State of the Union Address by President Donald J. Trump February 5th, 2019
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Healthcare: Senator Murray Discusses Rural Healthcare Challenges

(Spokane, WA) – Today, U.S. Senator Patty Murray told several hundred rural healthcare providers that federal support for rural healthcare is under attack in Washington, D.C. and that only a strong community defense can protect vulnerable patients and communities.

Murray outlined a series of recent cuts to federal health programs starting with the harsh cuts to Medicare and Medicaid that were signed into law last month. Murray said the cuts continue with the President’s recent budget proposal, which would eliminate rural safety net programs. The Senator said she worked to restore some of the cuts, but that it will require a loud reaction from local communities to protect investments in healthcare.

“One of the reasons politicians have been able to get away with all these cuts is because they’ve taken the “human being” out of the discussion. They talk about “reducing the rate of spending” and “reigning in federal programs.” But they won’t talk about the people who are hurt when a clinic closes or a doctor isn’t trained. They won’t talk about the human impact – so we have to,” Murray said.

“Friends if we let them get away with using words that leave people behind, then we’re going to get budgets that leave people behind. If we let them make this a debate about numbers – then the numbers win. If we make this a debate about people, then people will win. So our challenge is to put a human face on Medicare, Medicaid and safety net programs to prevent more budget cuts.”

Murray is a member of the Senate Rural Health Caucus and an advocate for rural healthcare. Murray has worked to invest in the Rural Healthcare Safety Net programs and in telemedicine efforts.

“I wouldn’t let politicians get away with saying that rural areas are somehow separate and different from the rest of the country. We’re all Americans. We all deserve affordable, high quality healthcare no matter where we live,” Murray said.

Senator Murray’s full remarks follow:

I’m really excited to be here to support all of you who are working on the frontlines everyday – helping people get healthcare. I know it’s not easy.

Today, I want to update you on what’s happening at the federal level on rural healthcare because we have so much at stake. Our government should be a strong partner supporting your work, and frankly I’m very troubled by the way things are moving in Washington, D.C.

In the Senate, I’m a member of the Rural Health Caucus – a group of senators who are very concerned about rural healthcare, and let me tell you – we have good reason to be concerned. Last week, the Senate passed a budget that I think is based on the wrong priorities. A lot of the programs that your patients rely on are threatened, and we’ve got to fight back. Today I want to talk about how we can do that.

Healthcare Builds Strong Communities

But first, I want to share some thoughts with you about healthcare in general and rural healthcare in particular. You know, I don’t just look on healthcare as a service. I think it’s much broader. After all, good healthcare builds strong and vibrant communities.

But the reverse is also true. When we fail to meet the health needs of our residents, our communities suffer. When seniors can’t find a doctor, when a new mother can’t get immunizations for her child, and when a person’s only chance to see a doctor is in the ER, it tears at the fabric of our community. That affects not only our health but also our economy and our way of life.

Many rural communities are already in pain. Agriculture has taken so many hits lately – everything from high fuel and fertilizer prices to problems with foreign markets. It’s not hard to see why so many are struggling. And that puts an added burden on the everyday challenges of providing healthcare in rural areas.

It’s Easy to Feel Discouraged

With the tremendous needs in our communities – and the limited resources – it’s easy to feel discouraged. It can feel like the only link between a family — and the healthcare they need — is resting on your shoulders – and often, it is. But if any of you feel discouraged, I think you’ll feel better after we give out this year’s awards. Because they show that even with all those challenges, local leaders are finding creative ways to get the job done – and that’s a great reminder for all of us. I think these awards are proof that some of the most innovative healthcare solutions are not coming from some Cabinet Department in Washington, D.C. but from communities large and small right here in the Northwest.

Rural Health Challenges

Frankly, one of the biggest challenges is to get the people in Washington, D.C. to understand what you’re facing. Maybe they don’t understand the special challenges in our rural communities. For example, rural residents often face higher rates of disease than urban residents. Rates of diabetes, cancer, and infant mortality are all higher in rural areas. And so are the barriers to healthcare. Here in Washington state, for every 100,000 residents, there are 135 specialty doctors in urban areas, but only 78 in rural areas. And rural residents are much more likely to be uninsured or to rely on Medicare or Medicaid. Rural areas tend to have more seniors than urban areas and often have more residents living below the poverty line.

Those are all serious challenges. But frankly I wouldn’t let politicians get away with saying that rural areas are somehow separate and different from the rest of the country. We’re all Americans. We all deserve affordable, high quality healthcare no matter where we live.

On that count, the federal government has taken several steps in the wrong direction recently– and we’ve got speak up to get back on the right track. To me, it’s a question of priorities.

Priorities

When I meet with families all across our state, they tell me that they don’t feel secure. They’re worried they’ll lose their job or their health insurance or their pension. They’re worried they won’t be able to send their kids to college. They see us spending billions in Iraq but not making investments here at home. I think to be strong here at home; we need to invest here at home.

