Join us for a conversation with Medical Alley Association's State Policy & Advocacy Manager, Jessica Young, and U.S. Representative Michelle Fischbach (MN-07) as they discuss her first year in congress and how her experience as the lieutenant governor of Minnesota and the first female president of the Minnesota Senate is helping her serve constituents, particularly around access to healthcare.
Intro (00:00):
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Jessica Young (00:40):
Welcome back to another episode of Medical Alley Association's "At the Table" podcast, where we explore how policy affects the healthcare community here in Minnesota's Medical Alley and beyond. I'm Jessica Young, state policy and advocacy manager here at the Medical Alley Association, and your host for today. Joining me is Congresswoman Michelle Fischbach, who represents Minnesota's seventh congressional district. Her constituency spans the western half of the state, running from the Canadian border all the way down to near the Iowa border. This is the congresswoman's first term, though she is certainly no stranger to representing the people of Minnesota. She has an impressive resume and has held a number of positions at the state level, including Lieutenant Governor, before being elected as the Congresswoman for the seventh district. Representative Fischbach currently serves on the agriculture committee and the judiciary committee. It is great to talk to you again, Congresswoman, and thank you so much for joining me today.
U.S. Rep. Michelle Fischbach (01:37):
Thank you. I really, really appreciate it. And I will just add that I do sit on the rules committee also. I sit on three committees, which which is a little unusual for a freshmen, but really do love all of the committees I sit on with ag and rules and judiciary.
Jessica Young (01:54):
Thank you for mentioning that. That is a good one to flag and one that I'm sure folks don't totally understand as it is more probably procedural, is that right?
U.S. Rep. Michelle Fischbach (02:03):
You know, it is a little bit. All of the bills come through the rules committee before they go to the floor and in rules committee, we determine how they're going to be handled on the floor, how long the debate's going to be. You know, what amendments may be ruled in order, things like that. So it's been very nice as a freshmen because, you know, before it gets to the floor, I see every bill before it gets there. So I'm really able to really understand, you know, get both feet, jump in with both feet and know what's going on and what's getting to the floor.
Jessica Young (02:37):
I was going to say, that's awesome. A great way to get exposure to a lot of different issues and a lot of different pieces of legislation. So great experience for your first year.
U.S. Rep. Michelle Fischbach (02:46):
Yeah. And it's just wonderful people on that committee and with a ranking member Cole and Congressman Reschenthaler, and they've been very, very kind to to a freshmen.
Jessica Young (02:59):
I love that. And my first question kind of ties well into that conversation. I'm sure you get asked this a lot, but can you just tell us about your first year in Congress and maybe specifically, what was the transition like from state Senator and then Lieutenant Governor to Congresswoman?
U.S. Rep. Michelle Fischbach (03:07):
Well, you know, I will tell you, not that I keep track, but I've been here 295 days. I have a ticker on my phone to remind me, you know, because since swearing in, because it seems like there's a lot more going on. When you, when you think of the days, it seems like a lot shorter, but when you're here, there's so much going on. But you know, I miss being in Minnesota obviously, and being in the legislature a little different. You know, you head to St. Paul and we're only five months long. And so here it's year round. And so you gotta adjust to that.
U.S. Rep. Michelle Fischbach (03:52):
But you know, I think that a lot of the issues we dealt with in my Senate district do really translate to the seventh district, you know, ag issues, workforce issues, those healthcare issues, those kinds of things really translate. Obviously though, on the federal level, there are new issues that I've been dealing with that, you know, never had to deal with antitrust issues in the Minnesota Senate. So it is a steep learning curve. The rules and procedures are a little different, but I've been catching onto those. And so I think that things have been going well. I haven't made any big mistakes yet, I guess.
Jessica Young (04:32):
That's good to hear. And I'm sure some of the experiences you had as Senate president have to be helpful, just understanding some of the procedural motions and things, even though they're a bit different.
