<?xml version="1.0" encoding="UTF-8" standalone="yes"?><oembed><version><![CDATA[1.0]]></version><provider_name><![CDATA[The Dish]]></provider_name><provider_url><![CDATA[http://dish.andrewsullivan.com]]></provider_url><author_name><![CDATA[Andrew Sullivan]]></author_name><author_url><![CDATA[https://dish.andrewsullivan.com/author/sullydish/]]></author_url><title><![CDATA[Nursing Us Back To&nbsp;Health]]></title><type><![CDATA[link]]></type><html><![CDATA[<p>Both California and Texas recently passed legislation expanding the scope of responsibilities that can be fulfilled by nurse practitioners. Mike Miesen <a href="http://projectmillennial.org/2013/05/30/two-states-are-about-to-pass-significant-health-care-legislation-and-you-may-not-even-notice/">makes the case</a> that &#8220;this is arguably more important&#8221; than recent news about California&#8217;s low premiums under Obamacare:</p>
<blockquote><p>We can expect the loosening of regulations to lead to cheaper, more efficient care in the long term; a nurse practitioner’s hourly rate is lower than a physician’s and, assuming they can both conduct a high-quality, basic check-up—and <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC100791/" target="_blank">evidence suggests</a> that quality and patient satisfaction is <em>higher </em>along some metrics nurse practitioners compared to physicians—everyone is better off. It’ll also mean shorter wait times, as the supply of available clinicians will rise.</p>
<p>Significantly, both of these factors could lead to clinicians accepting Medicaid patients at a higher rate than before. Worrying <a href="http://content.healthaffairs.org/content/31/8/1673.full.pdf" target="_blank">research</a> has shown that, increasingly, physicians have been unwilling to take on new Medicaid patients due to the low reimbursement rate relative to Medicare or private insurance. Relaxing scope-of-practice regulations will mean that these patients may soon be able to more easily receive the care they need.</p></blockquote>
<p>Relatedly, Soltas <a href="http://www.bloomberg.com/news/2013-05-30/to-reduce-health-care-s-costs-destroy-its-jobs.html">points out</a> that controlling healthcare costs will mean losing healthcare jobs:</p>
<blockquote><p>There is no pot of gold at the end of the rainbow where all of our health-care spending has magically accrued. Health care &#8220;costs&#8221; are really health care jobs. In surveys, hospital managers <a href="http://www.healthleadersmedia.com/page-1/MAG-278904/Automation-and-the-Healthcare-Cost-Curve">name</a> labor as their largest cost issue &#8212; not the Affordable Care Act.</p>
<p>Achieving any substantial reduction in the cost of care will require what economists call &#8220;<a href="http://content.healthaffairs.org/content/32/4/653.abstract">labor-saving technology</a>.&#8221; We will have to find ways to destroy health care jobs &#8212; or at least to slow their growth.</p></blockquote>
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