Salaries have changed, the minimum wage has risen and the doctors salaries have fallen. Ideas about relative worth and value are in flux. Health Care Competition and Regulation Health care is produced like other goods and services with resources that are scarce relative to human wants. Most people believe that the changes in finance and reimbursement over the last few years have moved health care markets toward a more competitive structure. A known consequence of competition is a reduction in profit.
Regulation is essentially a political process.
It constitutes the impositions of influence and power by those with a political majority on those who have customarily exercised power in a given sector of economic activity. Regulation deals poorly with qualitative issues and tends to penalize the very best or most efficient institutions while focusing on the worst. The market on the other hand tends to focus on efficiency, economy and consumer choice. Basic value choices are at issue. Despite what amounts to a ringing declaration of the worth and value of nurse practitioners that validates the focus of advanced nurse practice, advanced practice nurses have been reluctant to defend their value in terms of reimbursement.