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Pennsylvanias health care system always lagging behind

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(The Center Square) — Pennsylvania’s health system may get a deregulatory boost if nurse practitioners get their way, but it’s only one step toward lowering costs and making care more widely available.

Testifiers at a joint House hearing on Thursday warned that access to care in the commonwealth is stuck in the “dark ages” and beyond a one-fix solution.

But nurse practitioners expect some improvement in the near future as they lobby for full practice authority. Such a change would allow them to treat patients without the oversight of a physician, which is the norm in 27 states.

“I’m glad that after 10 years of warning about it, it is getting the attention it needs,” said Janice Miller, president-elect of the Pennsylvania Coalition of Nurse Practitioners. “It will take many different endeavors … to improve access and nurse practitioners can be a very large part of that without adding any cost.”

Finding ways to expand access without driving up costs is a big issue for the commonwealth: Rural hospitals are on the brink of disaster officials warned in February. As Pennsylvania ages and the working-age population shrinks, the tax revenues to shore up health care in underserved places won’t be there.

But what becomes law can have unintended consequences. A proposed fix of collaborative agreements, for example, could backfire. NPs must have an agreement in place with a physician to practice, but some must pay a monthly fee, while others aren’t charged. Legislators talked about possibly regulating the fees.

“If there is legislation to push taking away that fee or capping the fee, that will worsen the problem because then you’re going to have physicians who say ‘No, I’m not interested in collaborating at all unless I’m getting paid,’” Miller said.

Add to those problems vacancies in the State Board of Nursing that issues licenses and the opioid crisis, and the commonwealth has a pressing need to break from its usual pattern.

“Pennsylvania’s always lagging behind other states when it comes to health care improvements,” Miller said.