Friday, March 06, 2015
Professional Licensure and the Cost of Care
Last February 18, the US Supreme Court in a 6-3 decision ruled
that the Federal Trade Commission was allowed to charge the North Carolina
State Board of Dental Examiners with “anticompetitive and unfair actions.” It seems that spas and salons in the state
had been offering teeth whitening services, a service that had been shut down
by the Board as constituting the practice of dentistry without a license. The Board is dominated by dentists and
Justice Kennedy opined that “Active market participants cannot be allowed to
regulate their own markets free from antitrust accountability.”
Professional licensure is among the major barriers to cost
reduction in health care. Adopted for
the purpose of protecting the public from charlatans and unqualified providers,
they now effectively prevent provider organizations from experimenting with
different, more efficient ways of organizing and staffing the delivery of
health care services.
A case in point is the use of nurse practitioners and
physician’s assistants to provide primary care.
There is reason to argue that it ought to become standard practice and
some of it is happening but the change is proceeding at snail’s pace.
The North Carolina decision does not address that issue, but
it reminds us that professional licensure can have consequences other than
those initially intended.
