Rural areas face doctor shortages, other challenges

Our nation faces a severe and growing healthcare crisis. We spend too much on health insurance and fees, and we don’t always get the best care. Over 46 million Americans are uninsured. Across the country, American workers go to bed every night wondering if they will be able to continue paying for health insurance for themselves and their families. Small-business owners agonize over cutting healthcare benefits for their employees and themselves because they just cannot afford it anymore. People in rural and frontier areas have been particularly hard hit; they struggle not only to be able to afford healthcare, but to find doctors who can provide the services they need.

People are drowning in healthcare costs and we need to throw them a life preserver. I introduced a comprehensive healthcare reform bill last year, 10 Steps to Transform Health Care in America.

I fought hard to get the Democrat majority to take up legislation to reduce healthcare costs, expand access and improve healthcare quality. Unfortunately, they refused.

I hope that soon we can set partisan politicking aside and focus on reaching a bold and comprehensive solution to address our healthcare crisis. I am a strong believer in the 80 percent rule — we can agree on 80 percent of the issues, and on 80 percent of each issue. If we work together, Republicans and Democrats, we can find that 80 percent on healthcare reform, and we can do great things for the American people.

As we begin what I hope will be a robust national debate about healthcare reform, it is important to remember that one size does not fit all. Rural and frontier areas, like my home state of Wyoming, have very different needs than urban areas. As I often remind my counterpart on the HELP Committee, my friend Sen. Edward Kennedy (D-Mass.), what works in Boston might not work in Gillette, Wyo.

Last spring, I went on a 10-stop tour of Wyoming to talk to people about our nation’s healthcare crisis and my 10 Steps proposal to solve it. One of the concerns I heard often most often was about access to health care providers in a frontier state like Wyoming. Wyoming faces a shortage of every type of healthcare provider — even veterinarians. When I tell people on the East Coast that, they ask, “Wait, people don’t really go see veterinarians if they’re sick or hurt, do they?” I explain to them that if the only person you can see within 200 miles is a veterinarian, you’re happy if he or she will see you — and just hope you don’t get the same vaccines they give the animals!

Given such a severe shortage of healthcare providers in Wyoming, from primary care physicians to specialists, ensuring that frontier and rural areas can meet their healthcare provider needs is very important to me. It’s also an important part of 10 Steps. My plan builds on some of the good things we’re doing on the education front of the HELP Committee, like the America COMPETES Act and the Higher Education Act. These bills help ensure that more students develop the knowledge and skills in the areas of science, technology, engineering and math they need to be successful in fields like medicine and nursing. 10 Steps includes a provision to increase access to primary care in rural and frontier areas by helping future doctors and nurses who agree to come to underserved areas to pay for their education.

My bill also expands Community Health Center programs, which provide high quality healthcare to people in rural and underserved areas, regardless of their ability to pay. CHCs ensure that people can get the primary healthcare services they need, and cut down on costs for everyone by reducing the need for expensive emergency room care. The Senate has already passed this provision to renew and improve the CHC program that will expand access to primary care services and improve overall care in underserved areas of the country, including much of Wyoming. I hope that the House will quickly follow suit so that we can get that step signed into law, and then get started on the other nine.

Small businesses are the backbone of our country, and in rural areas, almost all businesses are small businesses. They have been hit particularly hard by skyrocketing healthcare costs, because the deck is stacked against them. Small-business owners and working Americans should have the flexibility to pool their members across state lines, and even across the country, and use their combined purchasing power to negotiate affordable healthcare options. We need to provide them with this kind of flexibility and allow small-business owners and their employees to choose the plan that best suits their needs.

Of course, regardless of where you live, you know that we need to do more to bring costs down.

We can save lives and reduce costs by utilizing health information technology and promoting hassle-free electronic medical records. We can also bring costs down and improve the quality of care by restoring our medical justice system so that doctors can learn from mistakes and patients can be compensated fairly for negligence. The current system serves no one but trial lawyers, and that needs to change. When you have a medical emergency, you should see your doctor in the operating room, not the courtroom.

We can also reduce the need for emergency room care and other expensive services by focusing on prevention. My plan recognizes the need to focus on preventive measures and help individuals manage chronic illnesses, so that America will finally have a system of healthcare, not sick care. This will reduce healthcare costs, and it will help people live healthier, longer lives.

But we must keep in mind that we live in a large country with diverse needs. Rural and frontier areas face unique challenges and need unique solutions. Federal mandates are not the best way to solve our health care crisis. Instead of more federal regulation and mandates, 10 Steps provides encouragement and incentives to purchase health insurance. It promotes competition that will bring more options, reduce costs and give people more control over their healthcare.

I don’t want to tell people what insurance they have to have — I want to help them get the health insurance they want to have. That’s what 10 Steps will do.

Enzi is the Ranking Member of the Senate Health, Education, Labor and Pensions Committee.