U.S. Rep. Michelle Fischbach (04:42):
Oh, absolutely. It was very helpful to have some, you know, some idea of the procedures and how a bill moves through the legislature. And it is a little different, you know, I mean, I can really geek out and, you know, we used Mason's in Minnesota now we use Jeffersonian and then there's a whole lot of rules exclusively for the U S house. So I've been getting to know those so that I better understand. And for me, it's part of understanding, you know, how to pass legislation and things like that, making sure you know all these stops that things have to take.
Jessica Young (05:16):
And it's a complicated process. We're lucky to have you there and that you're so engaged in sort of unpacking all those different procedures and some of the things that are specific to D.C. and the house in general. But I'll maybe pivot my questions if I can, to some more healthcare focused, I'm hoping you could tell us a little bit about some of the struggles or issues that your constituents might face related to the availability of and access to healthcare. I'm really curious about access to specialists, emergency care, preventive care and everything in between.
U.S. Rep. Michelle Fischbach (05:52):
Yeah. I mean, you know, in rural Minnesota, we are always struggling access for healthcare and making sure that it's available and, you know, it's difficult because you mentioned in the opening, you know, my district goes from the Canadian border almost all the way to Iowa. And in some of those, those are very rural areas and we need to make sure that people have healthcare available to them. And so it's always a struggle when we do have, you know, we have some really strong hospitals in the area, but it's always a struggle for them to attract doctors and making sure that they have enough nurses. And just even just, I think in general, any of the healthcare staff and those specialists in particular about how do you attract them to rural Minnesota?
U.S. Rep. Michelle Fischbach (06:35):
And I will say, something that I talked about on the campaign trail and talk a lot about here too, is as strong rural communities and healthcare is an important part of that because you need the education, you need the broadband. And I know we'll probably talk a little bit about telemedicine, but you know, those broadband making sure we've never had been, but you have to have — and housing. Housing has been a big one, but those strong rural communities to attract the doctors. So it's kind of this, you know, circular kind of struggle that you have to make sure that it is an attractive place to bring people. And healthcare is one of those. And so they've always been facing those struggles, and the education. And as you know, I was a chair of the higher ed committee when I was in the Minnesota Senate.
U.S. Rep. Michelle Fischbach (07:20):
We always talked about keeping those two-year schools, those rural schools, whether it be two or four year, strong so that they can educate those nurses, they can educate those LPNs. They can educate some of those healthcare workers closer to home, because then obviously if you have someone who's being educated there, they're more likely to to stay there and work there. So it is a struggle, not only make sure that we have the folks, but keep those facilities open, keeping them functioning. They're obviously expensive. You know, lots of things that you use for healthcare are expensive. But making sure that we can attract those doctors, I know that there have been programs with U of M for rural doctors, but looking at whether it be loan forgiveness, things like that to attract people to rural Minnesota, because I do think once people do experience rural Minnesota, I think that they are likely to stay and enjoy themselves. We do have that quality of life that is not always available in the Metro area — and no real insult to the Metro area, but I do favor rural Minnesota.
Jessica Young (08:32):
Yeah. And I really liked how you approach that kind of like a holistic sort of view of the issue that you want a strong rural community in every sense. And healthcare is a piece of that puzzle. And the next question I was going to ask you, I think you started to hit on, so I'll maybe ask it and if there's feel free to reiterate some of the things you said or mention anything new, but given your years of experience working in public policy and representing folks, you know, in CD7 and Senate district 13, what solutions can we consider to address the lack of access to healthcare in rural areas? You mentioned loan forgiveness, prioritizing two and four year degree programs. Is there anything else that comes to mind or things that you have seen that work well to sort of address this issue?
