Contrary to the opinion of almost every person who already has a government required license to work, many of the licenses required by the State of Iowa are not only unnecessary, their primary purpose seems to be to protect existing licensees against competition, rather than to protect the public.
I am sure that certain state licensing requirements do help to ensure the safety and quality of the service provided, but in almost all cases, private certification programs could serve the same purpose without involving the use of force by government, and without giving government backed protection to existing licensees. A great example of this is Certified Financial Planners (CFPs). Financial professionals who want to hold themselves to a higher standard can get this private certification, and then advertise that fact. The same is true of Realtors.
I’m sure that many licensed professionals also have various college degrees, private certifications, and other professional credentials. In many cases, these private credentials should be sufficient. Those who have them should advertise the fact, and not ask government to prohibit others from competing against them.
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.
Des Moines and surrounding communities should welcome Uber, the internet based company that coordinates ride sharing as an alternative to taxis and limousines. Uber is now available in the Des Moines area for both drivers (car owners) and for riders. Uber takes advantage of the fact that most privately owned cars are very under used, and that many car owners have available time to provide a ride to those who need one. What a great way to earn extra income, or to start your own business full time. Uber does extensive background checks on people who want to provide rides in order to ensure a high level of safety. Beyond that, Uber actively solicits riders to rate drivers on a scale from 1 to 5 with 5 being excellent. It has been reported that Uber stops working with drivers who’s average rating falls below 4.6. So, Uber strives for high quality. (Uber drivers also rate passengers, so it is possible that Uber can also stop serving customers who are abusive.) Although Uber will be very upsetting to existing taxi companies, the City of Des Moines and surrounding communities should make whatever legal and regulatory changes are needed to allow Uber to operate in the metro area. If Uber is not doing enough to provide for reasonable customer safety, then laws and regulations should address those issues. Licensing should not be necessary. Generating tax revenues or protection of existing businesses should be considered in the process of making any needed changes.
Contrary to the letter to the Register on 5/28/2013 by Michelle Anderson, “Iowans should have access to naturopathic docs”, we already have open access to naturopathic doctors and medicines. What we don’t have and don’t need is for our government to license practitioners and then require that their services be covered by insurance. Individuals are not calling for licensure in the interest of public safety. Practitioners are calling for licensure in order to have their products and services be a required service under Obamacare. Unfortunately, as long as our government continues to use its power to force insurance companies to cover politically favored medical products and services, there will be many special interests, such as naturopathic doctors and pharmacists, who will try to get on the government gravy train.
Iowa should not require registered nurses (RNs) to have a bachelor’s (4-year) degree in order to get a license to practice. Currently, Iowa law allows people to become RNs if they complete an associates (2-year) degree and pass a uniform exam. As the Des Moines Register reported, opponents of the bachelor’s degree requirement argue that bachelor’s degree programs have not proven to result in better care. (“Bachelor’s for nurses considered” 1/414/2012 – see link below.)
The Education Standards Of Practice Committee of the Iowa Board of Nursing is charged as follows: Review options and develop a proposal to submit to the Iowa Board of Nursing for the Associate Degree prepared nurse to educationally transition to a Baccalaureate in Nursing Degree as a license renewal requirement. Why was the committee not charged to investigate whether or not there are public safety problems with the current requirement, and, if any are found, whether or not requiring a bachelor’s degree would solve such problems? We do know that such a requirement would significantly increase the cost of becoming an RN for many people. That would likely result in fewer RNs and higher health care costs (and higher wages for RNs with bachelor’s degrees and more students in four-year colleges of nursing).
Of the 16 appointed committee members, 11 are RNs with a bachelors or higher degree, 3 are not nurses – representing consumers, community colleges, and four-year colleges, and 2 are nurses who appear to not have bachelor’s degrees. (See link to committee list below.) So, 12 of 16 appear to have a vested interest in making the bachelor’s degree a requirement.
The only purpose for government licensing of any profession should be public safety. More often than we would like, politically favored groups with vested interests ask to be licensed (or regulated) by government in order to to reduce competition and increase their own wages or profits. Since the committee meeting reported by the Register was not open to the public, we should presume it was because those with vested interests in making a bachelor’s degree a requirement did not want their comments heard.
The Register reported that there will be public hearing on this issue after the next closed committee meeting on December 13th. Let’s hope the public hearing is packed with people who care about both public safety and the freedom to practice a profession without unneeded government licensing regulations.