Nurse prac­ti­tion­ers bill would not im­prove health care

The Morning Call - - TOWN SQUARE -

Kim Jor­dan’s Aug. 17 op-ed (“Why Pa.’s nurse prac­ti­tion­ers should have more au­ton­omy”) sug­gests that nurse prac­ti­tion­ers are as ca­pa­ble at prac­tic­ing medicine as are physi­cians and, there­fore, should be given more au­ton­omy in or­der to re­duce health care costs and increase ac­cess to qual­ity care.

How can nurse prac­ti­tion­ers di­ag­nose ill­ness bet­ter than a doc­tor who has 15,000 hours of clin­i­cal train­ing ver­sus their 500 hours? How will nurse prac­ti­tion­ers re­duce health care costs when the Amer­i­can As­so­ci­a­tion of Nurse Prac­ti­tion­ers’ stated goal is pay par­ity with doc­tors?

How can care qual­ity increase when a doc­tor must train sev­eral ad­di­tional years to change spe­cial­ties, and a nurse prac­ti­tioner can change spe­cial­ties with no fur­ther train­ing? If nurse prac­ti­tion­ers are equal to physi­cians in abil­ity, why are they not re­quired to pass the same state med­i­cal li­cens­ing ex­ams and board cer­ti­fi­ca­tion ex­ams that doc­tors must pass?

The facts do not sup­port Ms. Jor­dan’s con­clu­sions. To pro­tect the qual­ity of our health care, please ask your state rep­re­sen­ta­tive to vote against House Bill 100.

Peter McIntyre Lower Ma­cungie Town­ship

over us­ing real es­tate taxes to fund pub­lic ed­u­ca­tion. Be­cause an “old tax” is fully im­pounded into economic re­la­tion­ships and as­set val­ues, chang­ing that tax will af­fect those re­la­tion­ships and val­ues.

In the prop­erty tax case, think of every prop­erty sub­ject to tax as being en­cum­bered by a li­a­bil­ity — the es­ti­mated present value of those fu­ture prop­erty tax obli­ga­tions. Each such prop­erty’s value is re­duced by that li­a­bil­ity.

Now comes the tricky part to be con­sid­ered when re­vis­ing the “old” prop­erty tax. If for­merly taxed prop­er­ties are re­lieved of some or all of the prop­erty tax, the en­cum­brance men­tioned above shrinks or dis­ap­pears, and those prop­er­ties’ val­ues may increase rel­a­tive to any tax­able prop­er­ties.

There­fore, those who ben­e­fit from prop­erty tax re­duc­tions do so in two ways: 1. de­creased an­nual cash out­flow, and 2. po­ten­tially in­creased prop­erty value.

James Lar­gay Up­per Saucon Town­ship

that in Rep. Frank Ryan’s bill, if some­one is re­tired un­der a de­fined-ben­e­fit pen­sion, as many as 20 to 25% cur­rently are, they are ac­tu­ally taxed on 100% of the gross of their monthly ben­e­fit, not just “in­come.” This ac­tu­ally does re­sult in dou­ble­tax­a­tion.

The cur­sory and off­hand sen­tence “pen­sion in­come would be taxed” seems de­signed to dis­tract from a ma­jor prob­lem in this bill. Open­ing up the door to tax­a­tion of pen­sions would also wreck a long­stand­ing cul­ture of state re­spect to­ward its se­nior cit­i­zens and throw them to the tax-hun­gry wolves in Har­ris­burg.

Rep. Ryan needs to swallow his pride and with­draw this bill, HB13, un­til this prob­lem is prop­erly ad­dressed.

Dwight D. Wei­d­man Green Town­ship, Franklin County

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