Removing Barriers to Medical Care   Leave a comment

I believe that we all have a right to medical care, but not in the way the progressives want us to believe. My belief is similar to the belief I have in the right of free speech and the press. You have a right to write and publish and to gain access to the tools to do so, but you don’t have a right to compel others do do it for you. So, if the local newspaper doesn’t want to run your article, it doesn’t have to, but if you pay for a blog or your own printing press, nobody has a right to stop you from publishing.

Image result for image of medical care as open marketI have the same belief in the right to medical care. You have a right to access care that you pay for, but you don’t have a right to compel others to provide it for you.

Sadly, the United States government at both the state and federal level have erected barriers that limit your access to medical care. The steepest of those barriers are the licensing laws. Removing those barriers should lower costs while improving quality.


Both of my children and two of Rick’s grandchildren were delivered by direct-entry midwives, but barriers against such practitioners in many states limit access, driving up prices and, if you compare US outcomes to European outcomes, endangering the lives of mothers and their children. 

Regarding the different classifications of midwives, the regulations vary from state to state. Nurse-Midwives are legal nationwide but different states have different regulations that cover what they may do, if they can work independently of a doctor, or if they must be supervised by one.

Certified Professional Midwives (CPMs) have been to a school for training but are not nurses. Twenty-six states allow CPMs to practice with some variations in what they legally can do.

Direct entry midwives typically study as an apprentice under someone else before beginning their individual practice, and their practice varies from state to state. Their legal standing is not clear in some states.

Since Medicaid pays for almost 50% of all births, midwives offer the nation an opportunity to save tax dollars while providing mothers with another choice. Europe uses direct entry midwives for 80% of their deliveries, nurse-midwives for most all of the others and their mortality rate for mother and child are much much lower.

It isn’t just the barriers to midwives that have created problems for patients. Other workers have seen their professions restricted as well, and with that comes physical and financial harm to patients. Nurse practitioners should be at the top of any list of professionals allowed to work without restrictions nationwide.

Nurse practitioners are an often overlooked source of health care and, according to Kaiser Family Foundation, can “manage 80-90% of care provided by primary care physicians.” Research shows that patients are just as satisfied with the quality of care provided by nurse practitioners as by primary care physicians.

An Institute of Medicine Report, from 2011, The Future of Nursing: Leading Change, Advancing Health, states that “what nurse practitioners can do once they graduate varies widely for reasons that are related not to their ability, education or training, or safety concerns, but to the political decisions of the state in which they work.”

Twenty states allow nurse practitioners to work independently of physicians to diagnose and treat patients. Twelve states require physicians to supervise nurse practitioners. Nineteen states allow them to practice as long as they have an agreement to work in collaboration with a physician. Other laws limit their scope of practice by not allowing practitioners to prescribe drugs.

With the aging of society, we will see an increase in the need for medical care, but layer upon layer of regulations makes it hard for practitioners to enter the field and thereby makes care expensive, complex and frequently unavailable.



Removing these barriers is key to improving access to medical care and lowering costs. Obamacare made those barriers even higher, but now we have an opportunity to remove the barriers entirely and allow the open market to work as it should. Let’s lead the way!


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