[Congressional Record Volume 155, Number 48 (Thursday, March 19, 2009)]
[Senate]
[Page S3545]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. BAUCUS. Mr. President, our next big objective is health care 
reform.
  We have a unique opportunity to move forward on health reform this 
year. Now we must act. We simply cannot afford to wait any longer to 
fix our Nation's health care system.
  We must work together to reduce health care costs, improve quality, 
and make coverage affordable for all Americans.
  In the Finance Committee, we have held 13 hearings to prepare for 
health reform. Last week, we held a hearing on our Nation's health care 
workforce. The hearing examined ways to address our current workforce 
needs. The hearing considered ways to prepare our medical providers for 
health care reform.
  At our hearing, four experts in the field testified about current 
health care workforce shortages, especially in primary care and 
nursing, and the witnesses told us that we must address these health 
workforce needs to meaningfully reform our health system.
  Dr. David Goodman, the director of the Center for Health Policy 
Research, said: ``The workforce we train today will shape, for good or 
bad, tomorrow's health system.''
  Dr. Goodman continued, ``It will be hard to improve access, achieve 
better health outcomes and decrease health care expenditure growth 
rates unless we get workforce policy right.''
  I could not agree more.
  Our efforts on health care reform are only as strong as our Nation's 
health care providers--the nurses, doctors, and other professionals--
who are on the front lines caring for patients.
  Investing in our health care workforce is critical as we work to 
expand health insurance coverage to millions of currently uninsured 
Americans.
  During our hearing, Dr. Allan Goroll, a primary care doctor and 
professor at Harvard University, told us about the Massachusetts 
experience following the enactment of State health reform. Dr. Goroll 
said that some newly insured people in Massachusetts are waiting up to 
2 months to get a doctor's appointment. That is simply unacceptable.
  For our health care reform efforts to succeed, we must directly 
address these health workforce challenges.
  It starts with primary care. Our current system greatly undervalues 
primary care. As a result, fewer students are going into the field. A 
recent study found that only 1 in 50 medical students plans a career in 
primary care internal medicine. That is down from more than one in five 
in the early 1990s. This trend is especially troubling, because it is 
clear that a strong primary care system is a key determinant of high 
quality, efficient medical care.
  During our hearing, we learned that areas of the country with a high 
proportion of primary care doctors spend less money on health care. And 
patients there have the same or better outcomes.
  We need to invest in our Nation's primary care providers to help 
improve the quality of our medical care and to bring down health care 
costs.
  Our workforce challenges extend beyond primary care. Our Nation's 
hospitals continue to face a nursing shortage. Recent news reports tell 
of shortages of general surgeons and dentists in rural areas. Many 
parts of the country need more mental health practitioners. And the 
list could go on.
  We need to tackle these challenges head-on. We need to place our 
Nation's health care workforce on sound footing. And we need to meet 
the medical needs of all Americans.
  This is going to require a renewed focus on the way that we pay for 
and deliver health care. We must ensure our payment systems reward high 
quality medical care and encourage medical students to go into critical 
fields like primary care.
  And we are going to need to take a hard look at our national 
workforce policies to make sure that our health care providers have the 
right training and skills to deliver excellent care.
  This effort is vital for our health reform efforts to succeed. So 
let's get to work now.
  Let's work together to strengthen our Nation's health care workforce. 
Let's build a health care system that delivers high-quality medical 
care for everyone. And let's act now.

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