[Congressional Record Volume 155, Number 84 (Monday, June 8, 2009)]
[Senate]
[Pages S6266-S6267]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BROWN (for himself, Mr. Dodd, and Mr. Casey):
  S. 1206. A bill to establish and carry out a pediatric specialty loan 
repayment program; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. BROWN. Mr. President, as Congress moves toward enacting ground-
breaking health reform legislation, it is imperative that we pay close 
attention to the unique developmental needs of children and ensure that 
we are doing everything possible to meet their growing needs.
  Meeting the health care needs of our nation's 80 million infants, 
children, and adolescents requires a stable and strong pediatrician 
workforce, comprised of well-trained pediatricians, pediatric medical 
subspecialists, pediatric surgical specialists, and psychiatric 
subspecialists.
  However, a November 2007 report released by the Maternal and Child 
Health Bureau's, MCHB, Federal Expert Work Group on Pediatric 
Subspecialty Capacity concluded that the lack of access to pediatric 
subspecialty care has reached crisis proportions and that the ratio of 
pediatric subspecialists and pediatric surgical specialists to children 
who need care is hazardously low.
  The MCHB panel concluded that the lack of access to pediatric 
subspecialty care is due to several factors, including an insufficient 
number of pediatric subspecialists, dramatically increased demand for 
pediatric subspecialty care, a fragmented system of pediatric primary 
and specialty care, and inadequate financing of medical education.
  In the U.S. there are approximately 28,000 pediatric medical 
subspecialists and surgical specialists responsible for caring for over 
80 million children. This is simply not enough.
  At a time when we are seeing aging workforce populations and 
decreasing numbers of physicians being trained in pediatric 
subspecialties, the demand for pediatric subspecialty care has reached 
unprecedented levels. In the last 10 years, our Nation's children have 
experienced dramatic increases in the incidence and prevalence of 
conditions such as asthma, diabetes, depression, obesity, and increased 
demand for surgical correction of congenital heart disease and 
orthopedic anomalies.

[[Page S6267]]

  The repercussions of this workforce shortage were enumerated during a 
hearing that I chaired on May 14th in the Committee on Health, 
Education, Labor, and Pensions.
  During that hearing, we were honored to hear the testimony of Dr. 
Marsha Raulerson, a practicing pediatrician in Brewton, AL. During her 
testimony, Dr. Raulerson explained how pediatric subspecialist 
shortages have a life-or-death impact in both rural and urban 
communities. She emphasized the need to develop initiatives to recruit 
medical students and residents into specific pediatric disciplines and 
to underserved geographic regions.
  That is why I am introducing the Pediatric Workforce Investment Act. 
This legislation would help address pediatric workforce shortages, 
particularly in medically underserved communities, by creating a 
pediatric specialty loan repayment program to encourage physicians to 
train and provide pediatric subspecialty care in areas desperately in 
need.
  To improve access to needed medical care for our children, the 
shortage of pediatric subspecialists must be addressed. Creating a loan 
repayment program to help defray costs and incentivize care in 
underserved communities is a good first step.
  I would like to thank Senators Dodd and Casey for being original 
cosponsors of this legislation and for being such strong advocates for 
children's health issues.
                                 ______