Health Care Workforce
On February 14, 2007, I introduced legislation with Senator Bill Nelson (D-FL) to help ensure that communities across our state have the doctors they need and the quality care they deserve.  Our bill, the Resident Physician Shortage Reduction Act, would expand the number of Medicare-supported physician residency training positions in states like Nevada that are facing significant shortages of resident physicians.  Under current law, there are caps on the number of those positions.  There are no exceptions to the permanent caps, and most importantly for Nevada, no adjustments are made for population growth.  Our bill will allow these caps to be raised and thus allow more physicians to train in Nevada, thereby ensuring that more will stay in the state to practice.

Because Nevada is facing a nursing shortage, I will also continue to support the comprehensive Title VIII nursing education and workforce programs.  These Title VIII programs merit funding because they help to encourage bright students to join the nursing profession, keep the current workforce strong, and open doors to advanced education.  We also need to ensure that working conditions -- such as needlestick laws, staffing ratios, and mandatory overtime rules -- support our nurses' desire to provide the highest quality care possible.

Rural Health
The federal government's rural health programs play a critical role in sustaining and improving the fragile health care infrastructure common in Nevada's rural communities.  For this reason, I have consistently worked to ensure funding for programs like the rural outreach grants and the State Offices of Rural Health.  Title VII Health Professions programs have been especially important to Nevada, improving access to primary care for medically underserved populations and supporting the health care workforce.  Nevadans directly benefit from Title VII programs that work to alleviate the shortages of primary care doctors, dentists, nurses, and other allied health professionals.

Health Care Infrastructure
Nevadans should not have to travel far away to receive the high quality health care they deserve and need.  Not only have I been working to improve rural Nevadans' access to health care, I worked to secure millions of dollars of federal support to improve the health care infrastructure in our state so we may meet the increasing needs of our growing population.

The Family Smoking Prevention and Tobacco Control Act
According to the Centers for Disease Control and Prevention, nearly one out of every five deaths in the United States each year are caused by tobacco use, more than the annual deaths resulting from HIV, illegal drugs and alcohol, car accident fatalities, suicide, and homicide combined.  In Nevada, more than 2,500 kids become new regular smokers every day and tobacco use costs the nation a staggering $96 billion in health care costs each year.  In Nevada, 3,300 adults die each year as a result of their own smoking and 440 adult nonsmokers die each year from exposure to secondhand smoke.  Despite the enormous public health and financial burdens of smoking, until now, tobacco products have been unregulated.

The Family Smoking Prevention and Tobacco Control Act of 2009 was signed into law on June 22, 2009.   This new law, which I cosponsored, gives the Food and Drug Administration (FDA) the authority and resources to regulate the manufacturing, marketing, and sale of tobacco products.  FDA regulation of tobacco will prohibit tobacco companies from: marketing their products to children, using deceptive marketing and labeling about the harm caused by tobacco, or secretly changing their products.  This new law will go a long way towards reducing the high rate of death and disease caused by tobacco.  As a result of this law, candy and fruit-flavored cigarettes that were intended to attract and addict children to nicotine have been banned.  Many tough new restrictions on tobacco marketing and sales to children that are required in the new law have also taken effect.  For example, new rules: ban tobacco sponsorships of sports and entertainment events; ban free tobacco samples and giveaways of non-tobacco items with the purchase of tobacco; prohibit the sale of cigarettes in packs of less than twenty to appeal to kids; require stores to place tobacco products behind the counter, and establish a nationwide prohibition on tobacco sales to children under 18 years of age.

The new law has also put an end to misleading cigarette descriptions such as “light” and “low-tar.”  All smokeless tobacco products will be required to carry a larger warning label, and packs of cigarettes will soon be required to have large, graphic health warnings that cover the top half of both sides of the package.