Stop the presses, there is an actual bill that has been introduced in the House and the Senate by a bi-partisan group of sponsors that does the following:
- Enhances competition
- Does not screw the poor
- Does not genuflect at the Very Serious People
- Could be signed into law without reservation by President Obama
The Pharmacy and Medically Underserved Areas Enhancement Act would allow pharmacists to offer health care services to Medicare beneficiaries in underserved areas – such as health and wellness screenings, immunizations, and diabetes management – by authorizing Medicare payments for those services where pharmacists are already licensed under state law to provide them. Most states already allow pharmacists to provide these services, though they cannot receive Medicare reimbursement for providing them.
Joining Brown in backing the bill are U.S. Sens. Chuck Grassley (R-IA), Bob Casey (D-PA), and Mark Kirk (R-IL). A companion bill was introduced yesterday in the House of Representatives.
If Medicare pays for something, most private insurers will quickly follow. This is a minor, technocratic change to the billing requirements of Medicare. It should slightly increase the pool of Primary Care Providers, it should make disease management slightly more efficient, and it slightly increases access to care while reducing the amount of driving needed.
Is this a Big Biden Deal? No, but it could be, if passed without poison pills, a minor improvement in the status quo for Medicare beneficiaries, while slightly reducing the guild powers of doctors. This is how Congress could work in a rational political environment.
The real reform on attacking the guild powers of doctors has to be at the state level. It should be a goal of anyone who wants to either reduce government spending OR increase access to affordable healthcare for more people to create the most permissive scope of practice and scope of service laws possible at the state level. In practical terms, that means creating laws that give nurse practicioners and physician assistants more autonomy to provide basic services; it means allowing dental hygenists to operate without supervision of a dentist (who mainly collects monopoly rents), it means allowing pharmacists to provide more basic care management services. It means shifting the MDs and DOs to higher complexity cases and away from routine, low complexity cases. This bill does not do it, but it is a step in the right direction.