Re: Re: ephedra - should we license herbalists?

[Guest guest]

On Tue, 06 Jan 2004 10:36:07 -0500

katja <katja@...> wrote:

>the herbal community, at least my corner of it, is pretty torn. some people

>are really in favor of certification and stuff, others are not. personally

>i'm a less-regulation type of girl, and i trust myself to make good

>decisions about the competency of the people i run across, and i trust my

>own competency, so in general i'm kind of against regulation and i don't

>feel like this is a great thing.

>

>however, my more realistic me says that our citizenry has given over so

>much of its personal responsibility in favor of regulation that i don't

>guess i should expect them to be willing to take responsibility for finding

>competent people without some kind of licensing process.

>

Licensing doesn't protect people from bad practioners, in fact it

usually lowers quality because it gives people a false sense of comfort

(thus they stop doing their own due diligence). It also allows people

who otherwise would be out of business to stay in business because they

were able to demonstrate their written competence and gain a license

without regards to whether they are actually good or not.

In this country (USA), the original licensing of professions of any sort

were a part of the Jim Crow laws in the south. They were designed to

keep many newly freed slaves from practicing crafts and trades they were

highly skilled in by requiring a test, which they often couldn't pass

because many of them couldn't read or write.

There are many many laws like this still on the books for many

professions, some quite ridiculous:

http://www.jewishworldreview.com/cols/williams111401.asp

Occupational licensing is a very effective tool for creating a monopoly

by restricting entry and often creates an artificial shortage thereby

increasing the profits of those who are already a part of the " guild. "

Democrats, We Are Begging You

Return to the days of yesteryear

http://tinyurl.com/2ryhp

[Guest guest]

As a follow up to my original post, here is an article that presents the

case against medical licensing

Democrats, We Are Begging You

Return to the days of yesteryear

http://tinyurl.com/2ryhp

http://www.fff.org/freedom/0194d.asp

The Case against Medical Licensing

by Lawrence D. , MD.

For the first 120 years of our history, America had, essentially, a free-market

health-care system.

There were few licensing laws or other barriers to entry into the

healing arts. A variety of practitioners offered services, including

herbalists, nature-care therapists, hydrotherapists, osteopaths,

allopaths and homeopaths. There was a variety of healing schools and

clinics. During this time, America was among the healthiest nations,

with the lowest infant mortality rate in the world. (Now we are tied for

19th among 19 developed nations.) Costs were not a problem because open

competition kept prices down. Low costs made health care widely

accessible. Laws against fraud and negligence protected the consumer.

Efforts to change the situation began as early as 1847. In this year, the

American

Medical Association (AMA) was formed to protect the interests of one

group of doctors-the drug healers, or allopaths. This group, by the way,

at times did more harm than good with their mercury, arsenic, leaches

and other crude methods. One of the AMA's goals was to improve the

income of its members. The best way to do this was to limit the supply

of doctors.

The AMA's efforts culminated in 1910, when Abraham Flexner, a former school

director who was not a physician, was commissioned by the Carnegie

Foundation for the Advancement of Teaching to evaluate medical schools.

He was the brother of Simon Flexner, head of the Rockefeller Institute

for Medical Research. Working closely with the AMA, he completed a

survey of medical schools that was practically a carbon copy of a report

the AMA had done several years before. The report found most schools to

be " substandard. "

Mr. Flexner and his friends at the Carnegie Foundation, Rockefeller Institute

and

the AMA convinced Congress that to " improve " health care, most healing

schools should be closed. They also recommended licensing of doctors and

hospitals as well as governmental subsidies to drug-medicine schools and

research. These measures were all adopted by Congress between 1910 and

1920. The number of healing schools fell from 131 in 1910 to 69 in 1944.

The closings meant many fewer physicians were trained. Not surprisingly,

only the drug-medicine schools survived. The other healing schools were

either shut down or failed because their graduates could no longer get a

license. The situation remains the same today, except that several

alternative groups, including chiropractors and naturopaths, have fought

back by the passage of their own licensing laws in many states.

