Gov. Mark Dayton declared recently that the Minnesota Board of Nursing was "asleep at the switch" for failing to revoke some nurses' occupational licenses, as documented in a Star Tribune series "When Nurses Fail" (periodically, October through December 2013). In response, the board is considering ratcheting up its enforcement, including gaining access to records of some nurses' personal use of prescription drugs.
Incompetent nurses who are repeatedly fired and rehired elsewhere should certainly prompt a review of the board's effectiveness. But the governor and legislators shouldn't stop there — they should also inquire into the law's effectiveness. They'll find occupational licensing laws don't work.
Research by both the Institute for Justice and Prof. Morris Kleiner, the AFL-CIO chair of labor policy at the University of Minnesota's Humphrey Institute, shows that occupational licensing laws don't protect consumers, but rather that they protect license holders from competition.
This is, in part, because licensing boards have conflicts of interest. In Minnesota, they comprise mostly members of the profession they oversee, and they depend on license holders' fees to pay the salaries of board members, inspectors and other employees.
But a second cause is underappreciated by elected officials.
Licensing boards rarely revoke licenses. The Minnesota Board of Nursing's failure to revoke licenses is the rule, not the exception.
This is because constitutional law recognizes the hard work that goes into obtaining a license and requires extensive hearings and proceedings before revocation, which may include going before a judge and appealing to higher courts. This process can cost boards hundreds of thousands of dollars in litigation expenses — far more than their revenue. To avoid these costs, boards give license holders multiple chances. This respects license holders' rights and saves boards' money, but it does not protect consumers who rely on licensing as a signal of quality, which it is not.
State leaders need to consider alternatives to occupational licensing that give consumers better information.