FT 19.02 Rural Health Act (Statute)

[Anna Komnene]

AN ACT
to improve rural health

Section 1 (Title & definitions)
i. The title of this act shall be, the "Rural Health Act."
ii. As it appears in this legislation, "depleted rural area" shall refer to communities so classified by the Ministry of Health and Human Services as having a shortage of healthcare workers.

Section 2 (Addressing the rural healthcare worker shortage)
i. The government shall appropriate a sum of $1 billion in the fiscal year of 2021 to finance a program of grants to students majoring in medicine and other healthcare-related fields to recompense up to 80% of their total educational expenses, including tuition, textbook fees, and room and board, who will agree to accept employment at a hospital, pharmacy, or healthcare clinic in a depleted rural area for five years after graduation.
ii. The government shall appropriate a further sum of $1 billion annually to finance a program of grants to hospitals and healthcare clinics in depleted rural areas to pay the salaries of doctors, nurses, and other healthcare workers hired after 1 April 2021.
(a) To qualify to receive this grant, the hospital or healthcare clinic must demonstrate
(1) the hired positions were necessary to adequately perform its mission; and
(2) the hospital or clinic would be otherwise unable to pay the salaries for the hired positions.

Sponsor: Harry S Truman

The floor is open.

[Unconditional Surrender Truman]

In the last few years we have seen a growing scarcity of healthcare workers in rural areas, as hospitals and clinics are forced to close for want of adequate staff. This bill would address the rural healthcare crisis by offering to recompense up to 80% of the educational expenses of medical graduates who agree to work for five years in a depleted rural area. It further appropriates funds to pay the salaries of these workers if the hospital or clinic in question is unable to do so.

[Anna Komnene]

This is a pretty interesting solution to a difficult problem. It reminds me of Teach for America. TFA has its set of problems with retention and integration, but the five year term might help get more people who want to set up roots. Maybe it would help to have the hospitals set up programs to integrate members of this program into their community, as a condition of the grants.

[Anna Komnene]

I'll introduce this amendment:

Section 2 (Addressing the rural healthcare worker shortage)
i. The government shall appropriate a sum of $1 billion in the fiscal year of 2021 to finance a program of grants to students majoring in medicine and other healthcare-related fields to recompense up to 80% of their total educational expenses, including tuition, textbook fees, and room and board, who will agree to accept employment at a hospital, pharmacy, or healthcare clinic in a depleted rural area for five years after graduation.
ii. The government shall appropriate a further sum of $1 billion annually to finance a program of grants to hospitals and healthcare clinics in depleted rural areas to pay the salaries of doctors, nurses, and other healthcare workers hired after 1 April 2021 and to provide programs meant to integrate said workers into their community.
(a) To qualify to receive this grant, the hospital or healthcare clinic must demonstrate
(1) the hired positions were necessary to adequately perform its mission; and
(2) the hospital or clinic would be otherwise unable to pay the salaries for the hired positions.

[Amanda Huggenkiss]

This is a very interesting proposal for a very severe problem. I support this, although it is somewhat unfortunate that the regional government can only make use of this lever because studying is so costly.

Maybe we should specify the exact moment by when medicine students should have to make this decision. I believe that this decision would be too early in the first semester, as students at that point are likely not able to set priorities that affect their future careers. Still, it should not be too late, so that students can enjoy the benefits of that program.

[Unconditional Surrender Truman]

Amendment is friendly.

[Anna Komnene]

The amendment is adopted.

[Anna Komnene]

Is this along the lines of what you're thinking Amanda?

i. The government shall appropriate a sum of $1 billion in the fiscal year of 2021 to finance a program of grants to students majoring in medicine and other healthcare-related fields to recompense up to 80% of their total educational expenses, including tuition, textbook fees, and room and board, who will agree to accept employment at a hospital, pharmacy, or healthcare clinic in a depleted rural area for five years after graduation.
(a) To be eligible to apply, an individual studying for a medical degree must have completed at least one year of medical school.
(b) An individual studying to be an RN nurse must have completed at least 1 semester of their program.
(c) An individual studying to be a BSN nurse must have completed at least 1 year of their program.

[Unconditional Surrender Truman]

I have no objection to that amendment.

[Amanda Huggenkiss]

Ah, thanks for the suggestion. Somehow missed this.

This goes in the right direction, but I'm not quite happy with that. As I stated before, I don't think we should pressure students to make such an impactful decision in or before their first semester, but I also don't think we should bar them the possibility to do so. I think students should have the opportunity to find their interests in the medical field before making this decision, but I don't see why this program should not include first-semester students when they have already come to that decision.

