This bill allowing state certified (think about that) nurse practitioners to practice without a doctor’s oversight has been introduced by a few Republican legislators, but every single Democrat should be on bill 1063, especially those claiming to be progressives.
Here’s a longer policy brief on this issue for our state legislative staffer friends, but the basic shape of the issue is that Pennsylvania currently forces certified nurse practitioners – people who have already completed a state certification process to do this job – to bill their primary care services through doctors’ practices, rather than independently.
So every time they provide primary care service to a patient, regardless of whether a doctor even saw that patient, they have to kick a cut of the money they earned upstairs to the MD.
This needlessly increases health care prices, and it’s purely a rent-seeking scheme cooked up by the physician lobby.
That’d be bad on its own, but at a time when we’re hearing about a “doctor shortage” in this state (mainly a primary care issue), it just doesn’t make sense to keep restricting state certified nurse practitioners from opening their own practices to provide basic primary care to the increased number of people who now have health insurance through the Affordable Care Act.
Across the United States, “scope of practice” laws vary wildly from state to state, so they don’t really have a basis in any kind of legitimate policy considerations. Rather, they’re a reflection of the relative political power of physician lobbies like the Pennsylvania Medical Society vs. nurse practitioner groups.
This isn’t anybody’s favorite election year issue, but it matters a great deal, and if you read this far then you should ask your local state House and Senate candidates to commit to the anti-shortage position when you next see them out campaigning.