But last week, the Senate took a wrong turn. It passed a budget plan that follows the wrong priorities. I stood up several times and introduced amendments to fix the budget so it better reflects our needs, but my amendments were rejected.

So we’re left with a budget that cuts community development, cuts housing for the disabled by 50 percent, doesn’t help enough seniors with prescription drugs, makes it harder for veterans to see a doctor, cuts education by the largest amount in 26 years, and leaves our children with massive debt.

That’s just wrong. We can do better, and I’m going to continue that fight in Washington, D.C. When it comes to rural healthcare, I need your help because the past year has been a real low point for federal support.

Recent Cuts

As you know, last month Congress enacted harsh cuts to Medicare and Medicaid in the Budget Reconciliation act. I fought against those cuts time and again – but the White House – and a majority in Congress decided that cutting taxes for the most well-off was more important that caring for our most vulnerable. I think everyone who voted for those cuts should be held accountable for their vote.

We know that these cuts will have a tremendous impact on rural hospitals, clinics and health care providers. That was a bad start. And the bad news continued with the President’s budget proposal last month.

Bush’s Budget Cuts

Simply put, the Administration is trying to weaken the Rural Health Safety Net. We are talking about programs that invest in rural health care, like the Rural Outreach Grants; Rural Hospital Flexibility Grants, Rural Health Research and Policy, National Health Service Corps, the Healthy Community Access Program, Rural EMA, and Title VII Health Professions. Programs that train health professionals in rural health communities are being all but eliminated. That just doesn’t make any sense.

Some Progress

Now in the Senate last week, we finally started to see some Members of Congress stand up to these misguided cuts. I joined with other Senators in supporting an amendment that added $7 billion to Labor, HHS and Education. That won’t begin to undo all the damage – but it’s a start. It showed that there is finally some awareness in Congress that we just can’t keep cutting these safety nets and assume no one is getting hurt. And that brings me to an area where I need your help.

They Don’t Talk About the Human Impact

One of the reasons politicians have been able to get away with all these cuts is because they’ve taken the “human being” out of the discussion. They talk about “reducing the rate of spending” and “reigning in federal programs.” But they won’t talk about the people who are hurt when a clinic closes or a doctor isn’t trained. They won’t talk about the human impact – so we have to.

Put a Human Face on the Safety Net

I want to leave you with an assignment. Let’s spend the next few months making sure that when a politician talks about “cutting spending” – someone in our community stands up and says – “What you really mean is cutting healthcare for children.” Or when someone in the Administration talks about “limiting entitlements” – let’s have local providers stand up and say, “you’re really talking about the healthcare my patients rely on.”

Friends if we let them get away with using words that leave people behind, then we’re going to get budgets that leave people behind. If we let them make this a debate about numbers – then the numbers win. If we make this a debate about people, then people will win. So our challenge is to put a human face on Medicare, Medicaid and safety net programs to prevent more budget cuts.

Progress on Health IT

But we can’t just play defense. We also need to build a better way to reach out to patients and a better way to deliver healthcare. And one of the most promising areas is through technology. I’ve visited the Inland Northwest Health System and have seen the work they’re doing with telemedicine – and I know that’s just one example of things you’re doing throughout the region.

I think technology can help reduce the disparities between urban and rural areas. Through telepharmacies we can connect a pharmacist in an urban area to patients in rural areas. But to do that, we need the right federal support.

That’s why, as a member of the Senate HELP Committee, I worked to pass a new Health IT bill. It will help more communities use Health IT to reduce errors, improve efficiency and cut costs.

But I knew that if we just had a law on the books, rural communities wouldn’t be able to afford the equipment and training to take advantage of the new law. So as I worked on that bill, I made sure that rural health had a role in developing the standards for Health IT. And I made sure we provided funding so small rural clinics, hospitals, and physician practices could pay for the equipment and training they need.

So friends, in conclusion, we have made progress in supporting small and rural communities, but there is so much more to do. I know it can seem overwhelming. I know it can feel like there is just too much work ahead. But I also know that if you weren’t doing what you’re doing now patients would not have the access they have today. We need you on the frontlines in our communities – providing the care and being the link – for our friends and neighbors.

It’s not just about health. It’s about our economy, our quality of life, and building strong communities. We need you to keep doing the important work you do everyday, but we also need you to step up and speak out when politicians try to take the “people” out of programs designed to help people. I can’t tell you how proud I am of what you manage to accomplish year after year under such difficult circumstances. But I can tell you this — when I’m sitting in a Senate hearing – and they’re trying to cut the rural safety net or when I’m standing on the Senate floor speaking out against cuts to Medicare and Medicaid, I speak with a passion that comes from knowing who I’m fighting for. . . all of you and the patients you serve.

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