If Obamacare makes anything clear, it’s that Washington can’t cure what ails our health care system.
The president’s landmark law is near collapse. Insurers are abandoning ship. Looming premium increases of as much as 43 percent next year are on the horizon.
This is not simply a political issue. It is a human issue. Nowhere is that more clear than Mississippi — a state with the least access to primary care and the worst health care outcomes.
State lawmakers can learn from D.C.’s failure. Instead of trying to stand between patient and physician, the Legislature can increase access to quality care and lower costs simply by abstaining from onerous new regulations and removing existing hurdles to competition.
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For inspiration, legislators should start with our state’s telemedicine regime. Mississippi was one of the first states to pass laws permitting doctors to treat and diagnose patients via broadband internet and videoconferencing. We are on the cusp of a telemedicine revolution with an array of video and audio options transforming the way consumers seek medical attention.
Considering nearly 60 percent of Mississippians live in primary care shortage areas, telemedicine is a boon for our state.
Telemedicine does not only increase access to care. One recent national study found that telemedicine services over just a 30-day period can save patients nearly $200 on office visits and more than $2,600 on emergency room usage.
Even with all of its promise, telemedicine in Mississippi is threatened by some industry calls to restrict providers and the technology used in its delivery. The Legislature should guard against protectionist ideas that would limit access to telemedicine.
While cultivating its 21st-century innovation in telemedicine, Mississippi should update other health care policies that are outdated.
Take, for instance, our “certificate of need” system. Medical practices seeking to open new facilities or even purchase new equipment must first obtain a “certificate of need” — a permission slip — from the State Department of Health and Office of Health Policy and Planning.
The process requires mountains of paperwork, significant expense and sometimes years of negotiations with government bureaucrats. Medical providers and their patients are at the mercy of state regulators.
These regulations prevent competition. Higher costs come with less competition. A study in 2009 found that states with “certificate of need” laws spend nearly 10 percent more on health care per capita.
If a Burger King can open next to a McDonald’s, then two health care providers ought to be able to compete for the same patient.
The Legislature can also increase access to quality care by addressing nurse practitioners’ “scope of practice.” In many instances involving basic care, nurse practitioners are capable of providing the same reliable treatment as doctors.
Twenty-one states extend full primary care authority to nurse practitioners. The Federal Trade Commission has deemed the use of nurse practitioners for basic care as “safe and effective.” What’s more, visits with nurse practitioners can be 35 percent less expensive than a visit with a doctor.
Unlike the 21 states that have empowered nurse practitioners, Mississippi’s laws still require nurse practitioners providing basic care to operate under a “supervisory agreement.” Under this agreement, a doctor examines a certain percentage of a nurse practitioner’s charts and gets paid a percentage of the nurse’s income. It is the medical equivalent of a chaperoned date.
Nurse practitioners are also forbidden from working beyond a certain distance from their supervising doctor. As such, rural patients still might not be able to benefit from having a qualified nurse in town.
The Legislature should consider removal of the supervisory agreement requirement or, at a minimum, codifying an extended distance agreement to provide greater access in rural communities.
All three of these solutions have a common theme and a common result. They all involve preventing or removing red tape to allow market forces to work. They all stand to increase access to care and drive down cost the old-fashioned way — through competition.
Perhaps — hopefully — Jackson can succeed where Washington has failed.
Russ Latino is the state director of Americans for Prosperity, a limited government and free market advocacy group, and an AV-rated attorney. You can write to him at email@example.com.