STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - January 12, 2007)
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By Ms. MURKOWSKI (for herself and Mr. Stevens):
S. 290. A bill to amend the Internal Revenue Code of 1986 to provide a tax credit to rural primary health providers; to the Committee on Finance.
Ms. MURKOWSKI. Mr. President, today I rise to introduce the ``Rural Physicians' Relief Act of 2007.' This important legislation will bring needed assistance to physicians who provide primary health services to rural America.
Physicians who provide health care in the most rural locations in America face challenges unlike their more urban counterparts. Often great distances, remote locations, limited transportation, and harsh climate--combine to make health care delivery extremely difficult to say the very least. Patient populations are small and spread out across extremely remote areas. As a result, many of these areas tend to be the most medically underserved areas in the Nation.
In my State of Alaska, a State that is larger than the States of California, Texas and Montana combined, nearly one-quarter of the State's population live in communities and villages that are only reachable by boat or aircraft. In fact, Alaska has fewer roads than any other State--even fewer roads than Rhode Island. And, unlike Rhode Island where over 90 percent of the roads are paved, less than 20 percent of the roads are paved in Alaska.
This means that approximately 75 percent of Alaskan communities are not connected by road to another community with a hospital. This means that all medical supplies, patients and providers must travel by air.
These remote populations tend to be among the poorest in the State. Air travel equates to excessively high health care costs--generally 70 percent higher than costs in the Lower 48 States. In short, ``rural' takes on a new definition in Alaska.
In Alaska, patient access to health care is exacerbated because our State also faces a chilling crisis--we have 25 percent to 30 percent fewer physicians than our population needs. In fact, Alaska has one of the smallest numbers of physicians per capita in the country. We need a minimum of 500 more doctors just to be at the national average of physicians per capita. An American Medical News article recently declared Alaska's precarious situation: ``Alaska has long ranked among the worst states in terms of physician supply.'
Our physician shortage crisis will only worsen. There is an expected retirement of at least 118 physicians in Anchorage alone in the next 10 years. In the 1990s, there were 130 new doctors each year. Now that figure has dropped to only 31 new physicians since 2001. Outside of Anchorage, one in every eight physician positions is vacant.
Additionally, many physicians are forced out of the Medicare and Medicaid programs because reimbursement rates simply do not cover the cost to treat those patients. With Alaska's growing population, especially of our elderly, this shortage will lead to the severe health care access crisis for all Alaskans.
On top of harsh physical challenges, Alaska's rural population also faces significant human challenges. These rural patient populations are often in the greatest need for primary health care services. Heart disease, stroke and other cardiovascular diseases are the leading causes of death in Alaska. Women in our state have higher death rates from stroke than do women nationally; and mortality among Native Alaskan women is dramatically on the rise, whereas, it is actually declining among Caucasian women in the Lower 48. The prevalence of chronic disease such as diabetes and even tuberculosis is increasing faster in Alaska than any other state. Each of these health concerns is magnified because access to health care--especially in rural Alaska--remains our greatest challenge.
The legislation that I introduce today with Senator Stevens seeks to lessen this problem. It will both assist physicians who currently practice in rural America and will provide an incentive to encourage physicians to practice in these remote and underserved areas. Specifically, it would give a physician who is a primary health services provider a $1,000 tax credit for each month that he/she provides services in a designated ``frontier' area. Furthermore, physicians who treat a high percentage of patients from frontier areas would also be eligible for the tax credit.
My hope is to encourage physicians to practice medicine in rural Alaska and throughout rural America. Creating incentives that offset the high cost of providing care in the most remote areas of nation will go far in recruiting physicians to the areas that are most in need of their services.
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