Wednesday, April 28, 2010

Remote Area Medical and Licensing

I listened to Stan Brock of Remote Area Medical on WBAI this morning and was appalled to learn that the mission of that organization, which provides free medical care to remote areas and within the US, is obstructed by licensure requirements. California has a bill pending in its legislature to exempt medical, dental and optical professionals licensed in other jurisdictions from state licensing requirements when providing free services within California. Good for California if it passes.

Until it does, a dental hygienist licensed in New York is not lawfully permitted to volunteer to go to Fresno and give free cleanings to poor people. An eye doctor licensed in Illinois cannot give exams and prescribe eyeglasses to poor folks in Appalachia. A physician licensed in Florida can't treat a charity case in Idaho.

The system of state licensure for these professionals is a preposterous and unnecessary restraint of trade. Teeth, eyes and human bodies don't change when state lines are crossed. A root canal in New Mexico is the same as a root canal in Maine. A colonoscope in Vermont takes the same route in Minnesota. It is time to develop a system of national or even international recognition of professional licenses so that professionals may move freely over borders and their clientele will have more choices.

I cannot think of a good reason for maintaining the present system. It protects local professionals from out of state competition, but I consider that a bad reason.

I would extend this reasoning to engineers, teachers, accountants and lawyers as well. Numbers don't change from state to state, and laws are not all that different across the country. Educational and engineering theory and practice is the same everywhere.

I would also advocate taking a good, hard look at the proliferation of occupational licensing requirements across the country and eliminate them where they serve no useful public purpose. Flower arranging, hair braiding, and any number of other occupations have been saddled with onerous licensing requirements that serve only as obstacles to entry into trade.

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