Rural Health Clinic Services Bill Statement on Signing H.R. 8422 Into Law.

At its best, the American health care system is unsurpassed, but its uneven distribution leaves millions of our people without access to adequate care. This problem affects both urban and rural areas but is more widespread in the latter; two-thirds of the people in areas without adequate health care live in rural America.

One of the most sensible and efficient ways to cope with this problem is to enable physician assistants and nurse practitioners to provide regular, high-quality care in small, convenient outpatient clinics. Through such programs as the National Health Service Corps and the Appalachian Regional Commission, the Federal Government has helped start and support these clinics and train the highly skilled professionals who operate them.

But there has been a major obstacle to the healthy growth of these clinics in the areas that need them: That is the failure of public and private health insurance programs to support them. the legislation I am signing today will correct this defect in our public health insurance programs, by requiring that the Medicare and Medicaid programs pay for the services of physician assistants and nurse practitioners in clinics in rural areas without adequate care. This reform will guarantee greater financial stability for clinics already in existence and help establish new clinics where they are needed most.

This legislation also establishes demonstration projects for reimbursing clinics in urban areas. We must keep in mind that many of our inner city residents also lack access to adequate health care.

This bill has come to my desk after exceptionally close and fruitful cooperation between several committees of Congress. In the Senate, Chairman Herman Talmadge and his colleagues on the Finance Health Subcommittee did a fine job in expediting this legislation. In addition, I'd like to commend Senators Jennings Randolph, Bill Hathaway, Dick Clark, and Patrick Leahy for their early and consistent work on this measure. In the House, Chairman Dan Rostenkowski of the Ways and Means Health Subcommittee and Chairman Paul Rogers of the Interstate and Foreign Commerce Health Subcommittee and their colleagues worked closely to produce this measure. In addition, I would like to express my appreciation to the chairmen of the two full House committees, Al Ullman and Harley Staggers. Congressman Bill Brodhead was also very helpful in securing the passage of this legislation.