[Congressional Record Volume 160, Number 143 (Thursday, November 20, 2014)]
[Senate]
[Page S6211]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 SENATE RESOLUTION 588--RECOGNIZING THAT ACCESS TO HOSPITALS AND OTHER 
HEALTH CARE PROVIDERS FOR PATIENTS IN RURAL AREAS OF THE UNITED STATES 
 IS ESSENTIAL TO THE SURVIVAL AND SUCCESS OF COMMUNITIES IN THE UNITED 
                                 STATES

  Mr. MORAN (for himself, Ms. Klobuchar, Mr. Hoeven, Mr. Boozman, Mr. 
Enzi, Mr. Grassley, Mr. Thune, Mr. Wicker, Mr. Crapo, Mr. Heller, Mr. 
Cochran, Ms. Heitkamp, Mr. Tester, Ms. Baldwin, Mr. Johnson of South 
Dakota, Mr. Donnelly, Mr. Durbin, Mr. Franken, and Ms. Hirono) 
submitted the following resolution; which was considered and agreed to:

                              S. Res. 588

       Whereas access to quality health care services determines 
     whether individuals in the United States can remain in the 
     communities they call home and whether their children will 
     return to those communities to raise families of their own;
       Whereas more than 60,000,000 individuals in rural areas of 
     the United States rely on rural hospitals and other providers 
     as critical access points to health care;
       Whereas rural areas of the United States need quality 
     health care services to attract and retain business and 
     industry;
       Whereas, to ensure that communities in the United States 
     survive and flourish, Congress must address the unique health 
     care needs of individuals in rural areas of the United 
     States;
       Whereas individuals in rural areas of the United States 
     are, per capita, older, poorer, and sicker than individuals 
     in urban areas of the United States;
       Whereas, according to the Department of Health and Human 
     Services, ``rural areas have higher rates of poverty, chronic 
     disease, and uninsurance, and millions of rural Americans 
     have limited access to a primary care provider'';
       Whereas, according to the Department of Agriculture, 
     individuals in rural areas of the United States have higher 
     rates of age-adjusted mortality, disability, and chronic 
     disease than individuals in urban areas of the United States;
       Whereas the 20 percent of the population of the United 
     States that lives in rural areas is scattered over 90 percent 
     of the landmass of the United States;
       Whereas the geography and weather of rural areas of the 
     United States can make accessing health care difficult, and 
     cultural, social, and language barriers compound rural health 
     challenges;
       Whereas individuals in rural areas of the United States are 
     more likely to be uninsured and less likely to receive 
     coverage through an employer than individuals in urban areas 
     of the United States;
       Whereas access to health care continues to be a major 
     challenge in rural areas of the United States, as--
       (1) 77 percent of the 2,050 rural counties in the United 
     States are designated as primary care Health Professional 
     Shortage Areas (commonly referred to as ``HPSAs'');
       (2) rural areas of the United States have fewer than half 
     as many primary care physicians per 100,000 people as urban 
     areas of the United States; and
       (3) more than 50 percent of patients in rural areas of the 
     United States travel at least 20 miles to receive specialty 
     medical care, compared to only 6 percent of patients in urban 
     areas of the United States;
       Whereas, because rural hospitals and other providers face 
     unique challenges in administering care to patients, Congress 
     has traditionally supported those providers by implementing--
       (1) specific programs to address rural hospital closures 
     that occurred in the 1980s by providing financial support to 
     hospitals that are geographically isolated and in which 
     Medicare patients make up a significant percentage of 
     hospital inpatient days or discharges; and
       (2) a program established in 1997 to support limited-
     service hospitals that, being located in rural areas of the 
     United States that cannot support a full-service hospital, 
     are critical access points to health care for rural patients;
       Whereas hospitals in rural areas of the United States 
     achieve high levels of performance, according to standards 
     for quality, patient satisfaction, and operational 
     efficiency, for the types of care most relevant to rural 
     communities;
       Whereas, in addition to the vital care that rural health 
     care providers provide to patients, rural health care 
     providers are critical to the local economies of their 
     communities and are one of the largest types of employers in 
     rural areas of the United States where, on average, 14 
     percent of total employment is attributed to the health 
     sector;
       Whereas a hospital in a rural area of the United States is 
     typically one of the top 2 largest employers in that area;
       Whereas 1 primary care physician in a rural community 
     annually generates approximately $1,500,000 in total revenue, 
     and 1 general surgeon in a rural community annually generates 
     approximately $2,700,000 in total revenue;
       Whereas the average Critical Access Hospital, a limited-
     service rural health care facility, creates 107 jobs and 
     generates $4,800,000 in annual payroll, and the wages, 
     salaries, and benefits provided by a Critical Access Hospital 
     can amount to 20 percent of the output of a rural community's 
     economy;
       Whereas hospitals in rural communities play a vital role in 
     caring for the residents of those communities and preserving 
     the special way of life that communities in the United States 
     foster; and
       Whereas the closure of a hospital in a rural community 
     often results in severe economic decline in the community and 
     the departure of physicians, nurses, pharmacists, and other 
     health providers from the community, and forces patients to 
     travel long distances for care or to delay receiving care, 
     leading to decreased health outcomes, higher costs, and added 
     burden to patients: Now, therefore, be it
       Resolved, That the Senate--
       (1) recognizes that access to hospitals and other health 
     care providers for patients in rural areas of the United 
     States is essential to the survival and success of 
     communities in the United States;
       (2) recognizes that preserving and strengthening access to 
     quality health care in rural areas of the United States is 
     crucial to the success and prosperity of the United States;
       (3) recognizes that strengthening access to hospitals and 
     other health care providers for patients in rural areas of 
     the United States makes Medicare more cost-effective and 
     improves health outcomes for patients;
       (4) recognizes that, in addition to the vital care that 
     rural health care providers provide to patients, rural health 
     care providers are integral to the local economies and are 
     one of the largest types of employers in rural areas of the 
     United States; and
       (5) celebrates the many dedicated medical professionals 
     across the United States who work hard each day to deliver 
     quality care to the nearly 1 in 5 people in the United States 
     living in rural areas, because the dedication and 
     professionalism of those medical professionals preserves the 
     special way of life and sense of community enjoyed and 
     cherished by individuals in rural areas of the United States.

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