[Congressional Record (Bound Edition), Volume 149 (2003), Part 2]
[House]
[Page 2069]
[From the U.S. Government Publishing Office, www.gpo.gov]




                      CRISIS IN RURAL HEALTH CARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Georgia (Mr. Marshall) is recognized for 5 minutes.
  Mr. MARSHALL. Mr. Speaker, this is the first time I have had an 
opportunity to speak to the Speaker, and it is an honor to do so. I 
speak on behalf of rural America, Mr. Speaker. It is an issue that is 
bipartisan. It is an issue that is of great concern to an awful lot of 
Americans.
  Last night in his State of the Union Address the President said all 
seniors should have the choice of a health care plan that provides 
prescription drugs. I hope that the President's plan when it comes out 
takes the opportunity to address some of the weak points in Medicare 
and to truly provide access to prescription drugs for seniors 
throughout the United States, including in rural areas.
  At the moment, Mr. Speaker, the formula for deciding how to reimburse 
medical providers discriminates against providers that are in rural 
areas. In my district we have had two rural hospitals close in the last 
2 or 3 years. One closed, then reopened, and went through two or three 
different sets of management. We have had a number of rural hospitals 
that have struggled just to make ends meet.
  This is caused in part by our funding formula under Medicare, and I 
hope the President in crafting his plan for prescription drugs and for 
Medicare reform will take into account the need to protect rural areas, 
to protect the citizens that are in rural areas, and to protect the 
economies of rural areas.
  At the moment the funding formula for Medicare reimbursement 
discriminates against rural providers and benefits urban providers. 
That formula needs to be adjusted. I believe this matter has been 
addressed before in the House. I hope that the Rural Health Care Caucus 
will be presenting to the House a bill that will address this matter, 
and I also hope that the President and the House will support that 
bill. If the President could incorporate the concepts behind that bill, 
which during the last session was called the Rural Community Hospital 
Assistance Act, then I think the Medicare reform that is offered by the 
President could well address the crisis in health care that we see 
today in rural areas.

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