Some of the people in my industry, home medical equipment (HME) dealers, think it would be a good thing if all HME dealers in the state were required to be licensed by the State of Iowa. They lobbied Senator Jeff Danielson who agreed to propose Senate Study Bill 1172 (SSB1172) which, if passed, would require such licensing. I am not aware of any patients who are calling for this. I’m not aware of any particular problems in our industry that have resulted in harm to patients. Almost all HME dealers are providers under Medicare, and Medicare requires all providers to be accredited by an independent accrediting agency. The purpose of accreditation is to help ensure that all services and products are provided in a safe and appropriate manner. It does not appear that licensing is needed for the safety of the public. Therefore, I presume that those who advocate for this bill are hoping is will help protect existing HME businesses against new competitors.
I think they learned about this political technique for protecting existing providers against competition from the orthotists, prosthetists, or pedorthists in Iowa. What’s that? You say you don’t know what an orthotist, or a prosthetist or a pedorthist is? They are medical professionals who, only a few years ago, successfully lobbied the Iowa Legislature to require a license to practice their profession in Iowa. (You’ll need to look them up.) The effect has been that many DME dealers are now prevented from selling specially fitted shoes to diabetic patients because they do not have the proper pedorthist license. I had never heard of pedorthists until we found out that we had to have a licensed pedorthist in order to continue to sell diabetic shoes. I had never heard of any complaints from the public, or of any public safety issues surrounding the sale of diabetic shoes by DME dealers. Again, I presume that the existing businesses were trying to protect themselves against new competition for DME dealers.
Professional licensing in Iowa is out of control. Any group that wants to prevent new competitors from entering their industry goes to the state to become a licensed profession. This not only needs to stop, it needs to be reversed. As the Des Moines Register has advocated, we need to go through all licensed professions to determine whether or not there is a real public safety concern that is actually solved by licensing. If not, we need to repeal the licensing requirement. If there is a real public safety need, then we need to make sure that the licensing requirement is limited to meeting that need, and that it does not go beyond that need in order to protect existing providers from competition.