amendment be agreed to, the bill, as amended, be read a third time and
passed, the motions to reconsider be laid upon the table, with no
intervening action or debate, and any statements relating to the bill
be printed in the Record.
The PRESIDING OFFICER. Without objection, it is so ordered.
The committee amendment in the nature of a substitute was agreed to.
The bill (S. 2302), as amended, was read the third time and passed.
Mr. SESSIONS. Madam President, I believe that is all I have. I yield
the floor.
The PRESIDING OFFICER. The Senator from Maryland.
Mr. SARBANES. Madam President, I was struck by the fact that when my
colleague from Alabama presented his chart on economic growth, it
stopped at the end of last year and did not carry forward into this
year. Of course, had it carried forward into this year, it would have
shown a declining trend in economic growth and that is a matter,
obviously, of very deep concern. In fact, there was a story last week,
a Reuters news story last week, that said:
Top U.S. executives are pessimistic about next year's U.S.
economy. About 70 percent of the chief executives surveyed by
the Business Council projected flat to 2 percent U.S.
economic growth. More bearish than forecasts by major
economists, the Business Council survey, often seen as a
gauge of corporate sentiment, was released ahead of a meeting
of the group's members, about 125 CEOs from companies . . .
Then they cite a number of the large companies in the country, saying
generally CEOs are a bit more pessimistic, referring to the difference
of opinion between executives and economists.
The U.S. economy actually grew at a 3.3 percent annual rate in the
second quarter of this year. Now these chief executives are projecting
a flat to 2-percent growth. My colleagues on the other side, if you
bring these uncomfortable facts to their attention, they say, well, you
are talking doom and gloom. But how are we going to realistically deal
with our problems if we do not face what our problems are?
I want to address one question, because the previous presentation
talked as though the only relevant factor is economic growth. It never
addressed job growth. It only addressed job growth in the sense of
saying if you had economic growth, you would have job growth. If you
didn't have economic growth, you would have job loss. But the problem
is more complicated than that, the problem we are confronting right
now. I want to point out a couple of factors in that regard.
This chart shows how unemployment has moved in previous postwar
recoveries, and how it is moving in this one. What it shows: Of course,
you obviously get a downward trend in employment as you go into a
recession. Then you try to come out of a recession. Of course,
recessions are measured by economic growth figures. In the average of
postwar recoveries, this is what has happened with respect to
employment. We have had this kind of growth. So we have had a good,
rising trend in employment.
In this recession, this is what has happened to employment. There is
a huge gap here in terms of the recovery with respect to jobs. That is
why we are so concerned about jobs. That is why we continuously stress
that point.
This figure was underscored earlier in the conversation we had about
the number of long-term unemployed, which has jumped so substantially.
One question becomes, Why are we not getting the jobs? I think one
answer to that is to be found in these two charts. What we see in
recent years is a sharp increase in productivity. In other words, that
is what a worker can produce for each hour of work. But we do not see
an increase in worker wages. Productivity is growing much faster than
worker wages. The workers who are producing more for each hour worked
are, in effect, not sharing in the benefits and their wages are running
virtually constant.
One might ask, What happened in other recessions? What usually
happens is that worker wages, as you come out of the recession, rise
commensurate with their share of the economy, which is about two-
thirds. But here is what is happening this time. The worker wages are
not rising, but the corporate profits are rising 65 percent. So most of
the benefit from the economic growth in this partial recovery is not
going to the workers, but it is going to corporate profits. This is in
marked contrast with previous recoveries. I want to underscore that
point. This is a very different pattern than we have seen in the past.
Of course, part of the reason for that is the policies of this
administration.
Then the counterargument is made on the other side: If you give the
corporation these profits, they will invest them and therefore
strengthen the economy, build the economy and create jobs. But here is
what has happened in this Bush administration. These are the growth
rates of plant and equipment investment by U.S. corporations. As you
can see, it actually is down, negative during this Bush administration,
compared with previous administrations in which it was a positive
figure. So what is happening is the benefits are being skewed away from
the workers, but those receiving the benefits are not investing them in
the economy in order to build businesses and create jobs. That, of
course, explains in part, in my view, why there is such a tremendous
lag in this recovery in terms of producing jobs. There is no way you
can get around the fact.
I listened earlier. No one actually challenged any of the figures or
facts about the employment situation. There is no way you can get
around the fact that this is the first administration in 75 years not
to have a net gain of jobs in the course of the administration. They
are still down 825,000 jobs from where they were when they came into
[[Page S11273]]
office. They are down 1.6 million jobs in the private sector and they
are down 2.7 million manufacturing jobs.
My colleague from Alabama says we have produced this year a gain of
93,000 jobs. He says that is a good thing. It is a good thing in the
sense that we want to be positive in producing manufacturing jobs. It
is not such a good thing if you put it in the context of the fact that
we have lost 2.7 million jobs since January of 2001. If you put the
figure in context, I am relieved that we gained a few manufacturing
jobs this year. That is certainly better than losing them. But if you
are looking at the record of this administration, the fact is in the
course of this administration they have lost 2.7 million manufacturing
jobs.
You can come to the floor and say we gained 93,000 manufacturing jobs
this year, and that is a good thing. As far as that statement goes, it
is a good thing. But it is in the context of the fact that we lost 2.7
million jobs over this time period, over the entire time period. That
also relates, of course, to the points that are being made now about
the gain in jobs that has taken place--well, the month that is usually
used by my colleagues on the other side is, I think, August of 2003. I
am pleased and relieved that we have gained some jobs. But the fact
remains these job gains have tailed off in recent months.
The other side would have a story to tell if they had sustained job
gains. They might have gotten out of the hole and actually produced
more jobs, a net gain of jobs in the course of their administration.
