[Congressional Record Volume 153, Number 7 (Friday, January 12, 2007)]
[Senate]
[Pages S517-S518]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. MURKOWSKI (for herself and Mr. Stevens):
  S. 290. A bill to amend the Internal Revenue Code of 1986 to provide 
a tax credit to rural primary health providers; to the Committee on 
Finance.
  Ms. MURKOWSKI. Mr. President, today I rise to introduce the ``Rural 
Physicians' Relief Act of 2007.'' This important legislation will bring 
needed assistance to physicians who provide primary health services to 
rural America.
  Physicians who provide health care in the most rural locations in 
America face challenges unlike their more urban counterparts. Often 
great distances, remote locations, limited transportation, and harsh 
climate--combine to make health care delivery extremely difficult to 
say the very least. Patient populations are small and spread out across 
extremely remote areas. As a result, many of these areas tend to be the 
most medically underserved areas in the Nation.
  In my State of Alaska, a State that is larger than the States of 
California, Texas and Montana combined, nearly one-quarter of the 
State's population live in communities and villages that are only 
reachable by boat or aircraft. In fact, Alaska has fewer roads than any 
other State--even fewer roads than Rhode Island. And, unlike Rhode 
Island where over 90 percent of the roads are paved, less than 20 
percent of the roads are paved in Alaska.
  This means that approximately 75 percent of Alaskan communities are 
not connected by road to another community with a hospital. This means 
that all medical supplies, patients and providers must travel by air.
  These remote populations tend to be among the poorest in the State. 
Air travel equates to excessively high health care costs--generally 70 
percent higher than costs in the Lower 48 States. In short, ``rural'' 
takes on a new definition in Alaska.
  In Alaska, patient access to health care is exacerbated because our 
State also faces a chilling crisis--we have 25 percent to 30 percent 
fewer physicians than our population needs. In fact, Alaska has one of 
the smallest numbers of physicians per capita in the country. We need a 
minimum of 500 more doctors just to be at the national average of 
physicians per capita. An American Medical News article recently 
declared Alaska's precarious situation: ``Alaska has long ranked among 
the worst states in terms of physician supply.''
  Our physician shortage crisis will only worsen. There is an expected 
retirement of at least 118 physicians in Anchorage alone in the next 10 
years. In the 1990s, there were 130 new doctors each year. Now that 
figure has dropped to only 31 new physicians since 2001. Outside of 
Anchorage, one in every eight physician positions is vacant.
  Additionally, many physicians are forced out of the Medicare and 
Medicaid programs because reimbursement rates simply do not cover the 
cost to treat those patients. With Alaska's growing population, 
especially of our elderly, this shortage will lead to the severe health 
care access crisis for all Alaskans.
  On top of harsh physical challenges, Alaska's rural population also 
faces significant human challenges. These rural patient populations are 
often in the greatest need for primary health care services. Heart 
disease, stroke and other cardiovascular diseases are the leading 
causes of death in Alaska. Women in our state have higher death rates 
from stroke than do women nationally; and mortality among Native

[[Page S518]]

Alaskan women is dramatically on the rise, whereas, it is actually 
declining among Caucasian women in the Lower 48. The prevalence of 
chronic disease such as diabetes and even tuberculosis is increasing 
faster in Alaska than any other state. Each of these health concerns is 
magnified because access to health care--especially in rural Alaska--
remains our greatest challenge.
  The legislation that I introduce today with Senator Stevens seeks to 
lessen this problem. It will both assist physicians who currently 
practice in rural America and will provide an incentive to encourage 
physicians to practice in these remote and underserved areas. 
Specifically, it would give a physician who is a primary health 
services provider a $1,000 tax credit for each month that he/she 
provides services in a designated ``frontier'' area. Furthermore, 
physicians who treat a high percentage of patients from frontier areas 
would also be eligible for the tax credit.
  My hope is to encourage physicians to practice medicine in rural 
Alaska and throughout rural America. Creating incentives that offset 
the high cost of providing care in the most remote areas of nation will 
go far in recruiting physicians to the areas that are most in need of 
their services.
                                 ______