8 ms·

For anyone that wants to read the study. (https://ij.org/wp-content/uploads/2018/11/Licensure_Report_WEB.pdf https://ij.org/wp-content/uploads/2018/11/Licensur

For anyone that wants to read the study. (https://ij.org/wp-content/uploads/2018/11/Licensure_Report_WEB.pdf https://ij.org/wp-content/uploads/2018/11/Licensure_Report_W...) I glanced through it and was not impressed.Why would they not show me what are the pros and cons of licensing besides just the cost. Would you not want someone to be able to verify that they have the skills to do what they say they offer. ( I understand that depending on the occupation this may be up for debate, due to verification issues and people gaming the tests, but I bet it becomes paramount where the occupation is related a matter of life or death like a doctor/surgeon. I am sure there are things where getting a license is ridiculous, but for other areas where it is absolutely necessary. What I found interesting is that, those with licenses make more money? It seems if I wanted to lobby an organization to suppress wages, it be at a place such as the " Institute for Justice."

mywittyname 8y ago
A lot of people have the luxury of raging against licensing and regulation because they don't remember the world before these existed. It's just assumed that most people are honest about their work and the who aren't will be swiftly punished. But in most cases, it's the opposite: the honest people get driven out because scammers can promise the world for a penny because they know they will never deliver. People were fed up with being swindled left and right, so they decided to get the government to step in. Obviously, they've been highly successful because Libertarians can't even imagine the world as it was 100 years ago.
- Consultant32452 8y ago
  I remember an unregulated internet. It was better.
  - trylist 8y ago
    The internet has literally never been unregulated.
    - Simulacra 8y ago
      I'd say it's fairly unregulated. Where else could the silk road, 4chan, or furnitureporn.com exist??
      - dontparticipate 8y ago
        I can put a kilo of cocaine in my trunk and drive on the highway, that does't mean the roads are unregulated.
      - starbeast 8y ago
        Very slowly through the postal system.
  - moate 8y ago
    Pics or it didn't happen.
  - awakeasleep 8y ago
    Didn't regulation create the Internet? Although if your point is "some regulations are better than others" I definitely agree with you.
    - Consultant32452 8y ago
      Software generally and the internet specifically are relative "wild wests" compared to most industries. Literally anyone can write software or create a website. You don't need any fancy degrees, you don't need a license/certification, and generally speaking you don't really need permission. There's very few things which are "difficult" to do, categories of content which will be difficult to get hosted. This is slowly getting chipped away though. There's more and more national internet filters, even in relatively free places like UK. There's GDPR, DMCA, SESTA/FOSTA, etc.
- pzone 8y ago
  The world is also very different than it was 100 years ago. Today we can review a barbershop on Yelp and complain they aren't cleaning their tools. Today we can share digital medical records and delegate decisions to nurse practitioners while having the option to fall back to a doctor if necessary. There may have been good reasons for certain licensing laws 100 years ago but that doesn't mean those reasons are still valid today.
deleted 8y ago
[deleted]
AnthonyMouse 8y ago
> Why would they not show me what are the pros and cons of licensing besides just the cost. Calculating only the cost is useful information. If you have something that produces a $5B benefit at a $4.5B cost, the proponents will tout a $500M gain without considering whether there is any alternative that can produce the same benefit at a much lower cost. It points out that there is a very large cost which is an opportunity for optimization. For example, if hairdressers are licensed due to questions of sanitation, perhaps the same benefit -- or more benefit -- could be achieved through periodic health inspections rather then licensing individual hairdressers. Perhaps having licenses for electricians is net positive, but the existing licensing system is wasteful or corrupt and makes it artificially more difficult to obtain a license than is optimal. Perhaps it is useful to license doctors and lawyers, but much of the work the law currently requires them to do is less sensitive and could reasonably be allowed to be done by nurses and paralegals instead. > What I found interesting is that, those with licenses make more money? This is the same kind of issue. If you make an extra $5000 but have to spend $5500 in time/money related to keeping your license, you're not making $5000 more, you're losing $500. But your customers are paying $5000 more. And someone who was qualified but couldn't navigate the Kafakaesque licensing system had to take a lower paying job doing something else.
- da_chicken 8y ago
  > Calculating only the cost is useful information. I mean, kind of, but it's not remotely the only relevant piece of information. I could make you a car for $2,000. Would you want to drive it at highway speeds in it? What do you think your chances of survival would be in an accident? The article makes a point to call out the music therapy case to conjure the specter of seemingly unnecessary regulation leading to regulatory capture, but the vast majority of licensed occupations are licensed because bad shit happened when they weren't. Doctors were quacks. Bridges fell down. Buildings caught fire. Planes fell from the sky. Millions of dollars in damages and countless lives were lost over and over because some greedy sumbitch decided to cut corners or defraud his customers or just didn't think about the consequences of his design or service decisions. These regulations exist because people ruined it. And I mean, is music therapy dangerous if it's misused? I don't know. I don't even know what music therapy is used to treat! What harm can unethical application music therapy cause? Physiotherapy can easily be unethical. So can psychotherapy and counseling. Why is music therapy harmless, especially if it's been shown to have measurable heath effects? And how can I tell the difference between an actual music therapist whose treatment is based on established practices, and some guy with a blindfold, some headphones, a nice couch, and an mp3 player? Rely on my for-profit insurance company to do that for me, when they have a conflict of interest as well? Yes, it's difficult to gauge the effectiveness of regulation, especially because you can't tell if what you got for $5,000 in regulation might have been just as effective as if it had cost $500. But arguing that the choice of whether or not to regulate comes down entirely to cost is kind of absurd.
notahacker 8y ago
