Healthcare cost and access have become such common political talking points that it sometimes seems like political grandstanding is more important than the needs of constituents. These issues may feel like background noise in Washington, DC, but they’re very real to the people living in Senate leader Phil Berger’s district. The ratio of patients to primary care physicians in Caswell, Rockingham, Stokes, and Surry counties ranges from 1,770:1 to a whopping 7,650:1 according the Robert Wood Johnson Foundation. For comparison, the state average is 1,420:1.
With Gov. Roy Cooper’s veto of the budget, Democrats and Republicans could be locked into a long debate over the next few weeks. In the meantime, a very real, very bipartisan healthcare option has been put on the backburner. It’s called the SAVE Act (SB 143/HB 185) and it’s time that legislators on Jones Street takes notice.
The SAVE Act’s sponsors looked at more than 40 years of evidence to determine some of the lowest-hanging fruit in healthcare and decided it was time to cut that red tape. More than 60 legislators from both parties signed on. It has been endorsed by groups as diverse as The Rural Center, Americans for Prosperity, and AARP North Carolina, among others.
This legislation would allow Advanced Practice Registered Nurses (APRNs), with a master’s degree at minimum, to practice to their full scope of practice, education, and training without “physician supervision” requirements. We put that phrase in quotes intentionally, because it doesn’t mean what physicians’ groups might have you believe: they aren’t looking over nurses’ shoulders, approving each patient plan, and telling the APRN to do what they say. These requirements can be met with a couple phone calls and one meeting per year. The physician can work in Wilmington while the nurse handles patients in North Carolina's “North Star.”
The major problem with the status quo is the physician can charge tens of thousands of dollars for this “supervision,” making healthcare more expensive. This presents a major roadblock for nurses who want to open their own practice in places like Reidsville or Danbury or Yanceyville. How many new businesses do you know that would consider breaking ground if they had to make up $30,000 in unnecessary fees just to break even?
Nurses, like any good physician, refer to specialists all the time when a patient shows up with complicating factors beyond their training. They don’t need a law to tell them that – it is one of the most basic tenets of the profession. Nurses have been ranked the most trusted profession in the country by Gallup for 17 years running. If you can’t trust them to know when they need outside help, then who can you trust?
Once the SAVE Act passes, it will be easier for Advanced Practice nurses to practice closer to the people who need it most. Easier access means fewer trips to Winston-Salem or Raleigh and less time away from work for the caregivers who have to make those drives. It means better preventative care to keep chronic problems from snowballing. It means opportunity for a higher quality of life for people across Sen. Berger’s district after decades of dwindling healthcare options.
AARP’s polling shows that 86% of Republicans and 86% of Democrats in North Carolina support this type of legislation, but it has yet to get a vote in either chamber. We are calling on Sen. Berger to support moving the SAVE Act. It’s long overdue, and the patients in his district can’t afford to wait any longer.
Director, AARP North Carolina
CEO, North Carolina Nurses Association