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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