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So I commend the gentlewoman from Connecticut, the gentleman from Ohio and the chairman of the subcommittee for accepting this amendment, and I ask my colleagues to support the amendment.
Mr. COOK. Mr. Chairman, I move to strike the requisite number of words.
Mr. Chairman, I rise in support of the amendment being offered by the gentlewoman from Connecticut. Children's teaching hospitals play a vital and
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Primary Children's Hospital in my State of Utah is one such hospital. It trains an average of 52 residents a year and has an outstanding reputation as one of the leading children's hospitals in the West. Most pediatricians in the 5-State Intermountain region have received at least some of their training at Primary Children's Hospital. But because children's hospitals treat few Medicare patients, they are at an economic disadvantage, since Graduate Me dical Ed ucation is funded through the Medicare program. As a result, they receive less than one-half of 1 percent of what other teaching facilities receive in Federal assistance. This is not right. Our children deserve the finest health care that we can provide.
The $280 million grant funding proposed in the amendment offered by the gentlewoman from Connecticut (Mrs. JOHNSON) is a modest effort to provide some equity and relief to these hospitals and enable them to continue their fine work. I was a cosponsor of H.R. 1579, and I am proud to support this amendment. I hope my colleagues will join me and stand up for children's health by voting for this amendment.
Ms. LEE. Mr. Chairman, I move to strike the requisite number of words.
Mr. Chairman, I rise in strong support of the amendment offered by the gentlewoman from Connecticut (Mrs. JOHNSON) to authorize $280 million in fiscal 2000 and $285 million in fiscal 2001 for a program that would provide grants to children's hospitals to train pediatricians.
On behalf of the Children's Hospital in Oakland, California, my district, I want to thank the gentlewoman from Connecticut (Mrs. JOHNSON) and the gentleman from Ohio (Mr. BROWN) for this amendment. This authorization is needed because freestanding children's hospitals are disadvantaged under the current Federal Graduate Me dical Ed ucation fu nding for children's teaching hospitals.
Freestanding children's hospitals receive an average of less than one-half percent of what other teaching facilities receive in Federal Graduate Me dical Ed ucation fu nding.
[Time: 17:15]
Now, in Oakland, California, in my district, Children's Hospital, a freestanding hospital, has 205 licensed beds. It is a regional trauma center and is an independent teaching hospital. It is a hospital that when my children were children played a very important role in the healthy development of my kids. It continues to be an exemplary medical fa cility and a very supportive environment for children and their families.
Now, because the hospital only treats children and not the elderly, it receives almost no graduate me dical pa yments from Medicare, the one stable source of Graduate Me dical Ed ucation su pport.
At Children's Hospital in Oakland, California, senior clinicians and scientists work with young doctors in pediatrics and pediatric specialities. It is these interns and residents who will become the pediatricians and scientists of tomorrow and who will bring us the miracles of the 21st century, a cure for cancer, new therapies, and other great possibilities. We need an equitable playing field in the price competitive health-care marketplace.
Medicare has become the only reliable source of significant support for Graduate Me dical Ed ucation in teaching hospitals. Because children's teaching hospitals care for children, they receive less than .5 percent of the Medicare Graduate Me dical Ed ucation su pport provided to other teaching hospitals. The current mechanism for Graduate Me dical Ed ucation fi nancing does not equitably recognize the contribution of these hospitals. So we must invest in children's health.
Independent children's teaching hospitals are less than 1 percent of all hospitals but train nearly 30 percent of all pediatricians and nearly half of all pediatric specialists. A strong academic program is critical to all facets of children's hospitals' missions. They care for the sickest and the poorest children, training the next generation of caregivers for children and research in order to improve children's health care. They are in the community, responding to the health care needs of our children and supporting their families.
So this amendment has broad bipartisan support. I urge my colleagues to support this amendment; and once again, I want to thank the gentlewoman from Connecticut (Mrs. JOHNSON) and the gentleman from Ohio (Mr. BROWN) for their support and commitment to children in our country.
Mr. BROWN of Ohio. Mr. Chairman, I rise in support of the Johnson amendment.
Mr. Chairman, I commend the gentlewoman for her work and also the gentlewoman from California (Ms. LEE) and others that have spoken before me. Before I introduced this legislation 2 1/2 years ago, I visited the Akron Children's Hospital in Akron, Ohio, and saw the outstanding kind of work that medical pe rsonnel in that hospital did in pediatric medical ad vancement. As has been outlined by previous speakers, there is not a very good funding stream for medical ed ucation in children's hospitals and especially in freestanding children's hospitals.
Ohio is the home, I believe, of more freestanding children's hospitals than any State in the country. With the squeeze of managed care, coupled with the peculiarity of the way that we fund Graduate Me dical Ed ucation th rough Medicare, children's hospitals simply cannot produce the pediatric specialists or, for that matter, the pediatric general practitioners that this country needs to produce. This is a very good amendment. This is a very important part of this bill. I commend the sponsor of the bill and ask for support of the Johnson amendment.
