Of Castles and Healthcare Licenses

Healthcare calls for human relationship and innovation, but once again Lansing is presenting us with standardization and state control through new healthcare licenses.

Current Michigan bills create new licenses for dieticians, music therapists, mental health transporters, and naturopathic physicians, as well as nurse temp agencies and facilities for pain treatment, dialysis, and heart catheterization. (Bill links in the footnotes.)

These individuals currently serve patients. Full stop. Any original thought they may have after years of accredited education should be left in peace to develop for the good of humanity.

Instead, licensing builds persuasive castles in the air. If we are aware of the pattern, we may avoid getting sucked in.

Licenses Promise Castles In the Air

Each licensing story begins with a magical, mythical narrative promising to solve the worst woes of a given part of healthcare. Where pain points throb, or someone claims they do, state license regulation promises relief.

That’s Phase 1.

Phase 2 is a flurry of healthcare worker networking and touchingly naive lobbying to pass the new license law. The litany of promises are repeated in person, in committee, in headlines.

Phase 3 is jubilation – it passed!! The governor signed! All our work paid off!!

Phase 4 would be fulfillment of all the promises, if that ever happened. But somehow, it never quite does. Two recent examples are the Midwife License Law of 2015, and the Licensed Professional Counseling Law of 2019.

Midwife License Law

Passing the Michigan Midwife License Law was, at its most basic, the decision of certified home birth midwives to outlaw their fellow midwives who declined certification. Of course, the narrative wasn’t anything so blunt.

Instead, Phase 1 focused on the shortage of home birth midwives. Licensing, it was promised, meant legitimacy, respect from other professions, the ability to bill insurance, and growth of midwifery!

Phases 2 and 3 followed. The Midwife License Law officially took effect in 2017.

Five years later, how many midwives are there in Michigan? The Licensing and Regulatory Administration (LARA) lists only 74 – virtually the same as before the law.

Licensed Professional Counseling Law

LARA itself brought professional counselors to a fever pitch of demanding passage of the Licensed Professional Counseling Law.

It all began when LARA announced it would stop facilitating CMS reimbursement for counselling services. Instantly, the industry was in an uproar. Overnight, a facebook group gained thousands of members eager to actively lobby legislators.

The bill passed, was signed, and jubilation ensued.

Three years have passed, and once again, the promises remain elusive. The most active concerns in the LPC facebook group remain CMS refusal to reimburse. Only now, the second concern is how much time billing takes from patient care.

Licenses Keep One Promise

The silent promise of licensing is kept 100% of the time. Every new license comes with the guarantee of state regulation, fees, and paperwork in exchange for the right to earn a living.

In short, control of the profession.

Recently Michigan regulators have cracked the whip over Michigan health professions with fee increases, controlling which medications are prescribed, and indoctrinating us with cancel culture.

Patients and professionals both lose healthcare freedom in the licensing game. The state is the clear winner, with educators a close second. The secret of DPC success is leaving insurance billing behind.

Instead of getting sucked in by castles in the air, Michigan residents can form a more realistic mental picture of licensing from farm life.

From the state’s perspective, unlicensed (free) healthcare practitioners are untamed, dangerous, and probably not quite clean. 

But above all, they are potential cash cows.

The state uses licenses as farmers use a bull tongs nose lead – a painful way to enforce compliance. Michigan professionals are already paying for over 750,000 active licenses.

It’s 2022. Healthcare freedom deserves better than more licenses.

Current license bills:

Dieticians
Music therapists
Mental health transporters
Naturopathic physicians
Nurse temp agencies
Facilities for pain treatment, dialysis, and heart catheterization

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