It’s the oldest story in business. Large, established player tries to use government to protect itself against upstart, entrepreneurial rival. Once you begin to look for these crony capitalist power plays, you see them all around. My pal Tim Carney, for instance, has done standout work highlighting how taxi cab cartels have tried to quash Uber, the smartphone-based limo service.
Here’s another instance of such crony capitalism, with far bigger implications. From the WSJ:
Nurse practitioners in five states are fighting for the right to treat patients without oversight from doctors, as they can in many parts of the country. The battle is particularly pitched in California, where a bill that would let some nurse practitioners do their work independently passed a key legislative committee this week. California doctors strenuously oppose the idea, arguing that it could jeopardize patient safety. Other nonphysician health professionals around the country also are lobbying to expand their roles, citing the shortage of doctors in some areas and the expected onslaught of millions of patients newly insured under the Affordable Care Act next year.
US health care is an industry in desperate need of disruptive innovation. As defined by innovation guru Clayton Christensen:
Many of the most powerful innovations that disrupted other industries did so by enabling a larger population of less-skilled people to do in a more convenient, less expensive setting things that historically could be performed only by expensive specialists in centralized, inconvenient locations.
Lots of examples of this. A classic case is how PCs disrupted mainframe computers by providing convenience and good-enough capabilities. Nurse practitioners can be, if government lets them, a similar disruptive innovation. Christensen:
Take nurse practitioners and physicians’ assistants. Because of advances in diagnostic and therapeutic technologies, these clinicians can now competently, reliably diagnose and treat simple disorders that would have required the training and judgment of a physician only a few years ago. Accurate new tests, for example, allow physicians’ assistants to diagnose diseases as simple as strep infections and as serious as diabetes. In addition, studies have shown that nurse practitioners typically devote more time to patients during consultations than physicians do and emphasize prevention and health maintenance to a greater degree. But many states have regulations that prevent nurse practitioners from diagnosing diseases or from prescribing treatment that they are fully capable of handling.
This is one of the many little battles that will need to be won to bottom-up transform health care in a way that boosts value and innovation.