[Congressional Record (Bound Edition), Volume 145 (1999), Part 16]
[Extensions of Remarks]
[Pages 23650-23651]
[From the U.S. Government Publishing Office, www.gpo.gov]



                HEALTH RESEARCH AND QUALITY ACT OF 1999

                                 ______
                                 

                               speech of

                        HON. MICHAEL E. CAPUANO

                            of massachusetts

                    in the house of representatives

                      Tuesday, September 28, 1999

       The House in Committee of the Whole House on the State of 
     the Union had under consideration the bill (H.R. 2506) to 
     amend title IX of the Public Health Service Act to revise and 
     extend the Agency for Health Care Policy and Research:

  Mr. CAPUANO. Mr. Chairman, I rise in support of the Pediatric 
Graduate Medical Education (GME) amendment offered by Mrs. Johnson of 
Connecticut. The amendment, identical to H.R. 1579, The Children's 
Hospital Research and Education Act of 1999, would provide targeted 
Graduate Medical Education funding to our nation's freestanding 
children's hospitals by creating a fair and equitable financing system 
for pediatric physician training.
  In today's increasingly competitive health care marketplace, 
independent children's teaching hospitals face serious challenges in 
receiving adequate patient care reimbursement to cover the added costs 
of their GME program. Unlike other teaching hospitals, freestanding 
children's hospitals do not qualify for the one remaining, stable 
source of GME financing--Medicare--because they care for children, not 
the elderly. As a consequence, these hospitals receive less than 0.5% 
of the level of Medicare direct and indirect medical education support 
that all teaching hospitals receive. Boston Children's Hospital, 
located in my district, estimates the cost of GME to be in excess of 
$20 million of which only $2-3 million is reimbursed from the state's 
Medicaid program. This leaves $17 million in unreimbursed expenditures 
that the hospital is forced to absorb. This gap in federal support 
jeopardizes highly successful pediatric training programs and places 
these children's hospitals at increasing competitive risk.
  Comprehensive GME financing reform is needed by all hospitals, 
however, its achievement is several years away at best. This bill 
addresses the need for interim federal GME support for these children's 
teaching institutions which although accounting for less than

[[Page 23651]]

1% of all hospitals, train nearly 30% of all pediatricians and nearly 
half of all pediatric specialists. The passage of H.R. 1579 would allow 
for freestanding children's hospitals to receive an immediate source of 
financial assistance through a capped, time-limited appropriation that 
would provide GME payments to children's hospitals. The measure would 
authorize a $280 million grant in FY2000 and $285 million in FY2001. 
The passage of this bill would help sustain the vital role played by 
our Nation's freestanding children's teaching hospitals and would make 
payments to children's hospitals commensurate with those provided to 
other teaching facilities.
  Without a consistent source of financial support, children's 
hospitals cannot fulfill their mission--providing clinical care for the 
sickest and poorest children, training the next generation of care 
givers for children, and investing in research to improve children's 
health care. If we really care about our children's future, we must 
ensure that they have access to the best medical care in the world. 
With this in mind, I urge each of my colleagues to give this amendment 
their strongest support.

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