Pennsylvania Needs to Improve Healthcare Accessibility

Recent debates over health care reform in Washington have centered around reorganizing insurance markets, but improving America’s health care system requires a more comprehensive approach. And states can lead the way.

Recognizing the importance of states in health care policy, the Mercatus Center released a revised version of their Healthcare Openness and Access Project (HOAP), which measures the accessibility of health care for patients and service providers. In includes ten subindexes that provide a picture of the health care system in every state.

Unfortunately, HOAP ranks Pennsylvania below the national average, leaving plenty of room for improvement. Below are just a couple areas policymakers need to address.

Medical Liability Subindex Ranking: 35

This index indicates the impact medical malpractice litigation has on medical service providers. Excessive malpractice costs are correlated with reductions in the supply of labor, investment, and services in the health care industry. Moreover, these costs compel medical practitioners to employ defensive medicine, which adds roughly $650 billion to $850 billion to our nation’s health care costs.


Higher malpractice costs compel medical practitioners to employ defensive medicine, which adds roughly $650 billion to $850 billion to our nation’s health care costs.


In Pennsylvania, the Medical Care Availability and Reduction of Error Act requires health care providers to carry a minimum of $500,000 per malpractice occurrence. Any cost above this minimum is paid out of a special state fund in the state treasury.

In 2005, a study surveyed 800 Pennsylvanian physicians to “determine the prevalence of defensive medicine.” The study found 92% of these doctors regularly ordered extensive tests and diagnostic measures for “assurance” purposes. Moreover, 42% refused to conduct high-risk procedures as well as refused to treat patients with “complications” in attempt to prevent malpractice litigation.

Ensuring that doctors are not overburdened by malpractice charges, while protecting patient reparation rights, is necessary to reduce health care costs.

Occupational Regulation Subindex Ranking: 43

Occupational regulation refers to the amount of licensing required to work in the health care industry. Like other professions, many seeking to work in health care must pass a training regimen and an examination to secure a state license. However, licensing requirements can go beyond patient safety and serve primarily as a barrier to entry.

Another determinant effecting the supply-side of health care resources is the ability for nurse practitioners to practice independently. Despite evidence demonstrating nurse practitioners can perform many primary care services as effectively as a doctor, Pennsylvania heavily restricts this practice.

Reforming these aspects of our health care system—as well as others identified in the Mercatus Center’s analysis—will improve the quality of health care while significantly reducing costs for Pennsylvanians.