It is in both the state and federal governments' interest to promote increased access to health care because people without a regular source of it pose a costly, long-term burden on our nation.

So it's not an understatement to say that Gov. Rendell's announcement last week of an ambitious plan to bring health insurance to the more than a million Pennsylvanians who are uncovered is a significant and meaningful change in the state's health-care system.

The governor's plans to expand coverage and buck rising health-care expenses through a series of cost-containment measures demonstrates great fortitude, but his leadership will require support from critical sources throughout the state.

One of the most promising areas of Gov. Rendell's cost-containment proposal is his plan to increase access to nurse-practitioner care. This is a timely, much-needed strategy considering that more than 141,000 nurse practitioners around the country currently are helping to fill the growing gap in primary health and preventive care.

The federal government and most states recognize nurse practitioners as highly qualified primary health-care providers. They provide high-quality care, studies have shown, and can prescribe many medications in virtually every state. Letting them help expand access to care in both community and health-care settings will have far-reaching benefits, especially in the larger context of health care in the United States.

From my perspective at the National Nursing Centers Consortium, the governor gets it. The lack of access and insurance is no longer just the burden of the poor - disparities have widened. With or without insurance, we are all affected by the staggering costs of health care through the widespread lack of access to basic care.

Nurse practitioners already provide high-quality comprehensive care to thousands of consumers across our state through nurse-managed centers, in family physician offices, hospitals and other venues.

Despite nurse practitioners' desire to expand access to care for all, they continue to hit arbitrary practice, reimbursement and regulatory barriers. This must change. On behalf of the National Nursing Centers Consortium, I urge the governor to support our call for insurance companies, medical providers and decision-makers to support nurse-managed care and nurse practitioners. This is a solution that will directly improve access to these important providers, and address what's at stake if the number of Pennsylvanians lacking access to quality and affordable care continues to increase.

As a longtime advocate for nurse-managed care and greater access to quality care for vulnerable populations, the consortium has worked with other organizations to help facilitate the type of change the governor will now champion. And we're fully behind the governor to make sure his plan gains support.

Few working Pennsylvanians can afford to pay for their health care if they are seriously ill or injured, or for insurance even when they can obtain it. Employers pay about half of health-care costs, which are rising faster than inflation.

We do know that more leadership is required - from legislators, medical providers, health insurers, and advocates to correct this disgrace. They must come together if we are to improve care in Pennsylvania and ultimately our nation.

I hope that every Pennsylvanian affected by rising health care costs will join me in not only watching, but in demanding change, and that other governors across the nation will stand up and take notice. *

Tine Hansen-Turton is executive director of the National Nursing Centers Consortium and vice president of Philadelphia Health Management Corp.