There’s been a lot of talk about what health reform will ultimately mean in terms of increased access to health care services because of the individual mandate to purchase health insurance and because barriers to access due to pre-existing conditions have been dropped.
 
The common theory is that more patients with health insurance will mean more patients proactively seeking care at physician offices, rather than waiting until an illness clears up on its own or becomes so acute the patient is forced to seek emergency hospital or urgent care.
 
As The Washington Post reports online, one group that sees opportunity is the American Association of Nurse Practitioners on behalf of its members. At least 14 states are debating laws that would expand the scope of care provided by nurse practitioners, which already varies widely as it is. It’s still an uphill battle – in 2012, NPs went 0 for 7 in efforts to expand state scope.
 
You’ve heard the debate before, but be prepared to hear it with more frequency. As the AANP points out, health reform will potentially deliver another 30 million covered patients into an already cramped, strained primary care health system. Allowing trained NPs to take on a bigger load will help the system absorb this capacity more effectively.
 
Physicians respond by saying that while there is clearly a role for NPs and other providers in the health care system, they are no substitute for the education and training of a physician. If health reform expands the number of covered patients as much as it potentially might, the question may be whether an NP is an effective substitute for not being able to be seen at all.