Repealing Mandatory Funding for Graduate Medical Education

Floor Speech

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Mr. CLYBURN. Madam Speaker, last month, Republicans voted to end Medicare. According to the nonpartisan Congressional Budget Office, their plan would raise seniors' health care costs by more than $6,000 per year, doubling their out-of-pocket costs.

Now, this week, Republicans want to cut training for new primary care doctors. This is another part of their attempt to repeal health care reform piece by piece. Madam Speaker, there is bipartisan agreement that we need more primary care physicians. Yet Republicans are bringing up a bill that will make sure that even fewer primary care doctors are trained to meet the growing demand. This is a terrible idea but not surprising.

I oppose this bill because we need to be training more primary care doctors, not fewer; but at a minimum, we must ensure that the Nation's neediest areas have access to the doctors they need.

This final amendment will ensure that training programs in the areas most in need of primary care doctors are to be prioritized for funding. This is common sense.

My district, like so many others represented in this body, has some very rural communities. In many areas, families have to drive for dozens of miles to reach the nearest doctor. People who live in remote communities, like Brittons Neck and Salters, travel great distances in search of primary care, and many don't have public or private transportation. This is not just an abstract debate about compassion. For many people, it is literally a matter of life and death.

Madam Speaker, we all know that, for decades, many communities across
the country have been left out of the American Dream year after year after year. We call these places persistent poverty counties--counties where more than 20 percent of their populations have existed below the poverty level for at least 30 years. Approximately 15 percent of all counties in America qualify as persistent poverty counties under this definition. Because a majority of these counties is rural, it only comprises about 7 percent of the Nation's population. These are the places that this amendment targets for funding.

These communities are diverse and are spread across the country, including Appalachian communities in Kentucky and West Virginia, Native American communities in South Dakota and Alaska, Latino communities in Arizona and New Mexico, African American communities in Mississippi and South Carolina, and urban communities in Philadelphia, New York, Baltimore, and St. Louis.

So I say to my colleagues on the other side: If you're going to cut funding for training new doctors, let us at least ensure that the communities with the greatest needs are placed at the front of the line. I urge my colleagues to vote "yes'' on this final amendment.

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