As the population grows and baby boomers increasingly require medical services, Americans are experiencing a shortage of primary care physicians. Unfortunately, the dearth of primary care physicians is being perpetuated by an eruption in health care regulations that are driving doctors out of the health care industry.
In the United States, there are 7,181 Health Professional Shortage Areas, as designated by the federal government. This means about 84 million Americans do not have access to primary care, a majority of whom reside in rural areas. By 2030, Americans could experience a shortage of 120,000 physicians, according to the Association of American Medical Colleges.
Nurse practitioners (NP) are well-trained, well-educated medical professionals that can deliver high-quality primary care to meet Americans’ increasing health care needs. If allowed to practice fully, NPs can evaluate and diagnose patients, order and interpret diagnostic tests, and initiate and manage treatments. Some states reduce NPs ability to practice to the fullest extent. Others go even further and restrict NPs from practicing without supervision, delegation, or team management by another medical provider.
According to a new report from American Enterprise Institute, 22 states and the District of Columbia allow the full practice of NPs, as recommended by the National Academy of Medicine and National Council of State Boards of Nursing. Another 16 states allow for a reduced level of medical practice by NPs. Unfortunately, 12 states severely restrict NPs.
To counter the growing threat of doctor shortages, several states are taking steps to increase access to primary care. For instance, Ohio, Texas, and Virginia are exploring ways to expand nurse practitioners’ scope of responsibilities and permit them to practice without direct doctor supervision.
Ohio legislators are considering a proposal that would allow well-trained NPs to work independently of physicians. Under current statute, NPs in the Buckeye State must complete a Prescriptive Authority Agreement—which can cost hundreds of thousands of dollars—in order to independently provide basic medical services, such as disease diagnosis, treatment, and prescription medication orders.
Every year, 248,000 NPs across the nation provide one billion patient visits. Because the demand for primary care is expected to increase dramatically, states should pursue measures that incentivize NPs to provide affordable care. Additionally, legislators should reduce regulations on direct primary care, repeal certificate of need laws, and eliminate maintenance of certification. The primary care shortage is not inevitable, unless states continue to stifle the services NPs can provide to millions of Americans who welcome the opportunity to receive affordable, high-quality care from NPs.
What We’re Working On
Health Care
Medicaid Expansion Increases Cost-Shifting Burden
In this Research & Commentary, senior policy analyst Matthew Glans examines a study from the Goldwater Institute that reveals Medicaid expansion in Arizona has increased the cost-shifting burden on consumers from the uninsured. “Arizona should pursue meaningful reforms that would help increase access to high-quality, more-affordable health care without increasing the state budget or the national debt by using Section 1115 waivers,” wrote Glans.
Budget & Tax
Defending Public-Sector Employees’ Post-Janus Freedoms (Guest: Robert Alt)
In this episode of the Heartland Daily Podcast, research fellow Jesse Hathaway is joined by Buckeye Institute president Robert Alt to talk about the new legal front in the war for public-sector employees’ rights to free association.
Energy & Environment
Fracking Creates Massive Consumer Savings and Investment in Pennsylvania
This Research & Commentary by policy analyst Tim Benson analyzes a report from the Consumer Energy Alliance that notes a massive increase in domestic shale development, led by fracking, has caused natural gas prices to plummet in Pennsylvania, saving Keystone State residents and businesses more than $30.5 billion from 2006 to 2016. In 2016, natural gas prices were 62 percent lower in Pennsylvania than 10 years prior, leading to $13.3 billion in savings over that period for residential consumers. This is significant because 1.6 million Pennsylvanians live in poverty. Commercial and industrial consumers also saved $17.2 billion.
Education
Bullying Statistics Show Arkansas Needs Child Safety Accounts
This Research & Commentary by Benson examines a WalletHub report that lists Arkansas as having the second biggest bullying problem for high school students. The report notes the Gem State, at 26.7 percent, had the highest percentage of high school students bullied on school property. Arkansas ranked fourth in the number of high school students bullied online (19.8 percent of students), fifth in the percentage of high school students who missed school out of fear of being bullied (10.8 percent), and tied for first in the percentage of high school students who attempted suicide (15.8 percent).
From Our Free Market Friends
Connecticut has Lowest Personal Income Growth
Marc Fitch of the Yankee Institute laments the last place standing of Connecticut among the 50 states for personal income growth. In the latest analysis by Pew Charitable Trusts, personal income in Connecticut has only grown less than a percentage point since 2007. For comparison, the national average is 1.6 percent. For the past two years, the Constitution State has experienced a decline in personal income, largely due to significant losses in the manufacturing and chemical industries and rising state and local tax burdens.
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Arianna Wilkerson worked in government relations at The Heartland Institute from 2017 – 2019.
