Barnett: Prevention is part of health-care cost control
By Scott Rochat
Saturday, September 16, 2006
More government will not solve the high cost of health care, Republican gubernatorial candidate Jim Barnett told an advanced nurse practitioners’ convention Friday.
Barnett was part of a panel addressing the Kansas Alliance of Advanced Nurse Practitioners. At present, he said, the United States spends 16 percent of its gross domestic product on health care and the health-care providers aren’t the ones making most of the decisions.
“I don’t believe the answer is to just add more government,” said Barnett, a physician and state senator from Emporia. “We have to work at the root of the problem.”
That includes more emphasis on prevention, he said, along with finding ways to serve the uninsured and allowing both the cost and quality of care to be clear to the patient. In general, Barnett said, medicine needs to be patient-oriented rather than profit-oriented, with health care that’s based on evidence instead of the fear of a malpractice suit.
The KAANP is about 20 years old and promotes the role of advanced registered nurse practitioners, nurses with advanced degrees who have the ability to prescribe medicine and treat patients in collaboration with a doctor. The actual rules about that collaboration vary from state to state,
“The role of the nurse practitioner is critical,” Barnett said. “It’s expanding. It’s essential. I wouldn’t want to go back to the days of not having a nurse practitioner in my office.”
Also on the panel were Rep. Peggy Mast, R-Emporia, and Larry Buening, the executive director of the Kansas Board of Healing Arts.
“We need to give as much authority as possible to ANPs and to PAs (physicians’ assistants),” said Mast, whose daughter is a nurse practitioner. “I know you’ll be able to provide important services to those in need.”
Some aspects of that may be expensive but ultimately worthwhile, she said, such as the adoption of electronic medical records for patients.
She urged the nurse practitioners to make sure their voices were heard in Topeka.
“I don’t know as much as you do about your practice or the roles you can perform in health care,” Mast said. “We need someone who can communicate with us in your area of expertise.”
Buening focused on some of the regulations regarding nurse practitioners. Traditionally, he said, the board has taken a loose approach about when doctors can delegate a case to a nurse practitioner or PA.
“If Dr. Barnett would authorize me to do brain surgery and ask me to do a brain surgery, I could do brain surgery,” Buening said.
That tightened up a little bit after 1998, he said, when the state added some rules about who a physician could delegate to.
Buening agreed that the role of a nurse practitioner was critical and hoped that the regulations eventually would work out to “something less than hierarchical structures and something more than the unlicensed practice of medicine.”