I agree with Valerie Stallbaumer in her letter to the editor in The Des Moines Register, (See link below), that the purpose of professional licensing requirements by government is to help protect the public from harm. I disagree with her that it also is to guarantee quality. Safety issues are usually objective: we know pretty well what kind of things can hurt people. Licensing should assure us that the licensed person knows and follows safe procedures. But for many licensed professions, quality is subjective. If acupuncture is not effective for some people, what is the harm as long as they don’t get an infection? The only reason I can think of why government would require a four-year program for acupuncturists is that acupuncturists and their schools lobbied for licensing to protect themselves against competition and to appear more professional. Acupuncturists, physical therapists, tattoo artists, and ear piecers probably can learn proper safety procedures related to “needling” in just a few days. We do need a complete review of licensing requirements and regulations in Iowa to eliminate those that prevent competition rather than protect people.
In today’s Des Moines Register, the guest opinion by Kollan Kolthoff was very vague in his call for “common sense reform” of the licensing of cosmetologists. (See link below.) He wrote, “…leaders from within the industry are uniquely aware that there are problems that need to be addressed.” I presume the industry leaders he refers to are existing licensed cosmetologists and licensed schools of cosmetology. After a person has completed the 2,100 required hours of education and paid as much as $20,000, it is very understandable that they would not want to see license requirements significantly lowered – thereby indirectly lowering the value of what they have already paid for. Similarly, licensed schools of cosmetology have a very strong financial incentive to maximize the number or hours of schooling required for a license.
He also wrote Iowa needs reform that, “…protects consumers against the deregulation of licensed beauty professionals.” Deregulation does not and should not mean a lessening of regulation to keep consumers safe. Deregulation should focus on removing regulations that have the primary purpose of protecting the income of existing cosmetologists and schools of cosmetology.
The same issues apply to a large number of occupations that require a license from the state. Most calls for licensing, and opposition to deregulation, come from existing businesses and licensees, not from the general public. Our elective representatives should establish a process to review and reduce licensing requirements in Iowa so that only public safety is is taken into account when requiring Iowans to get a license from the state before being able to work in any particular job.
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.