If you wanted to do the study fairly, you'd make also some attempt to quantify the benefits from fewer accidents, lower insurance premiums, lower remediation costs and faster work etc associated with licensed professionals carrying it out. In a number of fields, you might well get an indication that there's a net financial benefit to doing so (even before you start trying to quantify intangible stuff like peace of mind). If you wanted to represent the scope of the study honestly, you wouldn't claim the gross difference in earnings between licensed and unlicensed professionals as the "cost" You'd probably want something more granular than SOC code and age to identify the difference between the premium licensed professionals earn for having their document and the premium they earn for also being on average more experienced and capable professionals performing more specialised and difficult work than unlicensed ones in their field. But then the study is far more about headlines than anything else. Disappointed they weren't bold enough to note that the coefficient on "married" was similar in size to the coefficient on "licensed" and use the same dataset to argue that "U.S. Consumers and the Economy Loses Billions to Professionals Being Married"!
- dahfizz 8y ago
  > If you wanted to do the study fairly, you'd make also some attempt to quantify the benefits from fewer accidents, lower insurance premiums, lower remediation costs and faster work etc associated with licensed professionals carrying it out. I disagree. The report is eplicitly about the costs of licensing. It's not trying to be an all encompassing and comprehensive study of all possible pros and cons. Let those benefits be the focus of another study. "Hey $accountant, I need you to write up a report of all business expenditures." "Sorry boss, that wouldn't be fair. All I'll tell you is that we made a net profit of X million. I don't want to tell only one side of the story"
  - soundwave106 8y ago
    It's not a terribly useful study to me as a result. Granted, the parent piece from a libertarian think tank, so this type of report - an advocacy document - is what to expect. That's fine. But you can also find advocacy from the other side, too... for instance, an advocacy piece concerning the costs (via shoddy work) of using unlicensed contractors for construction, courtesy of Angie's List. (https://www.angieslist.com/articles/how-unlicensed-contractors-can-cost-you.htm https://www.angieslist.com/articles/how-unlicensed-contracto...) What we don't have is the proper detail to allow me to make up my mind which cases licensing makes sense, and in which cases licensing doesn't. Sure, licensing has costs. That doesn't tell me anything, because licensing may protect me from bad work quality, which also can cost money, or even possibly be a safety hazard (eg the shoddy electrician that didn't ground a light and nearly electrocuted another worker as a result in the Angie's List piece). I am fine with the position that occupational licenses aren't necessary for careers where licensing doesn't add any value. But my hunch is that in many careers, licensing adds value overall. The posted piece did nothing to change my position on this.
jstarfish 8y ago
> Would you not want someone to be able to verify that they have the skills to do what they say they offer. The state of Georgia (and likely many others) requires chiropractors to have a license. Please explain how the State is uniquely qualified to determine the competence of a practitioner of junk science?
- ahallock 8y ago
  Please explain how snide, dismissive statements contribute to a healthy discussion? There are chiropractic techniques which I do not agree are junk science and produce good outcomes for patients. For example: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081245/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081245/
  - grandmczeb 8y ago
    I don’t think anyone thinks patients can’t have good outcomes after having chiropractic techniques applied - it’s more a question of causality. A single case where spinal manipulation was used to successfully treat tinnitus is probably not a good argument in that case.
  - A2017U1 8y ago
    How does it compare against a placebo in a double blind trial? This is simply a single case report with no comparison. Chiropractic remedies have a long history of being questionable. Wikipedia provides many sources: > Systematic reviews of this research have not found evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain.[4] A critical evaluation found that collectively, spinal manipulation was ineffective at treating any condition > It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases. https://en.wikipedia.org/wiki/Chiropractic https://en.wikipedia.org/wiki/Chiropractic
zdragnar 8y ago
> What I found interesting is that, those with licenses make more money? Some (most? all?) US states require not only a degree but "ongoing education" every other year that can amount to a not insignificant chunk of wages. It's pretty awful from those I know in the field.
- jandrese 8y ago
  There is a cottage industry around passing around the material for those courses. My wife worked in the pharmacy field and had those requirements. The courses were mostly made by the drug companies and were thinly disguised marketing material.
- Simulacra 8y ago
  In the case of dietitians, ONLY a dietitian can be licensed in those states that require it, and only the dietetics board of all dietitians get to decide who can be license. In Florida there are 22 million people, but because of the license monopoly, only 4,000 dietitians.
sfifs 8y ago
Market forces working through reputation generally do take care of verification fairly well in many countries - even more so in this era of free access to information. I find it ironic that in "socialist" (India, China) countries, these things primarily seem to run via free market forces with little or no licensing restrictions of who can practice a trade while in "free market" countries, there's endless red tape of who is allowed to carry out what trade. Ultimately these systems are not about quality, they're about restricting free market in the labor pool to keep prices in a trade high.
- mcguire 8y ago
  Weird that you mention China. https://en.m.wikipedia.org/wiki/2007_pet_food_recalls?wprov=sfla1 https://en.m.wikipedia.org/wiki/2007_pet_food_recalls?wprov=... https://en.m.wikipedia.org/wiki/2008_Chinese_milk_scandal?wprov=sfla1 https://en.m.wikipedia.org/wiki/2008_Chinese_milk_scandal?wp... https://qz.com/1323471/ten-years-after-chinas-melamine-laced-infant-milk-tragedy-deep-distrust-remains/ https://qz.com/1323471/ten-years-after-chinas-melamine-laced... https://en.m.wikipedia.org/wiki/Chinese_drywall?wprov=sfla1 https://en.m.wikipedia.org/wiki/Chinese_drywall?wprov=sfla1
  - pzone 8y ago
    Product safety is certainly an area where strong regulation is valuable, however this article is focused on occupational licensing.

