III 

113TH CONGRESS 

2D SESSION S. RES. 588 

Recognizing that access to hospitals and other health care providers for 

patients in rural areas of the United States is essential to the survival 

and success of communities in the United States. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 20, 2014 

Mr. MORAN (for himself, Ms. KLOBUCHAR, Mr. HOEVEN, Mr. BOOZMAN, Mr. 

ENZI, Mr. GRASSLEY, Mr. THUNE, Mr. WICKER, Mr. CRAPO, Mr. HELLER, Mr. COCHRAN, Ms. HEITKAMP, Mr. TESTER, Ms. BALDWIN, Mr. 

JOHNSON of South Dakota, Mr. DONNELLY, Mr. DURBIN, Mr. FRANKEN, 

and Ms. HIRONO) submitted the following resolution; which was considered and agreed to 

RESOLUTION 

Recognizing that access to hospitals and other health care 

providers for patients in rural areas of the United States 

is essential to the survival and success of communities 

in the United States. 

Whereas access to quality health care services determines 

whether individuals in the United States can remain in 

the communities they call home and whether their children will return to those communities to raise families of 

their own; 

Whereas more than 60,000,000 individuals in rural areas of 

the United States rely on rural hospitals and other providers as critical access points to health care; 


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Whereas rural areas of the United States need quality health 

care services to attract and retain business and industry; 

Whereas, to ensure that communities in the United States 

survive and flourish, Congress must address the unique 

health care needs of individuals in rural areas of the 

United States; 

Whereas individuals in rural areas of the United States are, 

per capita, older, poorer, and sicker than individuals in 

urban areas of the United States; 

Whereas, according to the Department of Health and Human 

Services, ‘‘rural areas have higher rates of poverty, 

chronic disease, and uninsurance, and millions of rural 

Americans have limited access to a primary care provider’’; 

Whereas, according to the Department of Agriculture, individuals in rural areas of the United States have higher 

rates of age-adjusted mortality, disability, and chronic 

disease than individuals in urban areas of the United 

States; 

Whereas the 20 percent of the population of the United 

States that lives in rural areas is scattered over 90 percent of the landmass of the United States; 

Whereas the geography and weather of rural areas of the 

United States can make accessing health care difficult, 

and cultural, social, and language barriers compound 

rural health challenges; 

Whereas individuals in rural areas of the United States are 

more likely to be uninsured and less likely to receive coverage through an employer than individuals in urban 

areas of the United States; 


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Whereas access to health care continues to be a major challenge in rural areas of the United States, as— 

(1) 77 percent of the 2,050 rural counties in the 

United States are designated as primary care Health 

Professional Shortage Areas (commonly referred to as 

‘‘HPSAs’’); 

(2) rural areas of the United States have fewer than 

half as many primary care physicians per 100,000 people 

as urban areas of the United States; and 

(3) more than 50 percent of patients in rural areas 

of the United States travel at least 20 miles to receive 

specialty medical care, compared to only 6 percent of patients in urban areas of the United States; 

Whereas, because rural hospitals and other providers face 

unique challenges in administering care to patients, Congress has traditionally supported those providers by implementing— 

(1) specific programs to address rural hospital closures that occurred in the 1980s by providing financial 

support to hospitals that are geographically isolated and 

in which Medicare patients make up a significant percentage of hospital inpatient days or discharges; and 

(2) a program established in 1997 to support limited-service hospitals that, being located in rural areas of 

the United States that cannot support a full-service hospital, are critical access points to health care for rural 

patients; 

Whereas hospitals in rural areas of the United States achieve 

high levels of performance, according to standards for 

quality, patient satisfaction, and operational efficiency, 

for the types of care most relevant to rural communities; 


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Whereas, in addition to the vital care that rural health care 

providers provide to patients, rural health care providers 

are critical to the local economies of their communities 

and are one of the largest types of employers in rural 

areas of the United States where, on average, 14 percent 

of total employment is attributed to the health sector; 

Whereas a hospital in a rural area of the United States is 

typically one of the top 2 largest employers in that area; 

Whereas 1 primary care physician in a rural community annually generates approximately $1,500,000 in total revenue, and 1 general surgeon in a rural community annually generates approximately $2,700,000 in total revenue; 

Whereas the average Critical Access Hospital, a limited-service rural health care facility, creates 107 jobs and generates $4,800,000 in annual payroll, and the wages, salaries, and benefits provided by a Critical Access Hospital 

can amount to 20 percent of the output of a rural community’s economy; 

Whereas hospitals in rural communities play a vital role in 

caring for the residents of those communities and preserving the special way of life that communities in the 

United States foster; and 

Whereas the closure of a hospital in a rural community often 

results in severe economic decline in the community and 

the departure of physicians, nurses, pharmacists, and 

other health providers from the community, and forces 

patients to travel long distances for care or to delay receiving care, leading to decreased health outcomes, higher 

costs, and added burden to patients: Now, therefore, be 

it 

1 Resolved, That the Senate— 


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1 (1) recognizes that access to hospitals and other 

2 health care providers for patients in rural areas of 

3 the United States is essential to the survival and 

4 success of communities in the United States; 

5 (2) recognizes that preserving and strength6 ening access to quality health care in rural areas of 

7 the United States is crucial to the success and pros8 perity of the United States; 

9 (3) recognizes that strengthening access to hos10 pitals and other health care providers for patients in 

11 rural areas of the United States makes Medicare 

12 more cost-effective and improves health outcomes for 

13 patients; 

14 (4) recognizes that, in addition to the vital care 

15 that rural health care providers provide to patients, 

16 rural health care providers are integral to the local 

17 economies and are one of the largest types of em18 ployers in rural areas of the United States; and 

19 (5) celebrates the many dedicated medical pro20 fessionals across the United States who work hard 

21 each day to deliver quality care to the nearly 1 in 

22 5 people in the United States living in rural areas, 

23 because the dedication and professionalism of those 

24 medical professionals preserves the special way of 


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1 life and sense of community enjoyed and cherished 

2 by individuals in rural areas of the United States. 

Æ 


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