The Koch brothers have been on a tear, demanding the roll back of occupational licensing in states, claiming that “government overreach” is creating “barriers to opportunity” for average Americans. The PR posturing from Koch employees references occupational licensing for “pet grooming” and other seemingly frivolous enterprises.
The Kochs, of course, completely ignore the fact that occupational licensing rules have been successful at protecting consumers from fraud and abuse and establishing “best practices” for training in an industry. Licensure trains dentist aides not to pass on diseases, electrical journeymen not to burn down your house, construction workers on how to remove asbestos safely. Even dog groomers could benefit from these standards. PetSmart, for instance, has faced many complaints and lawsuits involving animals alleged to have been injured or killed in the largely unregulated dog grooming industry.
The Koch funded ALEC jumped onto the bandwagon, years ago, producing a series of bills attacking occupational licensing at the local level, attacking occupational licensing boards, and producing bills to make occupational licensure seem frivolous and unimportant.
Mackinac “Study” Fails to Examine the Evidence
Now, the Koch funded “experts” at the Michigan based Mackinac Center for Public Policy have jumped into the fray campaigning to eliminate many of the licenses required for doing business in that state. Mackinac is a member of the State Policy Network and a regular presenter at the American Legislative Exchange Council (ALEC).
Mackinac, best known for its efforts to lower wages and bust unions in Michigan, issued a report in 2017 on the need to eliminate licensing, training, and state oversight of many health care and other occupations.
The report cherry picks a few occupations that may have onerous education requirements for licensing as if those examples represent the over 180 occupations and 700,000 people licensed by the state.
What the report never does — except theoretically — is show whether the state licensing works to reduce harm and costs to consumers. The only way to do that is to record the number of disciplinary actions, including loss of licenses, taken by the state, but Mackinac prefers spin to facts.
CMD Takes a Look at the Data
The Center for Media and Democracy did what the state of Michigan apparently does not do, which is assess the total number and types of disciplinary actions taken over time. CMD took data from the Michigan Department of Licensing and Regulatory Affairs (LARA) for the period January 2017 through October 2017.
LARA has two categories of jobs with disciplinary actions reported each week — what it calls “Occupations” and “Health Care Providers.” “Occupations” includes such professions as accountancy, architecture, engineering, residential construction, land surveying, real estate sales and brokerage, debt collection, and others.
In the period studied there were over 260 disciplinary actions against licensees for fraud and other crimes against consumers. (This data reflects “individuals,” not all reported cases as some cases involve reinstatement of a license already reported.)
Without these actions health care professionals, such as M.D.’s, could continue hurting people. Action against even one health care professional, such as a nursing home administrator, protects the health of dozens or hundreds.
When licenses are taken away, permanently, or temporarily, the licensee has much less of a chance to commit future fraud. For example, a contractor using shoddy materials shut down by the state finds it much more difficult to get that next contract.
Even more clear are the benefits of state licensing of health care professions, including medical doctors, osteopaths, chiropractors, podiatrists, nurses, dentists, psychologists, speech and language specialists, respiratory care providers, social workers, and others.
For the ten-month period analyzed by CMD over 800 health care professionals were fined, lost their license, put on probation, or forced to do continuing education because of incompetence, sexual misconduct, malpractice, use of drugs, fraud, and other actions or behaviors.
Without these actions health care professionals, such as M.D.’s, could continue hurting people. Action against even one health care professional, such as a nursing home administrator, protects the health of dozens or hundreds.
Mackinac Center does not look at the social benefit, reduction in costs to patients, providers, and insurance companies of disciplinary action, suggesting that instead of relying on the government a person harmed could simply sue the negligent provider.
This is a cynical ploy, as lawsuits are generally not an easy option for average Americans. They not only don’t have the funds, they frequently don’t have the rights, thanks to the ALEC “tort” bills that have swept the nation making it harder for consumers to bring cases to court when they are injured or killed by products or providers.
ALEC is so hostile to lawsuits, it even passed a bill making it harder for you to obtain any compensation from a company whose negligence killed the family pet.
I am sorry about your experience. You are right that licensing is a mixed bad. The purpose of the article was to point out a new right wing intitiative where, again, the benefits of regulations goes unstated.
It is a good idea but will never happen. The driving force behind this legislation is to reduce the size of government and the number of public employees. I did not write that because I cannot prove it, but why would the right wing even care about this issue? But you are correct — a patchwork of regulations, especially where states are bad about sharing disciplinary data like medical malpractice, makes little sense. Advocating for national licensure was beyond the scope of the article. I was just pointing out the Mackinac Center writes as if the regulations and standards have no benefit. Don
Most professional licensure should be done nationally by the federal government under the Commerce Clause. State licensing boards tend to serve as cartel-enforcement mechanisms, artificially restricting supply, mobility, and competition. For professions that are genuinely limited to one or only a few states — coffee plant inspector, alligator wrangler, and the like — I have no problem leaving licensing to a state or multi-state board, but for professions like healthcare, there is no defensible basis for a state-by-state approach. (For “little laboratories of democracy,” substitute “pawns in a race to the bottom for labor standards, environmental standards, and tax regressivity” and “pawns in a race to the top for corporations and politically connected professionals.”)
Licensing is a mixed bag that I, a progressive, have often railed against. I have seen people who can pass a test do really crappy work in various trades and professions. There is an ass-covering aspect that happens which avoids responsibility for damages. Then we have the medical industry that sets insanely dangerous standards which make it just fine and legal to kill people with drugs such as statins or vaccines and the drug corporations and medical practitioners are protected by their licensing because they follow the book. I once had a dentist do bridge work that failed in 36 hours of installation. A repeat of the work and that bridge broke in half withing a 20 ft walk from the chair to the front desk! The DDS response? He did it by the ‘book.’ So much for licensing and standards.
I am sorry about your experience. You are right that licensing is a mixed bad. The purpose of the article was to point out a new right wing intitiative where, again, the benefits of regulations goes unstated.
People like this won’t stop until we make them.