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Cannon also points to provider-licensing as a limit on competition that drives costs higher. These laws restrict the entry of new physicians (a recent University of Virginia study concluded that "half of all US states could resolve their physician shortages within five years just by equalizing migrant and native licensure requirements"). Red tape also limits the scope of practice of non-physician providers, such as nurse practitioners, limiting options for consumers. Along the same lines, Schansberg would sweep away obscure but restrictive certificates of need, that require many medical facilities and providers to seek government (and competitors') permission before opening their doors. Making it easier for providers to offer their services, and expanding the range of provider choices from which consumers can pick, would certainly help to lower costs by increasing supply.
Schansberg also points to the escalating cost of medicines and suggests loosening the noose of FDA regulations to ease the path of drugs to the market and reduce costs. The FDA might abandon its gatekeeper role and move to issuing the equivalent of a Good Housekeeping Seal instead, so providers and consumers could make informed choices for themselves.
One way to compromise on the government’s “nanny state” tendencies and bureaucratic conservatism would be to allow “dual tracking”—where the government continues to regulate but allows informed choice until a final decision is made (Madden 2010). A better alternative would be for the FDA to allow private certifiers to regulate these markets. The FDA could then play the role of “certifier of certifiers,” rather than certifier of products (Miller 2000: 90). The FDA could allow certification, rather than treating its findings as a mandate for complete approval or disapproval. In other words, the FDA could merely provide information, instead of making a decision for those who might want to try a given drug.
None of these proposals are "pure" free-society solutions to the current health care mess, which several of the authors themselves admit. A truly free market in health services would evolve on its own to meet people's needs, rather than be designed and legislated. But these ideas constitute a step away not just from the Obamacare fiasco, but from the highly regulated, increasingly unsatisfactory situation that prevailed beforehand. They involve less coercion, fewer dictates from above, and more dynamism and choice.
Maybe someday we'll be able to pick and choose our health care in a world that offers all of the options and innovation that we find when we go out to eat. For now, though, let's just do our best not to end up with the medical equivalent of shit on a shingle.