The National Rural Health Association presented Sen. Kent Conrad with the Lifetime Legislative Achievement Award on the UND campus Aug. 11. The award, presented by Brad Gibbens, deputy director of the Center for Rural Health, was given in recognition of Conrad's work to protect and improve access to rural health care in North Dakota and across the nation.
In accepting the award and reflecting on his experience with rural health, Conrad told the roughly 60 in attendance that when he first came into office, North Dakota was near the bottom in terms of Medicare reimbursement for the state's hospitals and physicians. The formulas for reimbursement were based on historical costs, which were very low in North Dakota. As the state became more efficient compared to others around the country, reimbursements were even lower. So with the Medicare Modernization Act passed in 2003, Conrad attached amendments to the act that gave approximately $177 million in reimbursements over a number of years to North Dakota health care providers.
In the Affordable Care Act passed in 2010, Conrad and fellow legislators Sen. Byron Dorgan and Rep. Earl Pomeroy attached the Frontier Amendment, providing $52 million per year to North Dakota hospitals and more than $16 million per year to the state’s doctors. North Dakota is now at the average level of Medicare reimbursements, according to Conrad. "Those (accomplishments) are things I'll always carry with me," he said. "It meant a lot to me to get those changes adopted into law."
He noted that some members of the U.S. House of Representatives want to eliminate the Frontier Amendment. "That cannot be permitted to happen," he said. "It would be a grievous injustice and a serious blow to the quality of medicine in North Dakota."
In response to concerns he was hearing about the difficulties in enticing doctors to practice in rural areas of North Dakota, he created the Conrad State 20 Program in 1994, a J-1 visa waiver program that allows doctor, nurses and other health care providers from abroad who are trained in the U.S. to stay and practice in underserved areas of the country. The program later grew into the Conrad State 30 Program. Since 1994, the program has brought more than 10,000 doctors to serve in America, he said, including more than 100 in North Dakota. "It's really one of the things I'm most proud of," he said. "In later years, I had doctors--earnest and bright-eyed--come up to me and say, 'I'm here because of the Conrad State 30 Program.'" Recently Conrad secured an extension of the program through October 2012.
Conrad pointed out that the United States has the most advanced medicine in the world, but also the most expensive. In fact, $1 of every $6 in the U.S. economy goes to health care, he said, and in the not-to-distant future, it could be $1 of every $3. "That can't be permitted to happen," he said. "That won't work. We've got to change."
Conrad plans to re-introduce his Rural Hospital and Provider Equity Act (R-HoPE) legislation later this year, which would further improve Medicare reimbursement formulas for rural health care providers, extend expiring rural health provisions, and create a new loan program to assist rural hospitals in repairing and replacing aging buildings and infrastructure.
In presenting the award, Gibbens pointed out that not only did Conrad's rural health achievements include Medicare reimbursements, but also his support for the continuation of rural health programs important to North Dakota, such as the Rural Hospital Flexibility program and the state office of rural health. The award was addressed to Chairman Kent Conrad instead of Senator Conrad, due to his efforts as Senate Budget Chair, steadily advocate for the funding of rural health programs, even when there was considerable pressure to eliminate the funding.