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Our current health care "system" has been criticized for providing too little
care, too late, for too few people, at too high a cost. In this Article, Dean
Safriet argues that these problems require a fundamental restructuring of
existing health care delivery systems and more effective utilization of all health
care personnel. Dean Safriet urges immediate legislative reform to reduce the
restrictions that currently constrain advanced practice nurses, especially nurse
practitioners and certified nurse-midwives. Advanced practice nurses have
demonstrated repeatedly that they can provide cost-effective, high-quality
primary care for many of the neediest members of society, but their role in
providing care has been has been severely limited by restrictions on their scope
of practice, prescriptive authority, and eligibility for reimbursement. Eliminating
these restriction would enable advanced practice nurses to increase access
to health care while preserving quality and reducing costs.

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health care delivery systems, health care personnel, nurses