Nurse Practitioners, Texas and Economic Freedom

A Cursory Treatment

(I began writing about this on Facebook but then I remembered Facebook is about Baby Boomer forwarded email memes and celebrity posts.)

Every year, the Texas Nurse Practioner Association introduces a bill to, as we might put it in our Righty free market terms, deregulate nurse practitioners. We like that, right? We like removing regulations and economic constraints.

Well unless a powerful lobbying group like the AMA wants to squash it. Which it does. Every single year. Every year nurse practitioners in Texas introduce a bill to allow them to practice within their sphere independently of medical doctor oversight. Every year the AMA rebuffs that effort. Because unless doctors are paid to oversee nurse practitioners, especially out in rural areas where doctors do not want to practice, it will be chaos or something.

Why don’t the good conservative people of Texas want cheaper healthcare with greater access to medical practitioners? The staunchest of red states. A people that likes to live independently out on the frontier ranches in their minds with their independent lifestyle enabling Ford F-350 Texas Ranch edition dually trucks and AR-15’s to ward off the marauding gang members in their suburban communities. Well, mostly they are probably unaware of these issues and simply go to their doc’s office where there are nurses, nursing techs, physician assistants and nurse practitioners in a confusing web that the patient isn’t all that interested in.

Nurse practitioners, when operating fully, can diagnose patients and prescribe medication. They can do about 80% of what a primary care doctor can do only at about half the price. (See doctor salary vs nurse practitioner salary) But rather than stealing from physician rice bowls (There’s no evidence that the presence of NP’s lowers physician salary), they act as force multipliers. A clinic could staff 8 NP’s instead of 4 doctors. That is twice the patient load or perhaps twice the allotted 15 minutes to see a patient and really work to diagnose and educate them.

We talk about states’ rights and subsidiarity as a means to freedom. But what if these more local entities are unable to remove themselves from the grip of a special interest group like the AMA? A Union of economic interests that for some reason evades public scrutiny as such.

Right now Republicans are looking at repealing the ACA and enabling the free market to improve healthcare. One rather large but politically sensitive area of opportunity would be allowing nurse practitioners to freely practice their medical craft. And if that means tying federal funds to this policy, so be it.

Freedom at any price, right?

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