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  • Stephen Bloom

Guest column: Eliminate barriers to crisis-ready health care

An emergency is no time to trifle with bureaucratic red tape. At the outset of the COVID-19 crisis, many feared a surge of patients would overwhelm hospital capacity. Health officials sounded the alarm and identified policy changes that would enable them to meet the coronavirus challenge. And, in many cases, government responded.

In March, Gov. Tom Wolf issued executive orders designed to expand the state’s health care capacity, including temporarily suspending regulations that restricted where and how nurses and other health care professionals could practice.

For those aiming to ensure our health care system is always prepared, this raises an important question: If we cut the red tape during times of crisis, why not cut it permanently?

The fact is, before these regulations were suspended, our health system was suffering serious consequences. In April, PennLive reported that thousands of medical professionals across the country were getting furloughed or laid off. Though postponed elective procedures were partially responsible, another major factor was licensing requirements that made it difficult for medical staff to transition from their previous roles to help care for those suffering due to COVID-19.

Jess Poole, who previously worked out of Greensburg, is one such medical professional. Despite being a licensed nurse anesthetist with the training to intubate and manage patients, Pennsylvania wouldn’t recognize her specialty. Licensing restrictions made it impossible for her to contribute.

Health care heroes like Jess were forced to sit on the sidelines just when they were needed most. Thankfully, some state lawmakers are determined to keep this from happening again.

State Rep. Christopher Quinn (R-Delaware County) recently introduced legislation, HB 2779, that everyone concerned about conquering the virus should care about. Rep. Quinn’s bill would extend the suspension of certain bureaucratic regulations holding back our health system for one year — and establish a panel to determine which of those counterproductive regulations should be done away with for good.

Telehealth, or remote medical appointments often conducted via video calls, is a great example of a health care innovation that would have been limited under prior overly-restrictive regulations. The contagious nature of COVID-19 made telehealth an essential service in 2020, and utilization skyrocketed by 50 to 175 percent. This expanded use was made possible because Pennsylvania took steps to guarantee provider reimbursements by insurance companies and relaxed licensing restrictions that prevented providers from serving patients across state lines.

Even after the crisis subsides, telehealth promises increased access to care and reduced patient costs. For example, a Vermont Veterans Association saved almost $19,000 a year from reduced travel costs after offering telehealth options. A 2017 study found that patients experienced a cost savings of $156 per consultation due to reduced time and travel burden.

The removal of antiquated barriers to telehealth and the lifting other unnecessary regulations should be made permanent to expand access to care. For example, maintaining newly-increased practice flexibility for Advanced Practice Registered Nurse Practitioners would empower over 7,000 nurse practitioners in Pennsylvania to care for more patients.

Rep. Quinn isn’t alone in seeing an opportunity to improve health care access and reduce cost for all Pennsylvanians. Senate Bill 25 and HB 100, together sponsored by over 70 lawmakers, create a path for nurse practitioners to practice independently after a minimum of 3 years and 3,600 hours under the supervision of a physician. Empowering them to provide primary care could bring down the patient load per primary care provider from almost 1,000 patients per provider to 667 patients per provider.

Two other proposals, HB 1997 and HB 1998, would give doctors more flexibility over how to work with physician assistants. The result? Greater access by patients to customized care.

Another bill would allow pharmacists to offer flu shots to individuals 9 years of age or older, creating an additional 9,000 access points for flu vaccinations across the state. Empowering pharmacists to provide vaccinations to a wider age range can free up physicians to focus on their most urgent cases.

It is impossible to predict what the future holds for COVID-19. But by repealing unneeded health care regulations that are barriers to patient care, lawmakers can ensure Pennsylvania’s health system is always prepared for crisis.

Stephen Bloom is vice president for the CommonwealthFoundation, Pennsylvania’s free market think tank.

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