[Congressional Record (Bound Edition), Volume 147 (2001), Part 16]
[Senate]
[Page 22726]
[From the U.S. Government Publishing Office, www.gpo.gov]



 RECLASSIFICATION OF SCRANTON-WILKES BARRE-HAZLETON, WILLIAMSPORT, AND 
                 SHARON METROPOLITAN STATISTICAL AREAS

  Mr. SANTORUM. Mr. President, I wish to thank the senior Senator from 
Pennsylvania for working with me on this very important issue of 
Medicare provider payment policy, particularly in light of the unique 
financial pressures being faced by the hospitals in Scranton-Wilkes 
Barre, Williamsport, and Sharon metropolitan statistical areas, MSAs, 
which emanate in part from some glaring disparities in Medicare's 
payment formulas.
  As I travel around the Commonwealth, many health care leaders have 
conveyed to me their continued concerns about the impact of the 
Balanced Budget Act of 1997, BBA, on their health care delivery 
operations. Our Pennsylvania constituents, who represent rural, urban 
and community hospitals and systems, have shared with us detailed 
information about the financially strained health care delivery 
environment under the BBA.
  We are all aware of the administrative and financial challenges that 
health care providers all across the country face, particularly in 
their service to our Nation's elderly population. But the environment 
in which the hospitals in these three areas of Pennsylvania are seeking 
to deliver quality health care to their respective communities is even 
more challenging given that their MSAs contain areas or border on areas 
from which higher compensated providers, with similar health care 
delivery costs, draw their patients, and more importantly, their 
workforce. Facilities located in these areas must compete for workers 
and patients against hospitals in neighboring MSAs with drastically 
higher wage indices, even when labor and health care delivery costs are 
virtually identical. This situation is simply not sustainable.
  And these problems are only exacerbated by our Nation's ongoing 
nursing shortage, and the scarcity of other skilled care givers. Health 
care workforce shortages are particularly acute in these areas of the 
Commonwealth, and they have the effect of driving up the cost of health 
care and precipitating the need to increase wages. And although these 
hospitals have taken the step of increasing wages, further reductions 
in the wage index will make it impossible for the hospitals to retain 
or recruit all the caregivers that the communities require.
  Other regions near the Scranton-Wilkes Barre-Hazleton MSA, including 
Newburgh, Allentown and Harrisburg, continue to recruit workers from 
its skilled workforce.
  Likewise in the Sharon MSA: All of the hospitals in the Sharon MSA 
compete with the Youngstown, OH, MSA for nurses, pharmacists, radiology 
technicians, and other allied health professionals. As Senator Specter 
had mentioned, Youngstown pays nurses $2 to $3 more per hour than 
hospitals in Sharon, yet those hospitals receive the lowest area wage 
index in Pennsylvania.
  I have been working on this unique Medicare payment problem for more 
than 2 years now, seeking to enact at least a temporary 
reclassification of several Northeastern Pennsylvania counties into the 
Newburgh, NY--Pennsylvania MSA; Northumberland County into the 
Harrisburg-Lebanon-Carlisle MSA; and Mercer County into the Youngstown-
Warren, OH, MSA. As Senator Specter had mentioned, there are other 
areas around the country where glitches such as these can be found. And 
what we seek to do with the submission of this legislative language is 
to put our colleagues on notice that we are determined to work on a 
bipartisan basis to bring much needed relief to our negatively affected 
hospitals, and to do the same for other areas around the country where 
these circumstances have caused similar problems and merit similar 
response.
  I have recently spoken directly with Senate Finance Committee Ranking 
Member Grassley about this very issue, and my strong desire to achieve 
a legislative fix as soon as possible. I am also a strong supporter of 
legislation to set the rural wage index nationally at a uniform and 
higher rate. However, whether or not Congress considers a national 
solution to this area of Medicare law is unclear, and our hospitals 
cannot afford to wait for a national solution that may be a year or two 
away.
  In closing, I wish to relay to our colleagues that achieving this 
financial relief for these hospitals in Pennsylvania is of utmost 
importance to myself and Senator Specter. We are willing to work with 
our colleagues in any way in order to bring about stability in the 
funding of these community health care providers and to ensure that the 
many Medicare beneficiaries living in the Commonwealth have access to 
needed care.

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