Statement Senator Michael B. Enzi Hearing Addressing Healthcare Workforce Issues for the Future February 12, 2008

Committee to work from to identify and address the healthcare workforce issues thatconfront us. Today’s hearing will give us all an opportunity to highlight not only thoseissues that are unique to our states but also those that affect our nation’s healthcaresystem as a whole. In my home state of Wyoming, one of our biggest challenges is providing timely accessto healthcare providers. That kind of access has been hampered because Wyoming iscurrently facing a shortage of health care professionals – and I am not referring only tospecialists. Clearly, that is a problem that needs to be addressed on more than onelevel. To begin with, to have access to more health care professionals, we need more than anew, more effective grant program to increase their numbers. We need real reform of ourmedical system as a whole. I have introduced a Ten Step bill that will, when it isadopted, will greatly reduce the health professional crisis we are already seeing in stateslike Wyoming, Vermont, Alaska and Massachusetts. We will be focusing on the training of health professionals, today, but I want to make itclear that work-force issues also include affordable medical insurance for patients, healthinformation technology, better telehealth capabilities, and a liability environment forhealth care providers. Together, these foundations will help to make people feel moresatisfied with their career choice, more fulfilled by the work they do, and ultimatelyattracted to not only begin, but pursue the call of medicine for many, many years.That is necessary because Wyoming has a long list of health care needs. We do not haveenough primary care physicians, dentists, physician assistants and nurse practitioners.That is in addition to our shortage of subspecialists. Title VII of the Public Health Service Act is an important component of training ournation’s health care providers. Loan repayment, underrepresented minority programs,faculty training, and various other education programs are important programs that needto be continued. At the same time, we must coordinate the goals of the programs with theoutcomes that we measure. We need to improve these programs and our health caredelivery system. A few small tweaks are likely not sufficient. That would be like addinga new heel to an old shoe that we would be better off replacing with a new pair. I appreciate the efforts of Senator Kennedy, Senator Sanders and Senator Murkowski forbeginning this conversation. I look forward to examining many aspects of our healthwork force training including how we plan and pay for our pre and post graduatetraining. Before that, we need to encourage more individuals to consider a career inhealth care and serving in areas that are currently underrepresented. It seems to me it isalso important that we may need to broaden training sites to include more ambulatorycare sites in rural areas. Recent experience in Wyoming shows that with concentrated effort almost 2/3 of thefamily practice physicians who train in Wyoming will stay in Wyoming. I am interested in our witnesses’ thoughts on establishing a National Health Work ForceCommission so that we can start addressing the shortages identified today in acomprehensive and coordinated way. Again, I thank each of our witnesses who have taken the time to come here today. I lookforward to continuing the dialogue on this important topic and working with mycolleagues on solutions that will place good and affordable health care within the reach ofall Americans. ####