An ex-convict and entrepreneur, a barber for several players on the Green Bay Packers could be forced to shut his doors thanks to an occupational licensing law resembling regulations that have long choked the supply of health care providers.
For example, relaxing state licensing requirements for medical school graduates would instantly add almost 5,000 health care professionals to the workforce, a new report by The Heritage Foundation states. Similarly, allowing midlevel providers termed dental therapists to obtain licenses would expand access to oral health care, as The Heartland Institute has repeatedly testified to lawmakers.
But if lawmakers really want to understand how occupational licensing chokes provider supply, they should visit Albert Walker’s Imago Dei Barber Lounge in Green Bay, Wisconsin—while they still can.
“As a Chicago gang member in the 1990s, [Walker] spent time in prison for attempted murder, kidnapping, drugs, and auto theft,” according to a Wisconsin Policy Research Institute video uploaded to YouTube on May 17. “When he was released, Albert pursued his love of cutting hair, eventually attending cosmetology school, earning his license and becoming a stylist for a number of the Green Bay Packers.”
Packers defensive end Mike Daniels became a customer at Walker’s Imago Dei (“image of God”) Barber Lounge soon after Green Bay drafted him in 2012, Daniels states in the video. Daniels calls Walker a “great spiritual leader,” “older brother,” and “heck of a barber.” Walker even officiated Mike and Heaven Daniels’ wedding in 2014.
A Wisconsin occupational licensing regulation now jeopardizes Walker’s ability to serve customers by requiring him to obtain a manager’s license to operate his own facility “despite his education, license, experience, investment, and customers,” the video states.
Occupational licensing laws essentially require people to obtain certification from the state before representing themselves as professional service providers, even if the market already demands their services. Officials usually purport to enact such laws for safety reasons. The laws imply lawmakers’ distrust of consumers and employers to use sound judgment when hiring service providers.
“They’re asking for 4,000 hours of training under another licensed cosmetologist manager,” Walker says. “I’ve got to go pay somebody else with less experience than me—to manage my shop. … A lot of this red tape stuff—all it does is restrict guys like me, and it forces us just to give up, and we end up going back to prison.”
Wisconsin lawmakers have before them a bill that would remove the manager’s license requirement, Senate Bill 109. If passed, the measure would allow consumers, instead of regulators, to choose who cuts their hair.
While they are at it, lawmakers in Wisconsin and 45 other states should remove occupational licensing barriers restricting the supply of health care providers. For most medical school graduates, the next step toward practicing medicine and earning board certification is completion of a residency training program. But almost 5,000 graduates failed to place in a residency program in 2017—or more than 8,000 when counting non-U.S. citizen international students and graduates, according to “Addressing the Physician Shortage by Taking Advantage of an Untapped Medical Resource,” a May 31 report by The Heritage Foundation.
States could put these medical graduates to work immediately by letting them obtain “provisional medical licenses,” with which graduates could “enter into collaborative, contractual agreements with practicing physicians who agree to supervise the trainees,” the report states. Arkansas, Kansas, Missouri, and Utah have already passed legislation of this kind.
Allowing provisional medical licensure would give doctors and hospitals more flexibility to staff their offices. No doctor or hospital would be forced to employ and supervise a trainee with a provisional medical license, just as dentists are not forced to employ and supervise dental therapists in the few states that have legalized that profession.
Relaxing occupational licensing restrictions empowers consumers. Given the opportunity, patients would determine—with their repeat business or lack thereof—whether provisionally licensed doctors, dental therapists, or other professionals provide services of sufficient value. The same goes for barbers.
Consumers can choose their own health care providers, just as they can choose their own barbers. Lawmakers can help by letting them.
—Michael T. Hamilton ([email protected], @MikeFreeMarket) is a Heartland Institute research fellow and managing editor of Health Care News, author of the weekly Consumer Power Report, and host of the Health Care News Podcast.
IN THIS ISSUE:
STATE-RUN SINGLE-PAYER HEALTH CARE WOULD BE PROHIBITIVELY EXPENSIVE – AND POSSIBLE ILLEGAL
State lawmakers in California and New York voted this year to pass state-run single payer health care plans, despite the fact that both states would need to double their existing tax revenue to pay for the new entitlement.
Both proposals have cleared one legislative chamber—in California, the state Senate; in New York, the state Assembly—and still need further approval before they can become law.
But even if those political hurdles are overcome, and even if the two states figure out how they are going to come up with the necessary tax revenue—about $400 billion in California’s case, and somewhere between $91 billion and $225 billion in New York’s—to make those systems functional, both may run into another problem: The whole thing could be against the law.
“Technically, it would be illegal for a state to set-up a single-payer health care system without getting permission from the federal government,” says Gail Wilensky, a health economist who worked in the George W. Bush administration and now serves as a senior fellow at Project HOPE, an international health foundation.
That permission, granted by the Department of Health and Human Services in the form of a waiver, would allow states to repurpose federal funds for Medicaid or Medicare, for example, into a newly established state-run health care system. Wilensky told Reason that there’s no reason to assume the federal government would block single-payer plans, but not all waiver requests have been granted in the past and politics are sure to play a role in how the Trump administration would handle such a request. …
SOURCE: Eric Boehm, Reason
SIX STATES TAKE ON HIGH DRUG PRICES, COULD HIT DRUG MAKER PROFITS
A number of states have proposed bills that take on the rising cost of drug pricing. And, unlike in the past, many are on track to becoming law.