mywittyname 8y ago

A lot of people have the luxury of raging against licensing and regulation because they don't remember the world before these existed. It's just assumed that most people are honest about their work and the who aren't will be swiftly punished. But in most cases, it's the opposite: the honest people get driven out because scammers can promise the world for a penny because they know they will never deliver. People were fed up with being swindled left and right, so they decided to get the government to step in. Obviously, they've been highly successful because Libertarians can't even imagine the world as it was 100 years ago.

Consultant32452 8y ago
I remember an unregulated internet. It was better.
- trylist 8y ago
  The internet has literally never been unregulated.
  - Simulacra 8y ago
    I'd say it's fairly unregulated. Where else could the silk road, 4chan, or furnitureporn.com exist??
    - dontparticipate 8y ago
      I can put a kilo of cocaine in my trunk and drive on the highway, that does't mean the roads are unregulated.
    - starbeast 8y ago
      Very slowly through the postal system.
- moate 8y ago
  Pics or it didn't happen.
- awakeasleep 8y ago
  Didn't regulation create the Internet? Although if your point is "some regulations are better than others" I definitely agree with you.
  - Consultant32452 8y ago
    Software generally and the internet specifically are relative "wild wests" compared to most industries. Literally anyone can write software or create a website. You don't need any fancy degrees, you don't need a license/certification, and generally speaking you don't really need permission. There's very few things which are "difficult" to do, categories of content which will be difficult to get hosted. This is slowly getting chipped away though. There's more and more national internet filters, even in relatively free places like UK. There's GDPR, DMCA, SESTA/FOSTA, etc.
pzone 8y ago
The world is also very different than it was 100 years ago. Today we can review a barbershop on Yelp and complain they aren't cleaning their tools. Today we can share digital medical records and delegate decisions to nurse practitioners while having the option to fall back to a doctor if necessary. There may have been good reasons for certain licensing laws 100 years ago but that doesn't mean those reasons are still valid today.