U.S. Rep. Michelle Fischbach (09:17):
Well, and I did briefly kind of mention broadband in passing during the previous answer. But I think that one of the things, you know, we learned during the COVID shut down whatever you want to call it. You know, that telemedicine was a critical part of the, of the answer to getting people healthcare. And I think as we look at not only broadband, but we do look at telemedicine and how we're going to reimburse. Cause I know that during COVID, we reimbursed more and we're trying to take a look and see if some of those reimbursements for telemedicine can be made permanent. And it kind of ties in with broadband in the sense that we've got to make sure not only at the hospital or the clinic level at the provider level, that we have the ability to use telemedicine, but also at the patient level. Someone needs to make sure that the broadband has to be strong enough to get to their door.
U.S. Rep. Michelle Fischbach (10:10):
They have to have the ability, the equipment to use it. And so we need to make sure on both of those fronts that we are addressing those things and that the broadband is strong enough and it's available. I don't know if it's the complete solution. We can't do everything by telemedicine, but we certainly can do a lot more than we thought we could via telemedicine. And so I think that we need to continue to expand that. I don't think that it is a complete replacement. I think it is an enhancement. We still need to address those critical access hospitals and making sure that they're there and that we can get the specialists that we can, but we may be able to supplement where we can't always have those things and prevent people from having to drive hours to the Metro area or to the biggest city around to get all that care.
U.S. Rep. Michelle Fischbach (10:59):
So I think that we need to have some kind of balance, but we'll continue. You know, I did mention those loan programs. I think if we do more to encourage doctors to maybe do their residency or nursing students to do their clinicals in rural Minnesota, we can continue to engage them and show them that it is a great place to live and work and raise families. So I think more than anything, we have to do a part of it. We need to just sell rural Minnesota and make sure that we are encouraging them to at least see what's out there, because I think that they will see that it is a great setting to be in. We have good hospitals that are here that are doing their thing. And so anything that we can do on the state and federal level and loan programs, residency programs, things like that we need to encourage.
Jessica Young (11:51):
Absolutely. And I love your view and perspective on telehealth, because obviously this has boomed over the last 18 months and it can be really complimentary to in-person care. And I think of in particular, folks in a district like yours, where if they do need access to that specialist, that's located in St. Paul or Minneapolis, to be able to at least have that initial appointment with them over the phone and save drive time, time away from work, it can be a pretty cool technology. And similar to my previous questions, we kind of led into my last one. So I love the flow. It's going so well. The last question I wanted to ask you is what do you think the future of telehealth looks like for your district, the state and the country in general? And then kind of second part of that question. Can you just talk about the importance of innovation in the healthcare space?
U.S. Rep. Michelle Fischbach (12:41):
Well I'll take the first one. The innovation in the healthcare space is just necessary. And innovation in general, you know, always helps. You think about rural Minnesota, you think about before the internet, people couldn't move out there and work. And now we can have someone who telecommutes, you know, from a rural area, from a very rural area, as long as their broadband is good. So as you know, so that innovation and you think about it, tele-health a few years back was not something that people were thinking about, but a 15 minute checkup or just, you know, things like that. And people are driving two hours to get to just is unnecessary now. And so those things are really, I think, helping move medicine forward in rural Minnesota and making sure that people have it available to them.
U.S. Rep. Michelle Fischbach (13:36):
But I do say, and I kind of mentioned a little bit in the, in the earlier question about, you know, I think that it will enhance and it can improve healthcare in rural areas because we are able to use them complimentary of each other so that when someone really needs to come in, they will be able to come in. But if it's something they need to check up on, and I think you saw it a little bit with, you know, how a lot of the health plans started nurse lines or the hospital started nurse lines, they understand by even starting that years ago, they understand that maybe it's just something very simple and that it can be, you know, okay do this or that and if it's not better, please come in. But now with the, even the tele-health with the pictures that they're able to look at each other I think is even better that way that you can address things without someone driving several hours, or an elderly person having to go out in the cold, because we also deal with cold in Minnesota, a few years back, we had the polar vortex, nobody wanted to go out, but you had to if you had a doctor's appointment or something, and so some of those things can be addressed too.
