Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-mzp66 Total loading time: 0 Render date: 2025-01-14T11:32:22.343Z Has data issue: false hasContentIssue false

10 - Licensing of Health Care Professionals

from Part II - Seller Cartels

Published online by Cambridge University Press:  24 November 2022

Roger D. Blair ,
Christine Piette Durrance  and
Tirza J. Angerhofer
Roger D. Blair
Affiliation:
University of Florida
Christine Piette Durrance
Affiliation:
University of Wisconsin
Tirza J. Angerhofer
Affiliation:
Duke University, North Carolina
Get access

Summary

Health care professions are regulated by state licensing boards, which are charged with promoting public health, safety, and welfare by preventing charlatans, incompetents, and quacks from practicing. Typically, these boards are populated by members of the profession being regulated since they have the requisite expertise to police the profession. However, professionals with the power to grant licenses may have a financial incentive to use that power to reduce competition and exclude other medical professionals. Reduced competition leads to higher prices and reduced access to health care. Concerned about this conflict of interest, the Supreme Court in North Carolina Dental agreed that the state should supervise such boards through the state action doctrine. In this chapter, we explore the competitive concerns economists and the antitrust Agencies have regarding professional licensure regulations. We identify two general antitrust concerns: (1) the exclusion of some competitors through entry limitations or practice restrictions and (2) supervision requirements that make the employment of competitors less attractive.

Keywords

state action doctrineoccupational licensingstate licensing boardsNorth Carolina Dental
Type
Chapter
Information
Antitrust Policy in Health Care Markets , pp. 230 - 254
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allensworth, Rebecca Haw. (2017). Foxes at the Henhouse: Occupational Licensing Boards Up Close. California Law Review 105: 1567–1610.Google Scholar
Allensworth, Rebecca Haw. (2020). Licensed to Pill. The New York Review. www.nybooks.com/daily/2020/07/21/licensed-to-pill/.Google Scholar
Areeda, Philip, and Hovenkamp, Herbert. (2021). Antitrust Law. 5th ed., Vol. II. New York: Wolters Kluwer.Google Scholar
Blair, Roger D., and Durrance, Christine Piette. (2015a). Economic Effects of Licensing Health Care Professions. Antitrust Health Care Chronicle 28: 29–34.Google Scholar
Blair, Roger D., and Durrance, Christine Piette. (2015b). Licensing Health Care Professionals, State Action, and Antitrust Policy. University of Iowa Law Review 100: 1943–1967.Google Scholar
Bulusu, Siri. (2021). FTC Settles with Alabama Dental Board over Teledentistry Rules. Bloomberg Law. https://news.bloomberglaw.com/health-law-and-business/ftc-settles-with-alabama-dental-board-over-teledentistry-rules.Google Scholar
Bulusu, Siri, Hao, Claire, and Mulvaney, Erin. (2021). Worker License Rules Emerge as FTC Competition Oversight Priority. Bloomberg Law. https://news.bloomberglaw.com/antitrust/worker-license-rules-emerge-as-ftc-competition-oversight-priority.Google Scholar
Edlin, Aaron S., and Allensworth, Rebecca Haw. (2014). Cartels by Another Name: Should Licensed Occupations Face Antitrust Scrutiny? University of Pennsylvania Law Review 162: 1093–1164.Google Scholar
Federal Trade Commission. (2014a). FTC Letter to Massachusetts House of Representatives. www.ftc.gov/sites/default/files/documents/advocacy_documents/ftc-staff-comment-massachusetts-house-representatives-regarding-house-bill-6-h.2009-concerning-supervisory-requirements-nurse-practitioners-nurse-anesthetists/140123massachusettnursesletter.pdf.Google Scholar
Federal Trade Commission. (2014b). Prepared Statement of the Federal Trade Commission: Competition and the Potential Costs and Benefits of Professional Licensure. www.ftc.gov/system/files/documents/public_statements/568171/140716professionallicensurehouse.pdf.Google Scholar
Federal Trade Commission. (2015a). FTC Letter to South Carolina House of Representatives. www.ftc.gov/system/files/documents/advocacy_documents/ftc-staff-comment-south-carolina-representative-jenny.horne-regarding-house-bill-3508-3078-advanced-practice-registered-nurse-regulations/151103scaprn.pdf.Google Scholar
Federal Trade Commission. (2015b). FTC Staff Guidance on Active Supervision of State Regulatory Boards Controlled by Market Participants. www.ftc.gov/system/files/attachments/competition-policy-guidance/active_supervision_of_state_boards.pdf.Google Scholar
Federal Trade Commission. (2020). FTC Letter to Kansas House of Representatives. www.ftc.gov/system/files/documents/advocacy_documents/ftc-staff-comment-kansas-house-representatives-concerning-kansas-house-bill-2412/v200006kansashb2412aprnscomment.pdf.Google Scholar
Friedman, Milton. (1962). Capitalism and Freedom. Chicago: University of Chicago Press.Google Scholar
Grzinic, Barbara. (2022). 9th Circuit Aligns with SmileDirectClub’s Antitrust Claims. Reuters. www.reuters.com/legal/litigation/9th-circuit-aligns-with-smiledirectclubs-antitrust-claims-2022-03-18/.Google Scholar
Hicks, John. (1939). The Foundations of Welfare Economics. Economic Journal 49: 696–712.CrossRefGoogle Scholar
Just, Richard E., Hueth, Darrell L., and Schmitz, Andrew. (2004), The Welfare Economics of Public Policy. Northampton, UK: Edward Elgar.Google Scholar
Kaldor, Nicholas. (1939). Welfare Propositions in Economic and Interpersonal Comparisons of Utility. Economic Journal 49: 549–552.CrossRefGoogle Scholar
Kleiner, Morris M. (2015). Reforming Occupational Licensing Policies. The Hamilton Project. www.brookings.edu/wp-content/uploads/2016/06/thp_kleinerdiscpaper_final.pdf.Google Scholar
National Conference of State Legislatures. (2017). The State of Occupational Licensing: Research, State Policies and Trends. www.ncsl.org/Portals/1/HTML_LargeReports/occupationallicensing_final.htm.Google Scholar
National Conference of State Legislatures. (2020). Occupational Licensing Final Report: Assessing State Policies and Practices. www.ncsl.org/research/labor-and-employment/occupational-licensing-final-report-assessing-state-policies-and-practices637425196.aspx.Google Scholar
Norris, Conor, and Timmons, Edward J.. (2020). Restoring Vision to Consumers and Competition to the Marketplace: Analyzing the Effects of Required Prescription Release. Journal of Regulatory Economics 57: 1–19.CrossRefGoogle Scholar
Obama White House. (2015). Occupational Licensing: A Framework for Policymakers. https://obamawhitehouse.archives.gov/sites/default/files/docs/licensing_report_final_nonembargo.pdf.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×