deleted 8y ago

[deleted]

AnthonyMouse 8y ago

> Why would they not show me what are the pros and cons of licensing besides just the cost. Calculating only the cost is useful information. If you have something that produces a $5B benefit at a $4.5B cost, the proponents will tout a $500M gain without considering whether there is any alternative that can produce the same benefit at a much lower cost. It points out that there is a very large cost which is an opportunity for optimization. For example, if hairdressers are licensed due to questions of sanitation, perhaps the same benefit -- or more benefit -- could be achieved through periodic health inspections rather then licensing individual hairdressers. Perhaps having licenses for electricians is net positive, but the existing licensing system is wasteful or corrupt and makes it artificially more difficult to obtain a license than is optimal. Perhaps it is useful to license doctors and lawyers, but much of the work the law currently requires them to do is less sensitive and could reasonably be allowed to be done by nurses and paralegals instead. > What I found interesting is that, those with licenses make more money? This is the same kind of issue. If you make an extra $5000 but have to spend $5500 in time/money related to keeping your license, you're not making $5000 more, you're losing $500. But your customers are paying $5000 more. And someone who was qualified but couldn't navigate the Kafakaesque licensing system had to take a lower paying job doing something else.

da_chicken 8y ago
> Calculating only the cost is useful information. I mean, kind of, but it's not remotely the only relevant piece of information. I could make you a car for $2,000. Would you want to drive it at highway speeds in it? What do you think your chances of survival would be in an accident? The article makes a point to call out the music therapy case to conjure the specter of seemingly unnecessary regulation leading to regulatory capture, but the vast majority of licensed occupations are licensed because bad shit happened when they weren't. Doctors were quacks. Bridges fell down. Buildings caught fire. Planes fell from the sky. Millions of dollars in damages and countless lives were lost over and over because some greedy sumbitch decided to cut corners or defraud his customers or just didn't think about the consequences of his design or service decisions. These regulations exist because people ruined it. And I mean, is music therapy dangerous if it's misused? I don't know. I don't even know what music therapy is used to treat! What harm can unethical application music therapy cause? Physiotherapy can easily be unethical. So can psychotherapy and counseling. Why is music therapy harmless, especially if it's been shown to have measurable heath effects? And how can I tell the difference between an actual music therapist whose treatment is based on established practices, and some guy with a blindfold, some headphones, a nice couch, and an mp3 player? Rely on my for-profit insurance company to do that for me, when they have a conflict of interest as well? Yes, it's difficult to gauge the effectiveness of regulation, especially because you can't tell if what you got for $5,000 in regulation might have been just as effective as if it had cost $500. But arguing that the choice of whether or not to regulate comes down entirely to cost is kind of absurd.

notahacker 8y ago

If you wanted to do the study fairly, you'd make also some attempt to quantify the benefits from fewer accidents, lower insurance premiums, lower remediation costs and faster work etc associated with licensed professionals carrying it out. In a number of fields, you might well get an indication that there's a net financial benefit to doing so (even before you start trying to quantify intangible stuff like peace of mind). If you wanted to represent the scope of the study honestly, you wouldn't claim the gross difference in earnings between licensed and unlicensed professionals as the "cost" You'd probably want something more granular than SOC code and age to identify the difference between the premium licensed professionals earn for having their document and the premium they earn for also being on average more experienced and capable professionals performing more specialised and difficult work than unlicensed ones in their field. But then the study is far more about headlines than anything else. Disappointed they weren't bold enough to note that the coefficient on "married" was similar in size to the coefficient on "licensed" and use the same dataset to argue that "U.S. Consumers and the Economy Loses Billions to Professionals Being Married"!