Now that I think about it, I don't really see why we would need ANY deadline for students to enroll in this program - after all, it only allocates grants; it does not provide any further specialization that healthcare workers in rural areas absolutely should have completed during their studies. I just want the wording of the bill to make sure that students will not be pressured to take a very consequential decision very early in their studies.

Offering this amendment:

Section 2 (Addressing the rural healthcare worker shortage)
i. The government shall appropriate a sum of $1 billion in the fiscal year of 2021 to finance a program of grants to students majoring in medicine and other healthcare-related fields to recompense up to 80% of their total educational expenses, including tuition, textbook fees, and room and board, who, at any time during their studies, will agree to accept employment at a hospital, pharmacy, or healthcare clinic in a depleted rural area for five years after graduation.

[Anna Komnene]

I actually agree more with your original point. I think the issue could be because studying to be a doctor takes so long. It's basically 4 years of undergraduate + 4 years of medical school + 3+ years of residency = ~11 total years. So for doctors, in particular, you might see a higher drop out rate if people sign up as first years of undergrad, thinking they want to be a doctor, but not really being settled yet. I think the funding is retroactive the way it's currently written too, but maybe Truman could clarify on that point.

I'll object to the new amendment on that ground.

[Amanda Huggenkiss]

I think the funding is retroactive the way it's currently written too, but maybe Truman could clarify on that point.

If that is the case, I would happily drop my amendment.

[Anna Komnene]

I think the funding is retroactive the way it's currently written too, but maybe Truman could clarify on that point.

If that is the case, I would happily drop my amendment.

It's the way I'm interpreting "recompense," but we could add an amendment to make sure it's crystal clear about the retroactive expenses too.

[Anna Komnene]

Reading this again, I'm actually pretty certain costs from before and after applying would be included because it says "recompense up to 80% of their total educational expenses." Recompense and total being the keywords.

[Amanda Huggenkiss]

Good, if that is the case, I am withdrawing my amendment.

[AustralianSwingVoter]

Wouldn't it be better to recompense graduates after they've worked for 5 years in a rural area rather than during their studies? Otherwise the government will surely have to reclaim the grants from students who renege on their commitment, as some are bound to do.

[Anna Komnene]

I'm not necessarily opposed to reimbursing upon completion, but I'm not sure what we would gain from switching to a student loan format.

What does everyone else think?

[𝕭𝖆𝖕𝖙𝖎𝖘𝖙𝖆 𝕸𝖎𝖓𝖔𝖑𝖆]

I just think that the current proposal would self-evidently be appealing to more students than a recompense upon completion, which to me is an important point.

[Amanda Huggenkiss]

I just think that the current proposal would self-evidently be appealing to more students than a recompense upon completion, which to me is an important point.

I second this. I think it is very important to be as appealing as possible to students for the program to succeed.

[Anna Komnene]

I could be wrong, but the sense I'm getting is that the majority want to keep the bill as is. So I'll motion for a final vote. 24 hours for objections.

[Anna Komnene]

With no objections, we'll now have a final vote on this bill. Members please vote AYE, NAY, or ABSTAIN.

AN ACT
to improve rural health

Section 1 (Title & definitions)
i. The title of this act shall be, the "Rural Health Act."
ii. As it appears in this legislation, "depleted rural area" shall refer to communities so classified by the Ministry of Health and Human Services as having a shortage of healthcare workers.

Section 2 (Addressing the rural healthcare worker shortage)
i. The government shall appropriate a sum of $1 billion in the fiscal year of 2021 to finance a program of grants to students majoring in medicine and other healthcare-related fields to recompense up to 80% of their total educational expenses, including tuition, textbook fees, and room and board, who will agree to accept employment at a hospital, pharmacy, or healthcare clinic in a depleted rural area for five years after graduation.
(a) To be eligible to apply, an individual studying for a medical degree must have completed at least one year of medical school.
(b) An individual studying to be an RN nurse must have completed at least 1 semester of their program.
(c) An individual studying to be a BSN nurse must have completed at least 1 year of their program.
ii. The government shall appropriate a further sum of $1 billion annually to finance a program of grants to hospitals and healthcare clinics in depleted rural areas to pay the salaries of doctors, nurses, and other healthcare workers hired after 1 April 2021 and to provide programs meant to integrate said workers into their community.
(a) To qualify to receive this grant, the hospital or healthcare clinic must demonstrate
(1) the hired positions were necessary to adequately perform its mission; and
(2) the hospital or clinic would be otherwise unable to pay the salaries for the hired positions.

[YE]

Aye.

[Unconditional Surrender Truman]

Aye!

[Amanda Huggenkiss]

Aye.

[AustralianSwingVoter]

Abstention