OPINION | RYAN NORRIS: Not good enough

We must improve health-care ranking

A recent study ranked Arkansas' health-care system 47th in the country--and dead last for health-care outcomes.

There's no one in the state who thinks that's acceptable. To fix the problem, we need to abandon the idea that a one-size-fits-all government program is the solution.

But with a ranking of 47th in the country, we need to be looking for innovative answers. A "public option" or so-called Medicare-for-All would only exacerbate the problem.

Instead, we need to seek out a "personal option" that empowers patients and doctors, instead of bureaucrats.

To do that, we need more practitioners and providers.

According to the Arkansas Center for Research in Economics, 59 counties are medically underserved and another 15 are partially underserved.

So it is no surprise that Arkansas has a very low per capita ratio of primary-care physicians compared to the rest of the country.

The Association of American Medical Colleges reports that in 2020 Arkansas had only 83 primary-care physicians per 100,000 residents. This is well below the national state median of 94.7 primary-care physicians per 100,000 residents and leaves Arkansas ranked 37th among all 50 states. This shortage is especially harmful to rural communities where residents are forced to travel long distances to access health care, contributing to that last-place ranking in health outcomes.

Our state has made real progress over the past few years toward offering more personalized options to patients, including expanding scope of practice for skilled nursing professionals.

As a result of the 2021 legislative session, Arkansas now allows nurse practitioners to enter their own independent medical practices. The data is clear that such reforms lead to positive results, with studies finding that states that reduced barriers to practice had 40 percent more primary-care providers servicing rural areas than states that maintained the barriers.

An additional reform from the 2021 session was to expand "direct primary care" to include non-primary health care ("direct health care"). Direct patient care (DPC) is an exciting new subscription-based model of care delivery in which a patient contracts directly with doctors and nurses, cutting out the insurance-company middleman. DPC offers unparalleled access to affordable, high-quality care.

It's cheaper than insurance and enhances outcomes. One study of a Colorado pilot program found that DPC patients visit emergency rooms 31 percent less often than fee-for-service patients. A DPC program available to government employees in North Carolina cut out-of-pocket costs by almost half.

As we expand the number of direct primary-care providers, we can further hold down costs while expanding primary care access for patients. With DPC, patients get access to a wide range of medical services and care by paying a reasonable flat monthly fee.

Now we need to do more.

As ridiculous as it seems, for almost half a century Arkansas law has mandated that the state restrict the supply of health care available to residents.

Through certificate-of-need (CON) laws, the state bars health-care providers from building new facilities or expanding existing ones without getting the approval of state regulators who often include competitors of the providers seeking to expand.

CON is said to control health-care costs, but data from the Kaiser Family Foundation shows that Arkansas' health-care expenditures per capita have increased year over year and outpace Texas, where CON has already been repealed.

If you set out to intentionally squelch innovation and create state-protected monopolies, you couldn't do worse than CON laws.

The state Legislature should repeal Arkansas' certificate-of-need requirements and let health-care providers meet the needs of patients, not the whims of regulators.

Another step to expand the number of providers would be to create universal license recognition for medical professionals, a step 18 states have taken over the past decade to boost employment and speed access across a number of professions.

All these reforms are part of the "personal option." Not only do they work, but they're also popular.

A 2022 poll found that more than 62 percent of those surveyed would like to have a personal option in health care.

Expanding the number of providers would be even more effective if we had greater transparency in medical billing.

One poll revealed that 95 percent of Americans want policymakers to make pricing transparency a priority, probably because only 16 percent of hospitals comply with existing transparency guidelines.

These are some of the common-sense measures our lawmakers should consider, to provide every Arkansan access to quality, affordable health care.

No. 47 just isn't going to cut it.

Ryan Norris is state director of Americans for Prosperity-Arkansas.

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