dahfizz 8y ago
> If you wanted to do the study fairly, you'd make also some attempt to quantify the benefits from fewer accidents, lower insurance premiums, lower remediation costs and faster work etc associated with licensed professionals carrying it out. I disagree. The report is eplicitly about the costs of licensing. It's not trying to be an all encompassing and comprehensive study of all possible pros and cons. Let those benefits be the focus of another study. "Hey $accountant, I need you to write up a report of all business expenditures." "Sorry boss, that wouldn't be fair. All I'll tell you is that we made a net profit of X million. I don't want to tell only one side of the story"
- soundwave106 8y ago
  It's not a terribly useful study to me as a result. Granted, the parent piece from a libertarian think tank, so this type of report - an advocacy document - is what to expect. That's fine. But you can also find advocacy from the other side, too... for instance, an advocacy piece concerning the costs (via shoddy work) of using unlicensed contractors for construction, courtesy of Angie's List. (https://www.angieslist.com/articles/how-unlicensed-contractors-can-cost-you.htm https://www.angieslist.com/articles/how-unlicensed-contracto...) What we don't have is the proper detail to allow me to make up my mind which cases licensing makes sense, and in which cases licensing doesn't. Sure, licensing has costs. That doesn't tell me anything, because licensing may protect me from bad work quality, which also can cost money, or even possibly be a safety hazard (eg the shoddy electrician that didn't ground a light and nearly electrocuted another worker as a result in the Angie's List piece). I am fine with the position that occupational licenses aren't necessary for careers where licensing doesn't add any value. But my hunch is that in many careers, licensing adds value overall. The posted piece did nothing to change my position on this.

jstarfish 8y ago

> Would you not want someone to be able to verify that they have the skills to do what they say they offer. The state of Georgia (and likely many others) requires chiropractors to have a license. Please explain how the State is uniquely qualified to determine the competence of a practitioner of junk science?

ahallock 8y ago
Please explain how snide, dismissive statements contribute to a healthy discussion? There are chiropractic techniques which I do not agree are junk science and produce good outcomes for patients. For example: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081245/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3081245/
- grandmczeb 8y ago
  I don’t think anyone thinks patients can’t have good outcomes after having chiropractic techniques applied - it’s more a question of causality. A single case where spinal manipulation was used to successfully treat tinnitus is probably not a good argument in that case.
- A2017U1 8y ago
  How does it compare against a placebo in a double blind trial? This is simply a single case report with no comparison. Chiropractic remedies have a long history of being questionable. Wikipedia provides many sources: > Systematic reviews of this research have not found evidence that chiropractic manipulation is effective, with the possible exception of treatment for back pain.[4] A critical evaluation found that collectively, spinal manipulation was ineffective at treating any condition > It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases. https://en.wikipedia.org/wiki/Chiropractic https://en.wikipedia.org/wiki/Chiropractic

zdragnar 8y ago

> What I found interesting is that, those with licenses make more money? Some (most? all?) US states require not only a degree but "ongoing education" every other year that can amount to a not insignificant chunk of wages. It's pretty awful from those I know in the field.

jandrese 8y ago
There is a cottage industry around passing around the material for those courses. My wife worked in the pharmacy field and had those requirements. The courses were mostly made by the drug companies and were thinly disguised marketing material.
Simulacra 8y ago
In the case of dietitians, ONLY a dietitian can be licensed in those states that require it, and only the dietetics board of all dietitians get to decide who can be license. In Florida there are 22 million people, but because of the license monopoly, only 4,000 dietitians.

sfifs 8y ago

Market forces working through reputation generally do take care of verification fairly well in many countries - even more so in this era of free access to information. I find it ironic that in "socialist" (India, China) countries, these things primarily seem to run via free market forces with little or no licensing restrictions of who can practice a trade while in "free market" countries, there's endless red tape of who is allowed to carry out what trade. Ultimately these systems are not about quality, they're about restricting free market in the labor pool to keep prices in a trade high.

mcguire 8y ago
Weird that you mention China. https://en.m.wikipedia.org/wiki/2007_pet_food_recalls?wprov=sfla1 https://en.m.wikipedia.org/wiki/2007_pet_food_recalls?wprov=... https://en.m.wikipedia.org/wiki/2008_Chinese_milk_scandal?wprov=sfla1 https://en.m.wikipedia.org/wiki/2008_Chinese_milk_scandal?wp... https://qz.com/1323471/ten-years-after-chinas-melamine-laced-infant-milk-tragedy-deep-distrust-remains/ https://qz.com/1323471/ten-years-after-chinas-melamine-laced... https://en.m.wikipedia.org/wiki/Chinese_drywall?wprov=sfla1 https://en.m.wikipedia.org/wiki/Chinese_drywall?wprov=sfla1
- pzone 8y ago
  Product safety is certainly an area where strong regulation is valuable, however this article is focused on occupational licensing.