Other Papers Say: We can lower health care costs

Of the $4.5 trillion the U.S. spends on health care every year, the largest proportion — almost one-third — goes to hospitals. The cost of hospital services has consistently outpaced the overall inflation rate for at least two decades. If Vice President Kamala Harris and former President Donald Trump really want to reduce health care costs — as they both say — addressing this trend should be a priority.

Hospitals are heavily regulated, labyrinthine institutions that straddle the public and private sectors. In many cases, their pricing is subject to forces beyond their control. But absent a major reform to the U.S. health-insurance system, more straightforward changes can still help rein in spending.

Consider hospitals’ biggest expenditure — labor — which accounts for 60 percent of spending. Workforce shortages are often blamed for these costs. The government estimates shortages of almost 140,000 physicians over the next 15 years. Yet shortages aren’t inevitable. In many cases, they’re the result of policies that should be revised.

An obvious place to start would be so-called scope-of-practice laws. Most health care workers require a license, which is granted by state authorities. Officials establish education and training standards, as well as rules dictating what certain professions can (and often cannot) do. Proponents say such laws are needed to protect patients, and limiting complex cases to skilled professionals makes some sense. However, needlessly strict laws limit access to care and have been shown to increase costs.

The U.S. has fewer physicians per capita than most rich nations and has the highest doctor salaries in the world. Yet lawmakers have consistently opted to limit competition and preserve the status quo. Foreign-trained doctors, for example, must overcome a wall of state and federal restrictions before they can practice in the United States.

Increasing the supply of highly qualified workers who can perform needed tasks is the most straightforward way to lower costs. But while some state legislatures are considering proposals to relax their scope-of-practice laws, many have struggled to overcome medical associations’ resistance. Such complaints are generally off the mark: The point is to allow nurse practitioners and physician assistants to perform to the full extent of their training, not beyond.

Lawmakers need to strike a better balance. Promisingly, states including Florida, Tennessee and Virginia have granted provisional licenses to qualified foreign-trained doctors. More should follow their lead. Congress, meanwhile, should reform its outdated system of funding residencies, with a goal of boosting the number of doctors in fields or specialties facing shortages.

Fixing the American health care system is a monumental undertaking. That’s all the more reason to make simple improvements whenever possible. Increasing the supply of workers is a good start.