Viewers of the vice presidential debate were treated to a more civil exchange between Senator Vance and Governor Walz. This was a welcome change. It was also nice that healthcare was at least discussed—it was a glaring omission from the presidential debate.
What was less welcome was the same tired focus on the demand side of the healthcare system.
Both candidates seemed to support maintaining the Affordable Care Act or Obamacare. Yet premiums on the marketplace continue to grow—7% for 2025 following a 6% increase this year. The nation also faces ballooning national debt with no end in sight.
A common thread in listening to both candidates was laser focus on the demand side of the market. Governor Walz touted price controls on prescriptions drugs as a means for controlling cost. Senator Vance was more focused on immigration policy, blaming increased demand from new residents in the country. Neither side of the debate seemed to offer any serious or thoughtful solutions.
It is very clear that insurance coverage needs more fundamental reform and band aids aren’t going to fix the problem. Importantly, there is lower hanging fruit on the supply side of the healthcare market that can increase access to care without continuing the march to budget insolvency in the U.S.
One set of changes is making sure that healthcare practitioners can practice to the full extent of their training. Nurse practitioners, as an example, can help fill in gaps in primary care delivery across the United States. Rather than tethering nurse practitioners to physicians and forcing them to enter into expensive contracts with physicians, the majority of states now allow nurse practitioners the freedom to practice to the full extent of their training. And it doesn’t compromise quality and may even reduce the cost of several services.
Let’s also make sure that patients have access to the treatments they need. Pharmacists have more knowledge about the proper use of prescription drugs than physicians—physicians often consult pharmacists about the interactions of prescription drugs. Recognizing the untapped potential of these highly trained medical professionals, a few states like Idaho, Colorado, and Montana have given pharmacists limited prescription privileges. In Idaho in particular, the first state to pass this reform, Medicare patients now have better access to treatments for asthma and diabetes. Insurance companies are now expanding coverage of prescriptions made by pharmacists.
This is good news for patients, particularly patients in rural areas, who likely have pharmacies nearby, but may need to travel or face long wait times to get an appointment with a primary care provider.
Psychologists can also play more of a part in helping to cover the national shortage of mental health professionals. With Utah’s passage of SB 26 earlier this year, there are now seven states that permit psychologists to prescribe to their patients. Research shows that granting prescription privileges to psychologists reduces suicides and also increases the number of psychology practices.
Hospitals and a large number of other providers of healthcare services also face arcane laws that limit their ability to purchase new equipment or build new facilities. These laws, called Certificate of Need or CON laws, are a holdover from the 1970s. Originally intended as a means of controlling healthcare costs, federal regulators quickly learned that they were not fulfilling their intended purpose. Nevertheless, most states still regulate healthcare services with these outdated laws.
Two recent comprehensive analyses find conclusively that the costs of CON laws outweigh their benefits. In fact, a recent working paper finds that removing CON laws reduces healthcare spending.
In short, eliminating needless regulations on the healthcare workforce and healthcare facilities can go a long way in improving healthcare access and reducing cost. The demand side needs fixing, but federal policy makers seem focused on making things worse. Let’s pivot to the supply side and make sure that American citizens can get access to the healthcare that they need.
Edward Timmons is a service associate professor of economics and director of the Knee Regulatory Research Center at West Virginia University.
