Obstacles

Medical Licensing - An Obstacle to Affordable, Quality Care - by Shirley Svorny - Cato Institute Policy Anaysis; No. 621 September 17, 2008

Executive Summary - "In the United States, the authority to regulate medical professionals lies with the states. To practice within a state, clinicians must obtain a license from that state’s government.  State statutes dictate standards for licensing and disciplining medical professionals.  They also list tasks clinicians are allowed to perform. One view is that state licensing of medical professionals assures quality. In contrast, I argue here that licensure not only fails to protect consumers from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible.  Institutional oversight and a sophisticated network of private accrediting and certification organizations, all motivated by the need to protect reputations and avoid legal liability, offer whatever consumer protections exist today. 

Consumers would benefit were states to eliminate professional licensing in medicine and leave education, credentialing, and scope-of-practice decisions entirely to the private sector and the courts.  If eliminating licensing is politically infeasible, some preliminary steps might be generally acceptable.  States could increase workforce mobility by recognizing licenses issued by other states. At the very least, state legislators should be alert to the self-interest of medical professional organizations that may lie behind the licensing proposals brought to the legislature for approval."

Are consumers protected by education, licensing and other processes administered by political appointed bodies at the state level?  Are patients being served well in the US when there is greater import of foreign trained physicians than the capacity willingness of US medical schools to train US citizens for those rolls? Does the system truly protect the consumer?