The Treasury Secretary was projecting it would create a huge number of
jobs. It has not happened.
As this chart indicates, we are on a descending line month to month
in terms of job creation going back to the beginning of this year. That
is the concern about jobs.
It is fine and good to come to the floor and show economic growth
charts, although one would have hoped that the chart would have carried
out into this year and not stopped at the end of last year.
Second, one has to take into account what people are now saying about
what to expect on economic growth, and particularly the story from last
week about the Business Council meeting. The leading U.S. corporation
chief executives met in Irving, TX, where the top U.S. chief executives
said they are pessimistic about next year's economy. About 70 percent
of the chief executives surveyed by the Business Council projected flat
to 2 percent U.S. economic growth.
That is why we are concerned. That is why the public is concerned.
That is why working people are concerned. They feel it.
You may come to the floor and say everything is a rosy scenario. But
if you are long-term unemployed, you know it is not a rosy scenario.
Long-term unemployed now as a share of the unemployed is at the highest
figure it has been--over 20 percent now for 24 straight months.
Trying to portray a rosy scenario is not going to take care of the
problem of the long-term unemployed. We tried to do something about
that in the Senate. We tried to extend the unemployment benefits, but
that was beaten back, regrettably. People who exhaust their benefits
and aren't able to find a job find themselves in dire circumstances in
terms of meeting the needs of their families.
I think we have a serious job unemployment situation. I think we need
to face it. I don't think it helps to simply try to brush it away,
paper it over. These trend lines, regrettably, are not working in the
right direction.
Now, with this forecast from these top U.S. executives of the
Business Council, we can see that we face an even greater challenge as
we move towards 2005.
I simply close with the observation that this administration has not
produced a net gain of jobs in the course of its tenure. You have to go
all the way back to Herbert Hoover to find an administration, whether
Democrat or Republican, through that period that failed to produce a
net gain of jobs in the course of that administration. That, of course,
is one of the very key reasons this election that comes before us on
November 2 is so important for the future of our country.
I yield the floor.
The PRESIDING OFFICER. The Senator from Alabama is recognized.
Mr. SESSIONS. Madam President, I thank the distinguished Senator from
Maryland. I know he is very skilled in his knowledge of these issues. I
don't know how the President can be blamed for this or that, or how any
President can be.
I will just say this: When President Bush took office this economy
was in trouble. In the first quarter he inherited there was negative
growth; the second quarter was negative growth; the third quarter was
9/11. In the third quarter of former President Clinton's last year in
office there was substantial negative growth, and one-half of the value
of the NASDAQ stock exchange had been lost by the time President Bush
took office. I will just say that he inherited a problem. And in the
last 12 to 15 months, 1.9 million jobs have been created in this
country. We had growth as high as 8 percent late last year for the
third quarter, which is the highest growth in 20 years.
Yes. We have challenges. Five and four-tenths percent unemployment is
too high for me. It is a lot better than Europe. It is a lot better
than most countries in the world. But it is not good enough.
But I note this: The 5.4 percent unemployment rate that we have
today, which we are working to improve, is better than the average
unemployment rate of the 1970s, 1980s, or 1990s.
I hope we will continue to work on it here together in Congress, the
President and everyone, to see what we can do to continue to help grow
the economy. Certainly, if we don't have a growing economy we will not
create jobs.
Mr. SARBANES. Madam President, will the Senator yield for a question?
Mr. SESSIONS. Yes.
Mr. SARBANES. Was the Senator disappointed by the jobs figures for
the month of September of 96,000?
Mr. SESSIONS. I have not been disappointed for the last 6 months of
job figures. There have been some tremendous numbers. What was the
highest month we had this year? There were 300,000 or 400,000 jobs
created in 1 month, and there was 1 where it was 100,000. I would like
to see it stay at 200,000 or 300,000. Sure. The unemployment rate today
is stable. But we did add jobs.
Mr. SARBANES. The Senator has to go back to March of this year to get
the kind of job figures he is talking about.
Mr. SESSIONS. March of this year was just a few months ago. It is not
as if it were 5 years ago.
Mr. SARBANES. The concern is that these job figures are coming down
like this. It seems to me that the Senator has to face the fact that
this is where the job figures have been trending over the last 6
months.
Mr. SESSIONS. We had--how many was it? I believe 240,000 jobs were
created last month.
Mr. SARBANES. No.
Mr. SESSIONS. The month before last?
I reclaim the floor, Madam President. I was going to speak on another
subject.
The PRESIDING OFFICER. The Senator from Alabama has the floor.
Mr. SARBANES. I would like to answer the question he just put to me.
Mr. SESSIONS. Maybe the Senator could read the last 3 or 4 months in
job creation. Does he have them? There have been some pretty good
months in there.
Mr. SARBANES. Not in the last 3 or 4 months, earlier in the year.
Employment, again for the last 4 months, totaled 400,000 in the last 4
months. So it has averaged about 100,000 a month.
Mr. SESSIONS. It is better than what President Bush inherited from
President Clinton.
Mr. SARBANES. He inherited a very strong economy in terms of the
number of people who were working. And participation in the labor force
was up very high. We broke records in terms of job production in the
1990s in the number of people we put to work.
Mr. SESSIONS. All right. Madam President, I will just say this: The
economy was sinking when President Bush took office from President
Clinton. And a sinking economy inevitably means you are going to have
job losses, and that is what occurred. The President has turned this
economy around. We have seen some robust growth in the last year. And
we have created 2 million new jobs, as the Senator well knows, and we
can debate that round
[[Page S11274]]
and round forever. I think the glass is at least half full. I guess the
Senator is seeing it half empty.
____________________