It’s gotten to the point where Wall Street is starting to take notice.
“These laws are now at the ‘annoyance’ level, rather than material commercial impact but presumably once a coalition gels at [the] state level and reaps political rewards, more is possible,” Bernstein analyst Ronny Gal wrote.
Here are the states that have either passed bills, or are in the process of passing legislation that could increase transparency around drug prices.
In May, Maryland passed a drug pricing law that aims to curb generic drug price hikes by allowing Medicaid to alert the attorney general if drugmakers raise the price of a drug by 50% or more in a year, which could result in a fine. …
A new law in New York wants to pester drug companies for more information regarding drug price hikes, specifically when Medicaid spending rises. According to Gal’s note, it “smartly just ‘hassles’ drug companies for raising prices.” …
[Nevada:] The bill, known as SB 265, passed the Senate on May 19 and the Assembly on May 25, after facing opposition from lobbyists and nonprofit patient groups that disagree with the bill’s approach to reining in prescription drug spending. …
A ballot measure in Ohio, titled the Ohio Drug Price Relief Act, aims to cap the amount the state’s agencies pay for prescription drugs at the rate that the Department of Veteran Affairs pays.
It’s similar to California Prop 61, the most expensive ballot measure of the November 2016 election. Currently, the VA gets a discount of about 24% off traditional drug prices, and the agency can negotiate further discounts on top of that.
The ballot measure will be part of Ohio’s November election. …
California is taking a few different approaches to take on high drug prices. One, which limits drug companies’ ability to give gifts to medical professionals, passed the state senate in May. It’s now before the Assembly. …
In 2016, Vermont passed a bill that required drugmakers to provide justification for drug price hikes. In a report, state officials also had to report 15 drugs that had price increases of 15% in the past year, or 50% over the last five years. …
SOURCE: Lydia Ramsey, Business Insider
NINE SENATORS TO WATCH IN GOP’S DO-OR-DIE OBAMACARE REPEAL CRUNCH
In a process that has unfolded behind closed doors among tight-lipped Republican senators, the Senate is moving forward with its effort to repeal Obamacare, a conference-wide meeting planned for Tuesday, during which Republicans will hash out the major choices they’ll need to make in their legislation. But whether the options presented will appease the concerns of the dozen or so members who have claimed various sticking points or whose states pose unique challenges to the repeal effort remains to be seen. The senators had left for their Memorial Day recess last week saying that staffers were starting to work on draft legislation, but according to various reports, Republicans will only start writing legislative text for the thorniest issues after Tuesday’s meeting, with the hope for a vote in July or even late June.
“We’ve been talking about this for seven years, so now is the time to start coming up with some tangible alternatives and building consensus,” Sen. John Cornyn (R-TX) told reporters on Capitol Hill Monday afternoon.
Out of the 20 GOP senators from states that expanded Medicaid under Obamacare, at least a handful have come out against the way the program is phased out in the House repeal bill. Its provisions to defund Planned Parenthood, and to let states opt [out] of certain Affordable Care Act consumer protections, have also come up as points of contention for some Republican senators. …
Senate Republicans have said they are writing their own health care bill, but so far have not been able to point to any major changes to the House proposal they intend to make, beyond reworking its tax credit scheme. …
Here are nine Senate Republicans who present specific sticking points in the repeal debate, and are the ones to watch:
Susan Collins (R-ME) … Bill Cassidy (R-LA) … Lisa Murkowski (R-AK) … Dan Sullivan (R-AK) … Shelley Moore Capito (R-WV) … Dean Heller (R-NV) … Tom Cotton (R-AR) … Rob Portman (R-OH) … Cory Gardner (R-CO). …
SOURCE: Tierney Sneed, TPM
MAJOR OHIO INSURER WILL EXIT OBAMACARE MARKETPLACE IN 2018
One of Ohio’s major health insurers, Anthem Blue Cross and Blue Shield, will not sell policies to individuals and families in the Obamacare marketplace next year. The company cited a shrinking market for Affordable Care Act-related insurance and too much uncertainty in the federal regulatory environment.
To Obamacare critics, Anthem’s exit confirms that the law mandating health coverage is deeply flawed. Republicans in Washington jumped on the announcement to say this proves that repealing and replacing the 2010 law cannot wait.
But Democrats as well as healthcare advocates said the very problems cited by Anthem have been exacerbated by political and policy decisions by congressional Republicans and President Donald Trump. Revenue mechanisms in the act that were supposed to help insurers deal with financial uncertainty during the startup years have been short-circuited by Republicans who preferred to kill the act.
“This squarely falls in the lap of President Trump and the Congress,” said Kathleen Gmeiner, a project director at the Universal Health Care Action Network, in Columbus.
Countered Congressman Pat Tiberi, a Columbus-area Republican who has been working on a repeal-and-replace bill: “This is just more evidence that conditions under Obamacare are just going to get worse. It is collapsing under its own weight.” …
SOURCE: Stephen Koff, Cleveland.com