Starting next year, nearly 5 million uninsured Californians will suddenly have health coverage, due to the implementation of the Affordable Care Act, or Obamacare.

Sounds great, right? But having insurance doesn't guarantee Californians can actually get care - not if there is a shortage of caregivers.

That's exactly the situation the state faces in 2014. Even now California doesn't have enough primary care physicians. Forty-two of its 58 counties fall short of the federal government's most basic standard.

The California Medical Association wants to build more medical schools and expand opportunities for young doctors. That's a smart plan. But that's not going to be much help to the millions who go looking for a doctor next year and can't find one. Training a doctor takes a decade. That's a long time for a patient to sit in a waiting room.

The chairman of the state Senate Health Committee, Sen. Ed Hernandez, D-West Covina, has a good idea to help bridge the gap.

A practicing optometrist, he wants to expand the ability of nurse practitioners and other professionals such as pharmacists and optometrists to help treat patients with primary care. Their work would be limited to what they're already qualified to do but often not allowed to do. Changing the rules so that these health care professionals can provide direct service would make better use of their skills and provide at least some care for

Seventeen other states, including Washington, Oregon and Colorado, have expanded the scope of nurse practitioners. Doctors predicted a surge in medical errors, but studies have not found this.

The Institutes of Medicine, the health arm of the National Academy of Sciences, has recommended for years that nurses should play a larger role in diagnosing and treating patients and in helping to manage chronic diseases.

California already has about 17,000 nurse practitioners. They can be trained more quickly than doctors and at considerably less expense.

Hernandez's legislation, a package of three bills - SB 491, SB 492 and SB 493 - comes up for its first committee hearing Monday in the senate's Business, Professions and Economic Development committee. It's going to be a fight, because the CMA, which represents the state's doctors, is opposed. The association will argue that patient safety will be compromised.

Originally posted here:

Editorial: Bills the right prescription for California's health care provider gap