[Congressional Record Volume 165, Number 176 (Tuesday, November 5, 2019)]
[Senate]
[Pages S6383-S6384]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                               Healthcare

  Mrs. BLACKBURN. Mr. President, I wanted to speak for a few minutes 
today to talk a little bit about rural healthcare and to ask my 
colleagues for help in protecting the 20 percent of Americans who live 
in rural areas who are in danger of losing--or may have lost entirely--
access to healthcare in their communities.
  Since 2010, 118 rural hospitals have shut their doors. Fourteen of 
those facilities are in my State of Tennessee. Medical practitioners 
are paying attention to this trend and, more often than not, choose 
stability in the cities and suburbs over the uphill battle that comes 
with practicing medicine without access to the funding and modern 
resources many clinics now take for granted. As a result, rural 
patients are left to suffer through illnesses or emergencies or 
sacrifice time, money, and mileage for even the chance of a diagnosis. 
This system is broken, but this year, I have been able, by working with 
my colleagues on each side of the aisle, to kind of pick up the pieces 
around this.
  I have a three-bill rural health agenda, which comes at the direct 
request of smalltown mayors and local leaders who are struggling in my 
State to keep these communities afloat. Last week, my fellow 
Tennesseans, Congressmen Kustoff and Roe, introduced House companions 
to all three pieces of legislation.
  I will tell you, I have been talking to Tennesseans, and they want my 
colleagues in the Senate to know what we should do about this issue. If 
you have never lived in a rural area, hearing someone talk about 
driving 20 or 30 minutes to the nearest doctor probably really doesn't 
seem like a problem to you. But in the country, 30 minutes away 
translates into miles of driving through isolated areas. Chances are 
good that you will not even have cell service for part of that drive. 
There are no EMTs or rapid response teams. And if there is a local 
doctor, he or she may not have any specialized expertise, which could 
spell disaster for patients dealing with a complicated diagnosis.
  The first component of the agenda is the Telehealth Across State 
Lines Act, which would lead to the creation of uniform, national best 
practices for the provision of telemedicine across State lines and set 
up a grant program to expand existing telehealth programs and 
incentivize the adoption of telehealth by Medicare and Medicaid 
Programs. But implementation of telehealth will not eliminate the need 
for face-to-face interactions between patients and doctors.
  This leads us to another problem. Rural communities keep themselves 
afloat on strapped budgets, which means that plans to open as much as a 
bare-bones urgent care facility can be derailed by all the startup 
costs. The Rural Health Innovation Act--the second part of the agenda--
features two grant programs. The first one will fund the expansion of 
existing healthcare centers--such as local nursing homes--into urgent 
care walk-in clinics. Facilities will be able to use grant money to 
purchase equipment, hire physicians, physician assistants, nurse 
practitioners, and other essential staff.
  A second grant program will expand rural health departments to meet 
urgent care and triage needs. This is using programs that already 
exist, tailoring them to the needs of rural America.
  Of course, this points out the third issue: Expanded facilities are 
useless if there are no medical personnel. I have been working on this 
problem with my friend from Illinois, Senator Durbin, and he spoke 
about this on the floor a few minutes ago. We recognized from the 
beginning that throwing money and equipment at an updated facility will 
not convince medical professionals to establish a rural practice, so we 
wrote the Rural America Health Corps Act to encourage practitioners to 
set up shop in rural areas. The bill creates a new student loan 
repayment program that doctors and other medical professionals can take 
advantage of. In exchange for those loan payments, they will have to 
agree to serve for at least 5 years in a rural area with a health

[[Page S6384]]

professional shortage, but the benefit comes tax-free.
  I have spoken to rural communities all across my State. I know 
Senator Durbin has talked across the State of Illinois. I will tell you 
that these bills don't simply address a matter of convenience. My 
fellow Tennesseans want my colleagues to know they aren't just 
frustrated with the long drives and unanswered questions. They are 
worried that their child's cough will turn into pneumonia before they 
are allowed a full day off from work to drive to a pediatrician. They 
have no idea what they would do if they were diagnosed with an illness 
that requires continuous care.
  They do, however, know what would probably happen if someone they 
love suffered a heart attack or had another major emergency. They are 
very fearful.
  If these bills pass, they will no longer have to live with the 
knowledge that they have been abandoned by our healthcare system. They 
will have access to healthcare in their communities.
  I ask my colleagues to let these people know that yes, indeed, 
somebody is listening, and I ask them to do so by cosponsoring Senate 
bills 2406, 2408, and 2411.
  I yield the floor.