[Congressional Record (Bound Edition), Volume 145 (1999), Part 21]
[Extensions of Remarks]
[Page 31295]
[From the U.S. Government Publishing Office, www.gpo.gov]



              HEALTHCARE RESEARCH AND QUALITY ACT OF 1999

                                 ______
                                 

                               speech of

                            HON. TOM BLILEY

                              of virginia

                    in the house of representatives

                      Thursday, November 18, 1999

  Mr. BLILEY. Mr. Speaker, I am pleased that we are witnessing today 
the passage of legislation that is critical to improving the quality of 
health care in this country. The Healthcare Research and Quality Act of 
1999 will significantly increase health care research and science-based 
evidence to improve the quality of patient care.
  The health care system is a dramatically different system today than 
a decade ago when the Congress established the Agency for Health Care 
Policy and Research. The financing and delivery of health care has 
changed as we have moved to more complex systems such as managed care. 
At the same time, there has been an explosion of new medical 
information stemming from our biomedical research advances. As a 
result, patients and providers face increased difficulty in tracking 
and understanding the latest scientific findings.
  The legislation we are passing today represents the joint efforts of 
Senators Frist, Jeffords and Kennedy, together with Representatives 
Bilirakis, Dingell, and Brown. Senator Frist introduced the first 
version of this bill in June of 1998, and until last week this 
legislation was considered (and passed) as part of the Patient's Bill 
of Rights Act in that body. In the House, Representative Bilirakis 
introduced a companion bill, H.R. 2506, on September 14, 1999. 
Following Commerce committee hearings and mark-ups, the House voted 
overwhelmingly--417 to 7--to pass H.R. 2506 on September 28, 1999. Late 
last week, the Senate separated the AHCPR legislation from its 
Patients' Bill of Rights, and passed S. 580 by unanimous consent. This 
bill, which is before us today, reflects agreement between the 
authorizing House and Senate committees on legislation that each body 
has acted on with the broadest bipartisan support.
  S. 580 reauthorizes the Agency for Health Care Policy and Research 
for fiscal years 2000-2005, renames the agency the ``Agency for 
Healthcare Research and Quality,'' and refocuses the agency's mission 
to become the focal point for supporting federal health care research 
and quality improvement activities.
  The new Agency for Healthcare Research and Quality will: promote 
quality by sharing information regarding medical advances; build 
public-private partnerships to advance and share true quality measures; 
report annually on the state of quality, and cost, of the nation's 
healthcare; aggressively support improved information systems for 
health quality; support primary care research, and address issues of 
access in underserved areas and among priority populations; facilitate 
innovation in patient care with streamlined evaluation and assessment 
of new technologies; and coordinate quality improvement efforts of the 
federal government to avoid disjointed, uncoordinated, or duplicative 
efforts.
  AHCPR fills a vital federal role by investing in health services 
research to ensure we reap the full rewards of our investment in basic 
and biomedical research. AHCPR takes these medical advances and helps 
us understand how to best utilize these advances in daily clinical 
practice. The Agency has demonstrated their ability to close this gap 
between basic research and clinical practice.
  As I noted earlier, S. 580 contains some modifications that reflect 
agreement between the authorizing House and Senate committees. I will 
not list all of the changes we have made, but I would like to highlight 
a few.
  First, I am pleased that our bill has an increased emphasis on 
research regarding the delivery of health care in inner city and rural 
areas and of health care issues for priority populations including low-
income groups, minority groups, women, children, the elderly, and 
individuals with special health care needs including individuals with 
disabilities and individuals who need chronic care or end-of-life 
health care. The legislation will ensure that individuals with special 
health care needs will be addressed throughout the research portfolio 
of the Agency.
  A second provision included in the bill which I believe is extremely 
important for improving the health of our nation's children is the 
authorization to provide support for payments to children's hospitals 
for graduate medical education programs. The bill authorizes funding to 
the 59 freestanding children's hospital across the country that do not 
receive any GME funds today. These 59 hospitals represent over 20 
percent of the total number of children's hospitals in the U.S. and 
they train nearly 30 percent of the nation's pediatricians, about 50 
percent of all pediatric specialists, and over 65 percent of all 
pediatric specialists. I believe this is a strong addition to our bill 
which will ensure the training of pediatric physicians to improve the 
quality of health care for our children.
  Mr. Speaker, this legislation would not have come to fruition without 
the contributions of many individuals. I would like to take this moment 
to express my gratitude to Representatives Bilirakis, Dingell, and 
Brown, and to Senator Frist and his colleagues. I look forward to 
witnessing the enactment of S. 580 into law this year which will 
greatly improve the quality of health care for all Americans.
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