Op-Ed: Regulatory flexibility can improve health care and reduce costs

Op-Ed: Regulatory flexibility can improve health care and reduce costs

Originally published in Bangor Daily News – 09/11/20

I’ve been a nurse since 2003, primarily in the ICU, as well as being part of a federal medical disaster relief team for over a decade. In that time I have seen many new developments in health care, but one thing generally remains the same — regulations that restrict, and even impede, medical care while increasing costs. For the past two years, I have been working to grow my small business instead of working at the bedside, but have continued to see how excessive regulations impede health care, whether accessing it for a broken arm or a well-child appointment.

This year, we’ve faced unprecedented challenges here in Maine due to COVID-19, but I’ve been pleased to see some ongoing challenges to health care access eased via emergency orders. We should use the lessons that we are learning from COVID-19 and put in place policies that will better prepare Maine for future outbreaks while improving our healthcare system now. While COVID-19 has given us some lemons here in Maine, I look forward to turning them into lemonade and ensuring that we continue to improve healthcare access in our state.

First, we need to pass legislation to put a permanent end to certificate of need, the drawn out process by which local hospitals and nursing homes must seek the approval of not only the state, but also their competitors, in order to expand their services, add on to the current facility or simply increase their bed capacity. The Maine Department of Health and Human Services has accepted emergency certificate of need requests from facilities seeking to temporarily increase their bed capacity as a pandemic preparedness measure.

Easing regulations around these rules this spring and summer was paramount to maintaining our health care facilities’ flexibility to customize their care as necessary while dealing with COVID-19. If we can allow changes with certificate of need requests during a public health emergency, then why would we tie our hospitals’ hands at other times?

Imagine, if you will, a retailer having to ask permission of their competitor to expand. Ludicrous! By encouraging increased free enterprise in health care, Mainers can anticipate lower prices, more innovation and higher quality services as health care facilities seek to attract and retain customers.

Here in Maine we face a chronic health care provider shortage. Every facility in which I’ve ever worked has utilized travel nurses to fill those gaps, and I myself worked as a travel nurse in Detroit for a summer. The ease of obtaining a license comes into play at times when staff are considering their next travel assignment.

Under Gov. Janet Mills’ Emergency Order No. 16, health care providers in good standing that are licensed in another state can be issued a Maine license to practice very rapidly, reducing the waiting period from 45 to 90 days to 48 hours.

Maine’s health care provider shortage existed long before COVID-19. Now that we have learned we have the capabilities to expedite the licensing process, we should reduce the shortage by removing obstacles to licensure, including their expensive price tags. These reforms will give Maine a competitive edge in recruitment of the healthcare professionals that we so desperately need.

Mills also relaxed regulations relating to telehealth in Emergency Order No. 35. Throughout COVID, this has enabled physicians and other health care practitioners the ability to provide health care services using telemedicine or telehealth. Of course, not every health care need can be served with telehealth, but many non-urgent health needs can be met with this modality. If a physician in Lewiston can check in with a patient in Calais regarding their lab results, this can help remediate the health care provider shortage, decrease costs and save the patient a trip to the doctor’s office.

If these changes can be done safely during a national health crisis, why can’t they be done during stable times? We should remove these regulations permanently and safely ease the red tape around licensure so that Maine people can receive better access to health care at lower prices.

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