11.   Chinese courts have little power to enforce penalties in distant provinces and poor rural hospitals cannot afford to pay them.

12.   Clinton argued that a larger portion of that relief should go to rural hospitals, teaching hospitals and home care agencies.

13.   Donna M. Williams, executive vice president of the National Rural Health Association, said increased Medicare payments are essential to the health of rural hospitals.

14.   For struggling rural hospitals less revenue could mean closures and a big impact on patient care.

15.   Goodling said he was leaning against supporting the bill Wednesday, until House leaders made some last-minute concessions for rural hospitals.

16.   He was the first Georgia governor to use federal Hill-Burton funds to build rural hospitals.

17.   In an attempt to limit defections by rural Republicans, House leaders made last-minute changes that boosted Medicare payments to rural hospitals.

18.   Increasing payments to rural hospitals is a matter of fairness and economic necessity, lawmakers from rural areas said.

19.   It just applied last year to take part in a Medicare program designed to ease financial woes of rural hospitals.

20.   It also portends the rising value of rural hospitals.