[Congressional Record Volume 155, Number 34 (Thursday, February 26, 2009)]
[Senate]
[Pages S2561-S2562]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SANDERS (for himself, Mr. Begich, Mr. Bingaman, Mrs. 
        Boxer, Mr. Brown, Mr. Burris, Mr. Cardin, Mr. Casey, Mr. 
        Durbin, Mr. Harkin, Mr. Inouye, Mr. Kennedy, Mr. Kerry, Mr. 
        Johnson, Mr. Leahy, Mr. Menendez, Mr. Merkley, Ms. Mikulski, 
        Mr. Schumer, Ms. Stabenow, Mr. Tester, and Mr. Wyden):
  S. 486. A bill to achieve access to comprehensive primary health care 
services for all Americans and to reform the organization of primary 
care delivery through an expansion of the Community Health Center and 
National Health Service Corps programs; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. SANDERS. Madam President, I think everybody recognizes that our 
current health care system is in very serious crisis. We have 46 
million Americans who lack any health insurance. We have even more than 
that who are underinsured. The cost of health care is soaring. And we 
end up spending twice as much per person on health care as do the 
people of any other nation, despite having so many people uninsured and 
underinsured.
  While a lot of the discussion regarding the health care crisis 
focuses on insurance coverage, there is another crisis equally severe 
that we do not talk enough about; that is, the crisis in access to 
doctors and dentists--in fact, the crisis in terms of primary health 
care.
  The truth is that in our country today, we have some 56 million 
Americans, including Americans who have health insurance, who simply 
cannot find a doctor and, even more, cannot find a nurse. The absurdity 
of that is that when somebody cannot find a doctor, that person will 
end up going to the emergency room at great cost to our Nation or, 
equally likely, that person may not go to the doctor at all, gets sick, 
and ends up in the hospital, and we are spending tens of thousands of 
dollars treating that person when we could have spent far less if that 
man, woman, or child had access to a doctor when the illness first 
developed.
  I am very gratified, and I thank President Obama, I thank Senator 
Inouye and Senator Harkin, Congressman Obey, the Democratic leadership 
in the House for taking this Nation a giant step forward in terms of 
addressing the crisis in primary health care in the stimulus package.
  What happened in the stimulus package is that $2 billion was 
allocated for community health centers, to help those community health 
centers expand, to help in the growth of new community health centers. 
On top of that, another $300 million was appropriated for the National 
Health Service Corps. The National Health Service Corps is one of the 
important health programs we have in this country because it provides 
debt forgiveness and scholarships for young physicians so they can go 
out and serve in underserved areas.
  Many medical school graduates are leaving school $100,000, $150,000 
in debt, and they have no choice but to end up becoming specialists, 
making a whole lot of money in order to pay back those debts. What we 
have done in the stimulus package is almost triple the amount of money 
going into the National Health Service Corps, which means that we are 
going to be able to enable thousands of young physicians and dentists 
to go out and work in underserved areas, which is a huge step forward 
for primary health care. That was a very important part of the stimulus 
package.
  In fact, on top of all of that, this sum of money is going to create 
44,000 sustainable jobs as we create a primary health care 
infrastructure and as we provide health care to an additional 4 million 
Americans.
  As significant as what we did in the stimulus package is, it is only 
a downpayment for what we have to do to address the crisis in terms of 
primary health care. Therefore, I am very proud to announce that today 
I introduced, along with 21 of my Senate colleagues--and they are in 
alphabetical order--Senators Begich, Bingaman, Boxer, Brown, Burris, 
Cardin, Casey, Durbin, Harkin, Inouye, Kennedy, Kerry, Johnson, Leahy, 
Menendez, Merkley, Mikulski, Schumer, Stabenow, Tester, and Wyden--all 
of those Senators join with me in new legislation which, in fact, is 
going to revolutionize primary health care in America.
  Also today, the majority whip in the House, Jim Clyburn of South 
Carolina, introduced a similar bill which I believe has 78 cosponsors. 
That legislation is called the Access for All America Act. Its goal is 
to significantly expand community health centers all over this country, 
as well as the National Health Service Corps.
  The community health center concept was developed by Senator Ted 
Kennedy over 40 years ago. The truth is that the concept of community 
health centers has been long supported in a bipartisan manner. 
President Bush was supportive of the concept. Senator McCain certainly 
mentioned it in his campaign for President, and Senator Hatch--many 
Republicans have supported it, as well as many people on our side of 
the aisle.
  The reason for that bipartisan support is that everybody here 
understands that community health centers provide quality health care 
in a cost-effective manner. What community health centers do is provide 
comprehensive health care in terms of access to doctors and dentists. I 
point out that there is a major dental crisis all over this country. 
Community health centers by law have to provide mental health 
counseling. On top of that, community health centers provide the lowest 
cost of prescription drugs in the United States of America.
  Today, there are approximately 1,100 community health centers all 
over America. In my State of Vermont, we have gone from 2 to 7 in the 
last 5 years, and they are now providing health care to over 80,000 
Vermonters.
  We have 1,100 in this country today. What this legislation will do is 
go from 1,100 community health centers to 4,800 community health 
centers, quadrupling the number of health centers in America. By doing 
that, we will provide comprehensive, high-quality primary health care 
in every underserved area in this country--a giant step forward in 
terms of making primary health care accessible to every man, woman, and 
child in this Nation.
  In my view, we need to move toward a national health care program 
which guarantees health care for all people, but we can take this 
important step forward in terms of primary health care quite soon.
  Here is one of the very wonderful aspects of what this legislation 
does. Right now, we spend about $2.1 billion a year for community 
health centers. This legislation, over a 5-year period, will take that 
number up to $8 billion. It will go from $2 billion to $8 billion as we 
quadruple the number of community health centers.

  What study after study suggests is that in fact this investment will 
end up saving us money. This investment in primary health care will 
save us money because those people who get sick will now be able to go 
to a community health center--perhaps the most cost-effective primary 
health care in America--rather than walking into an emergency room, 
which is one of the most expensive health care providers in the 
country. In addition, when people have access to health care and get 
treatment when they need it, they are not going to get very sick and 
end up in a hospital, where it will cost tens of thousands of dollars 
to deal with their illness.
  So what this legislation does is quadruple the number of community 
health centers, and it very substantially increases the amount of money 
that goes to the National Health Service Corps so we can provide debt 
relief and scholarships to young physicians who will then go out and 
serve us in underserved areas.
  In my view, this legislation, if passed--and I think we have a good 
chance to pass it because there is a whole lot of bipartisan support 
here in the Senate for this concept, a lot of support in the House as 
well--will revolutionize primary health care in America. It will bring 
us to the day when virtually every American will have access to a 
doctor, a dentist, mental health counseling, and low-cost prescription 
drugs. It will enable us to produce the doctors, the dentists, the 
nurses, and the other health care providers we desperately need to get 
out

[[Page S2562]]

into rural, urban America, and underserved areas. It will be a major 
step forward in providing the primary health care infrastructure we 
need as we in fact move to a national health care program.
  This is important legislation, and I thank all of the 21 Members of 
the Senate who have already come on as original cosponsors. We hope 
that many more will come on in the coming weeks and months. My hope is 
we can get this bill out of committee and see it passed as a stand-
alone piece of legislation.
  Mr. President, I yield the floor, and I suggest the absence of a 
quorum.
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