Mr. THOMAS. Mr. Chairman, I rise in support of Representative NANCY JOHNSON's amendment to the Health Research Quality Act (HR 2506). This amendment authorizes $280 million in FY 2000 and $285 million in FY 2001 for graduate tr aining programs at children's hospitals.
Mr. Chairman, the way the government currently finances graduate me dical ed ucation ma kes little objective sense. The system has unfairly penalized children's hospitals.
The training of physicians, in what is known as Direct Graduate Me dical Ed ucation, i s financed through Medicare's Hospital Insurance Trust Fund. Thus, the funds a hospital receives depends on the number of Medicare patients it serves. Since children's hospitals treat very few Medicare patients (primarily those with End Stage Renal Disease), they receive almost no funding from the Medicare program. Medicare pays teaching hospitals $7 billion in Graduate Me dical Ed ucation, o r about $76,000 per resident. Yet children's hospitals receive only about $400 per resident, despite training more than one-fourth of the nation's physicians and a majority of the pediatric specialties. In addition, free-standing children's hospitals constitute less than 1% of all hospitals but train more than 5% of all residents.
This illustrates one more reason why the entire direct graduate medi cal educ ation prog ram is in need of fundamental reform. Why should the training of residents who go on to treat patients of all demographic profiles be financed out of a program designed for the elderly and disabled? Second, why should we pay certain hospitals 5 or 6 times the amount per resident as we pay for the training of equally qualified residents at equally prestigious universities and teaching hospitals in other regions of the country?
Senator BILL FRIST, also a former physician, headed a task force within the Medicare Commission, which recommended that direct medical educ ation be f unded outside of the Medicare structure. I believe we can provide a more secure funding structure through a multi-year appropriations process because it provides a larger pool of resources: the General Fund. In addition, an appropriations process will provide needed oversight into the inequities that is lacking in the current entitlement structure.
I am pleased that Representative NANCY JOHNSON and the children's hospitals support the Medicare Commission's recommendation that children hospital DME be funded through the appropriations process. I strongly endorse this amendment and hope we can finally start providing needed resources to children's hospitals so that they may secure the important missions they perform.
Mr. SESSIONS. Mr. Chairman, freestanding children's hospitals are disadvantaged under the current federal GME (Graduate Medi cal Educ ation) fun ding structure. GME is principally funded through the Medicare program.
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Children's hospitals receive on average less than one-half of one percent (0.5%) of what other teaching facilities receive in federal GME funding. This grant program would provide GME support for children's hospitals that is commensurate with federal GME support that other teaching facilities receive under Medicare.
Training programs are necessary to ensure quality health care for children. The education and t raining programs of these institutions are critical to the future of pediatric medicine and therefore to the future health of all children.
In 1998, Children's Medical Cente r of Dallas served as the training site for 77 pediatric residents. Although hospitals like ``Children's Med. Center of Dallas'' represents less than 1% of all hospitals in the country, independent children's teaching hospitals are responsible for training nearly 30% of all pediatricians, nearly half of all pediatric subspecialties and train over 5% of all residents nationwide.
This amendment would establish interim assistance to children's hospitals to maintain their teaching program while Congress addresses the inequities in the current GME system through Medicare reform. The grant program would provide $280 million in FY2000 and $285 million in FY2001.
Mr. PORTMAN. Mr. Chairman, I rise in strong support of Mrs. JOHNSON'S amendment to establish interim funding assistance to children's hospitals. The amendment will enable children's hospitals in Ohio and across the nation to maintain their teaching programs while Congress addresses the inequities in the current graduate medical educatio n (GME) sy stem through Medicare reform.
The nation's 59 freestanding children's hospitals, including Children's Hospital Medical Center i n Cincinnati, train about 30 percent of the nation's pediatricians and nearly half of all pediatric specialists. Many residents of other hospitals who require pediatric rotations are trained at these facilities as well. Although they make up less than 1 percent of all hospitals, freestanding children's hospitals educate and train over 5 percent of all residents nationwide.
However, the current system of federal funding assistance is tilted against pediatric training. Graduate medical educatio n is funde d primarily through Medicare based on the number of patients that teaching hospitals treat. Since few Medicare patients receive care at children's hospitals, these facilities get less than one-half of one percent of what other teaching hospitals get in federal GME funding. This unfair situation threatens the future of our nation's pediatric workforce and also hinders the development of new treatments since teaching facilities perform the majority of health care research.
Congress recognized this problem in the Balanced Budget Act of 1997 by directing both the Medicare Payment Advisory Commission and the Bipartisan Commission on the Future of Medicare to address the financing of graduate medical educatio n in child ren's hospitals as part of a comprehensive evaluation of GME. However, GME reform will take a while to develop. Therefore, the Johnson amendment will provide immediate financial assistance to children's hospitals comparable to the federal GME support that other teaching facilities receive under Medicare. It would do this through a capped, time-limited authorization of appropriations.
