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Deregulation: The prescription for cost and scarcity in healthcare

Deregulation: The prescription for cost and scarcity in healthcare

Niklas Kleinworth
June 8, 2023

Under a shroud of good intentions, government regulations often hurt the very people they intend to help. This is because the bureaucratic hurdles created by regulations cause the free market to become lethargic, which stunts simple solutions to large-scale problems.

Nowhere is the burden of overregulation more potent than in the health care market. Some would argue that the American health care system is not a free market at all, leading to its growing inefficiencies and more rapidly inflating prices.

This is the first article in a three-part series probing the issues with government regulation. We start by looking into how Idaho has successfully used deregulation by expanding the prescription authority for pharmacists.

Many patients may put off addressing a simple ailment, in the belief that it is not severe enough to incur the cost of a visit to the doctor. Moreover, primary care may be nonexistent for some patients in the state, with 32 of Idaho’s 44 counties designated as health resource shortage areas.

Lawmakers finalized a rule this year from the Board of Pharmacy that revises the scope of practice for a pharmacist to include prescribing medications within the scope of their training.* This act, the latest of several legislative actions on health care, is a substantial improvement from just five years ago. Back then, pharmacists were only allowed to prescribe medications from a list approved by the Board of Pharmacy. This latest policy change gives pharmacists more latitude and discretion, which will help patients.

Pharmacists have an essential role — delivering the therapeutics prescribed by the doctor. Cutting out the middleman — the doctor — for simple medical conditions may not only lower costs; it also may increase access to treatment and preventative medicine.

Only a physician can manage certain medical conditions, and patients who need a doctor will be helped by this change. Letting some patients consult a pharmacist frees up physicians’ time, which can be used to treat both seriously ill people and those with less complex conditions.

A study published last year found that expanding prescriptive authority for pharmacists allowed for more access to medications to treat chronic conditions. Meanwhile, there was no corresponding decrease in prescriptions from specialists, demonstrating increased access, not a redistribution of patients from specialists to pharmacists.

Deregulation could also save patients money. Patients who receive a prescription directly from a physician incur an average cost of $106, according to researchers at the Mercatus Center — $134 in today’s dollars. What would this mean for Idaho? It’s hard to say; there needs to be more thorough research on the cost of diagnosis and prescriptions from pharmacists before an honest statewide estimate for patient savings could be provided.

Addressing healthcare costs and shortages should not stop with pharmacists. Some policy experts also propose expanding scope-of-practice restrictions for well-trained professionals like nurse practitioners.

Critics in Idaho and on the national stage argue that expanding the scope of practice for non-physicians will harm patients and lead to more substance abuse. But this is not the case, according to some studies. In fact, increasing access to timely health care could improve patient health.

Deregulating the health care market allows professionals to practice within the full scope of their training, alleviating pressures on the system and on patients. Though Idaho has taken the lead on pharmacist deregulation, the Gem State should do more to increase the supply of health care. The success of pharmacy deregulation points to the value of relaxing government intervention to permit a more free market in health care.


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