Problems with licensing can be divided into several groups:

Philosophical and Political Objections

o Licensing changes the profession of healing from a citizen's sovereign

right to contract with another to a state privilege. This greatly

expands the power of the state and reduces the sovereignty of the

individual. Also, the state is permitted to intrude deeply into one of

the most intimate contracts-that between the physician and patient.

o Medical-practice laws in most states make it a criminal offense to " diagnose,

prescribe, or treat anything, mental or physical, real or imaginary "

(quoted from the Arizona medical practice act). These laws needlessly

criminalize thousands of well-intentioned individuals who have done no

harm to anyone. Heavy-handed tactics, including daylight raids by SWAT

teams, have been used to enforce licensing laws. Also, the laws are so

vague that enforcement is often arbitrary and based on personal

antagonism, vindictiveness, or envy rather than clear legal guidelines.

o Licensing boards have police power, but are made up only of members of the

same profession. Ordinary citizens have little or no representation, but

must abide by decisions of the licensing board.

o Licensing is inextricably involved with the welfare state. For example,

Medicare will

only reimburse licensed practitioners. In Arizona, registered dietitians

fought hard to become licensed, not because of any public need, but so

that they could receive government insurance reimbursement. Medical

licenses also serve as " tickets of entry " for many government research

jobs, grants and fellowships. Medical licensing is, in fact, an integral

part of an arbitrary system of forced wealth redistribution.

Economic Objections

o Licensing places a barrier between the buyers and sellers of health services.

This restriction of trade reduces the supply of services. Reducing the

supply of health services increases the cost of services.

o Expensive schooling, internships, exam fees and licensing fees raise the cost

of entry

into the profession. These costs are passed on to the consumers of

health services, raising prices.

o Licensing reduces competition among practitioners, resulting in higher prices

and reduced quality of care.

o Licensing reduces innovation by specifying what is " approved " practice.

Reduced

innovation raises costs and lowers the quality of services.

Medical Objections

o Licensing reflects a fundamental misunderstanding of the nature of the healing

arts.

Healing is a gift and an art. Many gifted individuals cannot afford, or

for other reasons are not able to enter and complete, the six to twelve

years of schooling necessary to obtain a medical license. Licensing

deprives the population of the skill and art of these individuals.

o Licensing blocks innovation and the practice of alternative methods of

healing.

o A licensed physician is no longer responsible only to the patient. His loyalty

is divided

between satisfying the patient and satisfying his licensing board.

Social Objections

o Licensing gives the consumer of health care a false sense of security in his

physician

that can lead to false and unfulfilled expectations. This impairs the

doctor-patient relationship and contributes to dependency and, later,

anger and resentment. The present malpractice crisis is in part due to

excessively high expectations of the public, generated in part by

licensing of physicians.

o Licensing discriminates against the poor, who have more difficulty meeting

educational

and other requirements for licensure. Licensing has also been used to

keep minorities and women out of the healing professions.

Without licensing, private certifying agencies would spring up to replace state

licensure.

Many such groups already exist. One could still choose an AMA-approved,

board-certified physician. But one could also choose among a variety of

alternative practitioners who are not permitted to practice at present.

The public would be better protected from fraud and malpractice because

no physician would be shielded by his license. Physicians would be

directly accountable to their patients. Health care would operate in a

manner similar to car care. There would be many levels and types of care

available. Not everyone enjoys the same level of car care, but most

people receive care, innovations are permitted, and competition keeps

prices in check.

The negative effects of licensing include higher prices, reduced innovation,

reduced access to care, restriction of the right to contract, and much

poorer health of our population. Licensing also is an integral part of

the welfare state whose principles are alien to our American way of life.

America once did very well in the area of health care without medical

licensing. It is time to move toward our previously successful

experiment with a free-market system of health care.

Dr. has a medical degree and works as a health consultant and

writer in sdale, Arizona.