U.S. Rep. Michelle Fischbach (14:51):
So I see the future as we continue to promote broadband and making sure that we get it into our rural areas. I see that can really be one of the tools in the toolbox for us in rural Minnesota, making sure that people have health care available to them.
Jessica Young (15:08):
Yeah. You make excellent points and broadband has come up a couple of times and you know this well that it's sort of an annual issue, I would say, at the state legislature. And we've seen federal administrations prioritize broadband too. But I think the future of virtual care seems exciting and tele-health is one of the big steps forward. So hopefully it continues to help folks in your district and alleviate some of the stressors and roadblocks that come with finding appropriate healthcare, but really appreciate your perspective on that issue. And I know Medical Alley members are on the front lines innovating, and they're leading the way with some of these new technologies. So to hear from you and hear your perspective from your district, I think is extremely valuable. So I appreciate you diving into some of those more specific issues. Before we wrap, is there anything that you would like our listeners to know? Policies you might be working on issues that you're particularly passionate about? I'll kind of hand it to you if there's anything you want to close with?
U.S. Rep. Michelle Fischbach (16:11):
Well I will just say, I know that we have great medical innovators in Minnesota, great medical companies, and we have done a lot in making sure that those critical access hospitals that we do have clinics. I mean, obviously I would like to see those stay and be stronger and make sure that we continue what we have. There are places that have lost them in the last few years. And I hate to see that, but I'd like to see those clinics. So that is something that I'm working on and I'll go back to that and that strong rural community issue, and healthcare is just a critical part of that and making sure. So anything that I can do to make sure that we keep keep those and and enhance them and make them workable for folks, I think is so, so important.
U.S. Rep. Michelle Fischbach (16:59):
And I continue to look at, can we get our schools to make sure they have enough room for all the folks who want to be nurses? You know, I know that a few years back we were dealing with shortages of student space for nursing programs. And so we want to make sure that those are available. So there's a whole lot of kind of aspects of that we need to be looking at to make sure that we are able to provide that and the innovation that we have gone through in the last, I mean, 20 years even is just amazing, and that is due a lot to the innovators we have in Minnesota and moving things forward and making sure that people are staying healthier and are able to get the kinds of whether it be, you know, equipment or medical care or those kinds of things available. And so I want to make sure that we do provide that to every Minnesotan. And so that's what I do moving forward is making sure that rural Minnesota isn't left behind and that we are continuing to promote that because that is — like I said earlier, I am partial to rural Minnesota. So I want to make sure that people have the opportunity to to live and work there and raise their children there.
Jessica Young (18:18):
Absolutely. And you're a fierce advocate. Your constituents, and frankly, Minnesotans are lucky to have you in DC sharing that perspective. And I have had the pleasure of working with you at the state level. So it's so fun for me to talk to you again and connect again and hear how your work is going out there, but it was great talking with you today, Congresswoman, and thank you for your time. I know you're busy and thank you for your insights on truly some of the most complicated policy issues. We're really lucky to have you in Congress.
U.S. Rep. Michelle Fischbach (18:45):
Well, thank you very much. I appreciate it. And we are working hard and I will say just since folks will be listening to this, please, if there's anything you think, of reach out to the office if there's any questions or anything like that. Because the more we hear from the seventh district in Minnesota, the better we can represent you and understand what kinds of things we should be addressing. So I appreciate the opportunity to just share a few things today, but, but really want to have conversations every day and make sure that we are actually doing what people need us to be doing.
Jessica Young (19:21):
That's awesome. Absolutely. And I know from Medical Alley's perspective, we look forward to the continued relationship and working with you for years to come. So thank you again. And I want to say to a special thank you to our listeners. Your continued support allows us to bring you great conversations like this one. So if you enjoyed it, please consider subscribing to the Medical Alley podcast and giving us a five-star rating. We will see you next time on "At the Table."