Doctors. They help you when you're sick. But they also need expensive training before they
can get their degrees, so they end up being really expensive to visit. And lots of medical
problems aren't that serious. Maybe a nurse could help with them, instead. Studies show
that for routine care needs, outcomes for patients treated by licensed nurse practitioners
are actually no different from those treated by doctors. And the patients actually enjoyed
the experience with nurses more. So why don't more people skip the doctor and go see the
nurse instead? In 19 states and DC, where nurse practitioners have full practice rights,
they actually do. But in California, Texas, New York, Florida, and other states where most
Americans live, they have much stricter rules about what nurses are allowed to do on their own.
These regulations pop up in blue states, and they pop up in red states. And the rationale
is always patient safety, despite those studies. In 2010 the Institute of Medicine, a federally-chartered,
independent scientific advisory group strongly recommended the other states move to liberate
their nurse practitioners. But the real political problem is that nurses are cheaper. Medicare
pays them 15% less than it pays doctors. And MDs don't want the competition. But as America
expands the number of people with health insurance, we need to expand our capacity to deliver
healthcare to people without breaking the bank. That means building a regulatory system
that's actually about defending patient safety, rather than defending doctors' incomes.