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Thursday, April 2, 2020

ANALYSIS/OPINION:

“Flatten the curve!” 

It’s the dictum that has come to define the American policy response to the COVID-19 pandemic. It means reducing the rate of the virus’ spread to prevent the health care system from being overwhelmed. Unfortunately, some hospitals are already on the verge of buckling under the enormous strain. Health care workers on the frontlines of the pandemic are often working grueling, 13-hour shifts and scrambling for more supplies.


They need help. Of course, it’s paramount that policymakers aid in slowing the disease’s rate of spread, with measures like ordering shelter-in-place, banning public gatherings and mandating remote work. But those aren’t the only tools at their disposal here. Small regulatory changes could expand the amount of hospital space and number of care providers, giving the health care system some of the relief it absolutely requires.

Changing licensing laws would certainly help. As it stands, medical professionals in other states are often barred from traveling to help other regions because of state laws that don’t recognize licenses earned outside of their borders. As a result, when they move to a new state, these professionals have to reapply — often an expensive and time-consuming process.

But they don’t have that kind of time, and right now, the number of health care workers is lower than it could be. That’s exactly why several governors, like Massachusetts Gov. Charlie Baker, have created temporary measures to expedite the process of getting out-of-state recognition to fit within 24 hours, allowing more health care workers to join in the effort to treat the virus where it’s hitting the nation most. More states should follow their lead. 

And these changes should be permanent.

Yet, that’s not the only regulation strangling the availability of medical aid. Scope-of-practice laws constantly slap away helping hands. They dictate which medical activities health care workers can perform. Of course there ought to be some regulation in this area, but highly-qualified workers, like nurse practitioners and physician’s assistants, are kept from performing procedures that they’re trained to do out of an overabundance of caution. 

Most of the evidence, for example, shows that the quality of primary care patients receive doesn’t decline if they are treated by a nurse practitioner instead of a physician. Even better, while it’s increasing access to care, expanded scope-of-practice reduces costs. On the other hand, unnecessarily restrictive scope-of-practice laws do the exact opposite: Raising costs and reducing access. Amid a pandemic, these laws make it that much harder for our health care system to save lives — for no good reason.

Policymakers should actively work to fix this. Gov. Newsom of California has already wisely pushed urgent reforms to the state’s scope-of-practice laws, hoping to give hospitals more flexibility in dealing with a massive influx of patients and help reduce doctors’ workloads. Mr. Newsom’s also created new, easier paths for retired doctors to return to the profession in this time of crisis. He has the right idea.

But that’s not all we can do to help. We also need more physical capacity in our hospitals. For that, we’ll have to reform our certificate of need (CON) laws.

Right now, 35 states and the District of Columbia have CON laws, which require existing or potential new hospitals to prove a “demonstrable need” to state and local governments before expanding or opening new facilities. Established hospitals often support these regulations, because they prevent the formation of competitors and give them monopoly power in health care markets. Even under normal times, these regulations are bad news — reducing competition, thus raising prices and reducing access to care. And these certainly aren’t normal times.

As it stands, CON laws are blocking sorely-needed expansions in hospital capacity. Some hospitals have already reached capacity, and some states such as Illinois have CON laws that require a lengthy approval process before an existing hospital can build new beds. 

North Carolina, a state with one of the more restrictive CON law regimes, temporarily suspended those laws two weeks ago, allowing healthcare providers to circumvent the approval process to build new hospital beds. As of March 31, according to the Pacific Legal Foundation, 13 states (in addition to North Carolina) with CON laws have issued temporary suspensions or reforms to allow for a better response to the crisis. States with CON laws still on the books, such as Illinois and Florida, need to follow suit. 

These regulations were deadly before pandemic ever hit our shores, and with COVID-19 wreaking havoc on our country, the consequences of these ill-considered policies are even more dire. These regulatory reforms aren’t silver bullets, but they’d certainly make the immediate response of the health care system a little stronger. And amid a pandemic, it could very well save countless lives. There’s no excuse — we have to try.

• Alex Muresianu is a Consumer Freedom Fellow at Young Voices. Find him on Twitter @ahardtospell.


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