The Institute for Reforming Government (IRG), a Delafield-based free-market think tank, this week released a report detailing several reforms to improve Wisconsin’s healthcare system.
A major problem the document tackles is the state’s anticipated shortage of 2,263 physicians by 2035. Areas expected to be especially underserved are those west of Milwaukee, northwest of Madison, east of Lake Winnebago, and various locales along the state’s northern border.
IRG suggested addressing this concern by heightening acceptance rates at medical schools, relaxing some licensing requirements, and dropping some restrictions on doctors who received their training abroad. According to a 2021 analysis by the Association of American Medical Colleges cited in the report, American medical school acceptance rates declined from 52 percent to 38 percent over the last two decades.
“Altogether, it is expected for the country and Wisconsin to face a considerable shortage of physicians, led by an unmet increasing demand, the slow growth of new professionals in the area and the retirement of the current workforce,” the report states. “This shortage is expected to cause both a decrease in the amount of healthcare services provided and an increase in the concentration of providers, with a consequent increase in healthcare prices and, therefore, lower chances for the population to access quality services in the state.”
The report, written by IRG scholars Chris Reader and Alex Ingatowski and University of Chicago economist Tomas J. Philipson, suggests another way to increase the availability and affordability of care is to expand the medical responsibilities of nurse practitioners (NPs) may assume. According to the American Association of Nurse Practitioners, Wisconsin is considered a reduced-practice state, meaning NPs are not freely allowed to evaluate and diagnose patients or manage their treatments.
IRG’s report insisted that safety concerns do not justify restricting NPs scope of practice to the extent that current law does. The document cited studies of states that expanded NP responsibilities during the COVID-19 pandemic, concluding that freeing NPs to perform more duties was effective in preventing some COVID deaths.
Other IRG recommendations aim to reform the state’s Medicaid system by shifting childless adults using that system to the insurance exchange. The number of childless adults receiving Medicaid has increased from 158,000 to 283,000 over the last three years, putting intense pressure on the system. Another suggested change would broaden opportunities for value-based purchasing of high-cost prescription drugs for Wisconsin’s Medicaid patients.
The think tank expressed hope that this blueprint for healthcare reform would generate discussion among policymakers for market-oriented ideas regarding an issue on which central planners have often enjoyed the upper hand.
“Since Obamacare in 2009, the left has taken complete ownership over the issue of healthcare while the right has offered no viable solutions of their own,” Ignatowski said in a statement. “But after today, this changes. IRG is proud to release our groundbreaking report with Professor Phillipson that shows policymakers, lawmakers and industry stakeholders how to make Wisconsin the national leader in state-based healthcare solutions that actually drive down costs and, most importantly, improve outcomes for patients — the only standard that should matter.”
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Bradley Vasoli is managing editor of The Wisconsin Daily Star. Follow Brad on Twitter at @BVasoli. Email tips to [email protected].