Opinion: To lower health care costs, widen the pool providing routine care
Rethinking who is allowed to do certain health care tasks—and increasing the supply of providers at every level—could help lower health care costs in the U.S., according to an opinion piece co-authored by Harvard T.H. Chan School of Public Health’s Thomas Tsai and Ashish Jha.
Tsai is an associate professor in the Department of Health Policy and Management and Jha is a department associate as well as a senior fellow at the Belfer Center at Harvard Kennedy School. In a May 4 Boston Globe article, they argued that letting nurses, pharmacists, and AI handle routine care could lower costs and increase efficiency.
“American health care has largely refused to ask a key question: What level of training does a specific task actually require?” the co-authors wrote. “Managing a stable patient’s diabetes medications does not require the same skills as diagnosing a rare autoimmune condition. Performing a routine colonoscopy does not require the same training as performing cardiac surgery. A system that insists otherwise is wasteful.”
Making better use of a range of providers other than physicians—such as nurse practitioners, pharmacists, licensed practical nurses, medical assistants, and trained aides—could generate substantial reductions in the cost of delivering care, because those providers get paid less.
The co-authors also recommended broader use of AI for tasks such as generating clinical notes from patient visits, assisting with diagnoses, and renewing routine medications for chronic conditions. And they highlighted the shortage of health care providers at every level. They recommended that Congress pass legislation adding 14,000 residency slots for physician training, and that nursing schools—currently turning applicants away by the thousands—make investments so that more can be trained.
The Boston Globe piece is part of a series called “The Cost Cure,” which outlines a reform agenda that could substantially slow health care cost growth without harming care. Jha either wrote or co-authored all of the articles in the series, and Tsai co-authored three, including one on ending policies that protect hospital monopolies and one on the importance of value-based care—when doctors are paid to keep patients healthy instead of for every service they provide.
Read the Boston Globe opinion piece: To lower health care costs, fix who does the work
