Nurse practitioners can help fill doctor gap

Re: "Expect longer waits for a doctor as shortage looms," April 28

I appreciate Examiner reporter Matt Connolly mentioning that expanding the role of nurse practitioners in Virginia is a potential solution to filling the shortage of primary care physicians. Eighteen states and the District of Columbia currently allow nurse practitioners to act as primary care providers. According to Robin P. Newhouse et al. (2011), research from 1990-2008 reveals that the health outcomes of patients were the same whether physicians or nurse practitioners treated them.

If the care delivered by both professional disciplines is comparable and nurse practitioners are working successfully in other states, what is preventing medical organizations and state licensing boards from letting nurse practitioners work independently in Virginia?

As demand for primary care services increases, health care professionals need to quit arguing with each other about superiority and collaborate to meet patients' needs.

Candice Teague

Nursing student,

University of California, San Francisco

O'Malley laid egg with gas tax hike

Martin O'Malley, Maryland's tax-and-spend governor, got his way once again. The Maryland Senate passed O'Malley's massive 80 percent gasoline tax hike over Easter weekend. Now Maryland families and businesses will be unfairly burdened with the fifth highest gas tax rate in the nation.

Adding more pain at the pump and increasing the cost of food and daily household items will evaporate more money from your family's budget.

Voters should remember this 80 percent gas tax hike, which was avoidable, foolish and unnecessary, when they go to the polls for the next election.

Al Eisner

Silver Spring

Welfare benefits should be determined at local level

Politicians often quote the Constitution's "to provide for the ... general Welfare" as justification for welfare spending. However, that clause gives the reason for the government to collect taxes: to protect the well-being (welfare) of everyone in the populace (general), not to subsidize individuals.

The Constitution enumerates the exact ways that tax money may be spent and it does not include welfare checks. Furthermore, the 10th Amendment states that if it isn't listed, the government can't do it.

Shouldn't the needy get help? Of course. But how is the best way to help them?

Buying wholesale is more economical than in the high-rent district because there are not nearly so many overhead costs passed on to the buyer. The same principle applies to distributing tax money. At the federal level there are many layers of overhead, fewer at the state level and fewer yet at the county or city level. The savings are obvious.

And then there are private donations. When you give a dollar to a needy person, they get the whole dollar. And the closer one is to the recipient, the better able one is to discern if he is truly needy or whether he could provide for himself. The best way to truly help is not to be an enabler of dependency on others.

It is time we demand that our legislators understand the restrictions placed on them by the Constitution.

Sue Long

North, Va.