The Johnson amendment is essentially the language of the Children's Hospital Education and Rese arch Act, H.R..1579. I am an original cosponsor of a bipartisan bill, which is supported by over 190 Members of the House, including the chairs, ranking members and other members of subcommittees and committees of jurisdiction--the Commerce, Ways and Means and Appropriations Committees.
I urge my colleagues to support this important amendment to provide children's hospitals with a level playing field by addressing the federal funding GME gap they face, and, at the same time, give children a better shot at growing up healthy.
Mr. HOBSON. Mr. Chairman, I rise in support of the amendment offered by the gentlelady from Connecticut. This issue is particularly important for children in Ohio, where thousands of sick children every year are treated at Ohio's six independent children's hospitals.
Over the recent district work period, I visited the Children's Medical Center i n Dayton, Ohio. Not only does the Center provide first rate care for children, it also provides a caring and attentive environment that allows parents and relatives to actively participate in their children's care. We all know how important it is to be near our children when they are sick, and the nation's children's hospitals provide the atmosphere and specialized care that is the best medicine for our children.
At some hospital serving adult populations in Ohio, the federal reimbursement for resident training is about $50,000 per resident. This federal commitment to graduate medical educatio n has help ed ensure that our doctors and the quality of care they provide are the best in the world.
However, due to the way the reimbursement formula has been set up, the federal commitment to graduate medical educatio n at child ren's hospitals is much smaller. For example, Children's Hospital in Columbus, Ohio received about $230 per resident last year.
This amendment restores some fairness to the reimbursement rates that children's hospitals receive and will help ensure that Ohio and other states with children's hospitals will continue to train qualified pediatricians. This is an issue of fairness, and an investment long-overdue, and I urge my colleagues to support this amendment.
Ms. DUNN. Mr. Chairman, I rise in support of Representative JOHNSON's amendment to provide grants to train medical resident s at independent children's hospitals. I commend my friend for her leadership on this important issue and ask my colleagues to support her amendment.
The problem is simple: the federal government provides funding for graduate medical educatio n through Medicare. Independent children's hospitals throughout this nation treat children under the age of 21, which is primarily a Medicaid population. Consequently, these hospitals do not receive Medicare funding for the medical professi onals they train.
To rectify this discrepancy, this amendment will provide funding to children's hospitals that train medical doctors to be pediatricians. These hospitals are critical to serving sick children and providing important research to improve the quality of children's lives.
Earlier this year, Speaker HASTERT joined me in visiting the Children's Hospital and Regional Medical Center i n Seattle, Washington. With 72 pediatric residents a year, Children's Hospital in Seattle is the dominant provider for training of pediatricians in the Pacific Northwest, covering the region of Washington, Wyoming, Alaska, Montana and Idaho.
In 1997, Children's Hospital invested $8 million in its medical educatio n program and was reimbursed only $160,000 from Medicare and $2.4 million from Medicaid. This hospital cannot meet the needs of our community if it is forced to reduce the number of residents it trains. This amendment will improve quality of care by continuing to provide doctors who specialize as pediatricians or other pediatric subspecialties.
Independent children's teaching hospitals are less than 1% of all hospitals, but they train nearly 30% of all pediatricians. More importantly, we can continue our commitment to helping the sickest and poorest children in our communities.
As a parent of two sons, I know the importance of good quality health care for our children, and we must be very careful to leave no child behind. I urge my colleagues to support this important amendment. It is an investment in our children's health.
The CHAIRMAN pro tempore (Mr. QUINN). The question is on the amendment offered by the gentlewoman from Connecticut (Mrs. JOHNSON).
The amendment was agreed to.
AMENDMENT NO. 19 OFFERED BY MR. MCGOVERN
Mr. McGOVERN. Mr. Chairman, I offer amendment No. 19.
The CHAIRMAN pro tempore. The Clerk will designate the amendment.
The text of the amendment is as follows:
Amendment No. 19 offered by Mr. MCGOVERN:
Page 46, after line 2, insert the following section:
SEC. 4. STUDY REGARDING SHORTAGES OF LICENSED PHARMACISTS.
(a) IN GENERAL.--The Secretary of Health and Human Services (in this section referred to as the ``Secretary''), acting through the appropriate agencies of the Public Health Services, shall conduct a study to determine whether and to what extent there is a shortage of licensed pharmacists. In carrying out the study, the Secretary shall seek the comments of appropriate public and private entities regarding any such shortage.
(b) REPORT TO CONGRESS.--Not later than one year after the date of the enactment of this Act, the Secretary shall complete the study under subsection (a) and submit to the Congress a report that describes the findings made through the study and that contains a summary of the comments received by the Secretary pursuant to such subsection.
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