Stephan:   Think about what this report is really saying: Underneath whether nurse practitioners can provide high enough quality service there is a more fundamental issue: The American healthcare system doesn't have enough physicians. Year after year, decade after decade, we spend more than any other nation on earth on healthcare, more even than several countries combined. Yet we don't have enough primary care physicians to deliver healthcare. Norway can do it. Sweden can do it. France can do it. We can't. Using the system we have now, according to the WHO, we rank 38th in the world. It is shameful. We are having the nurse practitioner debate because of our failures, not our successes. It is plan B.