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Mutualist Blog: Free Market Anti-Capitalism

To dissolve, submerge, and cause to disappear the political or governmental system in the economic system by reducing, simplifying, decentralizing and suppressing, one after another, all the wheels of this great machine, which is called the Government or the State. --Proudhon, General Idea of the Revolution

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Location: Northwest Arkansas, United States

Sunday, March 05, 2006

License to Shrink Heads

From Rad Geek. A psychologist (ahem, psychotherapist) falls afoul of the licensing cartels for having not genuflected to the gods of "Bureaucratic Rationality":

[Lucy Wightman] was liked in part because she was more laid-back than your typical psychologist. She didn’t wear makeup, and dressed in flowing skirts and turtleneck sweaters during her meetings with patients. Often her dog, Perry, was by her side. "My daughter, says one Braintree mother, fell in love with her at first sight."...

Wightman was indicted on 26 counts of felony larceny, six counts of filing false health-care claims, six counts of insurance fraud, and one count of practicing psychology without a license. Michael Goldberg, the president of the Massachusetts Psychological Association and a psychologist in Norwood, compares it to a surgeon operating without a medical license.

… When Al Deluca, 38, began seeing Wightman in the summer of 2003 to talk about his marital problems, he says Wightman told him not to file an insurance claim because she was not licensed. Many patients, however, believed that she was. The word psychology was in her business name, and that, according to Eric Harris, a lawyer for the Massachusetts Psychological Association, is enough to put an unlicensed practitioner in violation of the law. Her e-mail address is "Dr. Wightman." Her billing statements are printed with "Lucy Wightman, Ph.D."

… While a person can legally practice psychotherapy without a license in Massachusetts, state law requires that psychologists have a degree in psychology from a state-recognized doctoral program and that they be licensed with the state Division of Professional Licensure. Licensed psychologists must also have two years of supervised training. They must take specific courses, pass an exam, and meet continuing-education standards long after they have tacked their degrees to the wall.

… “I HAVE A FULL CASE LOAD RIGHT NOW,” WIGHTMAN E-MAILED IN mid-November. She was talking about her practice, still running and apparently still prospering. The name has changed. It’s now called South Shore Psychotherapy, a notable distinction legally. The people who come to see her don’t care what she calls herself.

In the medical field, likewise, the state's licensing cartel sets a minimum level of expertise and training that you're allowed to hire. Even for a medical problem that doesn't require that level of training, you've got to buy the whole package. I discussed the issue in an earlier post, "The Right to Self-Treatment." While many medical tasks require the full expertise acquired in the full course of med school and internship, many do not: what about setting an ordinary fracture, say, or listening to someone's lungs and doing a sputum culture to prescribe a round of antibiotics for pneumonia?

A paralegal has all the expertise needed to help someone, say, file the papers for a Chapter Seven, and talk him through the process. But only a licensed attorney who has absorbed the full law school curriculum of torts, contracts, property, criminal law, etc., can perform this basic task.

Same thing goes for practicing skilled trades. If you teach yourself to do specific rewiring or plumbing tasks satisfactorally, and then do them for your neighbor in return for some consideration (only those tasks that you've learned to do well, mind you), then you fall afoul of the licensing cartels. Their effect is to set hurdles for translating skill into service, and for transmitting skill from one person to another, and thus to create artificially higher prices for basic services.

13 Comments:

Anonymous Battlepanda said...

This reminds me of the story I heard on NPR about excessively difficult standards in getting the floristry license in Louisiana, basically to curtail competition.

March 05, 2006 7:22 PM  
Blogger Kevin Carson said...

I hear it's even worse in some places like New York. If there's any evidence you've been working on the plumbing yourself, the unions won't touch it. I'm all for unions as a collective bargaining agent dealing with an employer, but not as a cartel for screwing the customer.

March 05, 2006 10:17 PM  
Anonymous Stefan said...

I don't want to burst your bubble, as I am well aware that in a libertarian society caveat emptor will be the rule rather than the exception. However, putting "Lucy Wightman, Ph.D." on a business card sounds a lot like fraud to me. The article says she got her degree from a diploma mill, and I think a reasonable case can be made that this is not what most people understand by the term "Ph.D". Keep in mind that in a libertarian society people can still commit fraud by deception or trademark violation (although that might not go for you mutualist types?).

That said, one of the advantages of a free-market would be that the diploma mills would still exist, but consumers and employers would be more watchful, perhaps using something like a Consumer Reports magazine for Ph.D.'s to make their decisions. The whole mess is a disgusting example of the harm the regulatory state perpetuates by its very existence.

March 06, 2006 1:41 AM  
Blogger Kevin Carson said...

Stefan,

I don't think caveat emptor should cover outright fraud or deception, even in a free market society. To the degree that she misrepresented her credentials, she was clearly in the wrong. But that's a separate issue from operating without a license as such. I should have dealt more with the first issue in the post, and distinguished between them. Sloppy writing on my part.

March 06, 2006 12:53 PM  
Anonymous Wild Pegasus said...

I'm not sure that caveat emptor will be the rule of libertarian legal societies. There's nothing in libertarianism to compel caveat emptor, and in cases like product liability, it seems manifestly unjust.

- Josh

March 06, 2006 4:54 PM  
Anonymous Stefan said...

Well since caveat emptor is the natural state of affairs, I'm assuming it would return to this once government is eliminated.

If you think about it, no seller can ever guarantee for all time that no harmful effects whatever will result from using a product. If you have some previously unknown lethal allergy to a compound found in turkey, for example, and you buy my turkey and eat it, it's hard to see how I'm responsible for the consequences.

Does this mean sellers are never responsible for harm resulting from use of their products? Of course not; if I sell you apples laced with enough cyanide to kill you, then arguably I cheated you since in ordinary english "apple" refers to the natural un-poisoned sort you find on trees. But if I sell apples with a disclaimer reading "Warning, these apples may or may not be poisoned" and the buyer reads the disclaimer, then once again it's hard to see how I have responsibility.

Since there are a myriad number of ways in which a product can have harmful side-effects, I conclude that something like caveat emptor will be the rule rather than the exception with trades under a free market. It's simply impossible to guarantee that no harm will accidentally result from a given product for all individuals. Therefore, while some countermeasures might be available (perhaps you get the "We don't sell poisoned apples" seal-of-quality from the local Wicked Queen), I think you'll be seeing the label "Satisfaction is not guaranteed" on an awful lot of products once the regulatory state is gone.

Note further I do not regard this as a bad thing, per se. As I have argued, this kind of problem is inherent in commerce in the first place. The only role the regulatory state performs is to give people a false sense of security ("I can buy apples since government regulations prevent them from being poisoned"), and prevent certain beneficial but risky transactions (like those involving new untested cancer drugs).

March 06, 2006 7:07 PM  
Blogger Kevin Carson said...

Josh and Stefan,

What it boils down to, IMO, is that if some kind of civil law of torts persisted in a free market court system, the implied warranty--along with other forms of implied contract--would continue to exist as well. The implied warranty is that a product will do the job it was sold for, and meets the normally expected standards for that class of product. Of course, filling in the content depends on what are regarded as reasonable expectations in a particular market area. But if you sell a car with sawdust in the tranny, your victim has a right to his money back. The seller might be able to get away with it if he had a sign posted along the lines of "Warning: transmission may be stuffed with sawdust." But "as is, no refunds" just wouldn't cut it.

March 06, 2006 10:01 PM  
Anonymous P.M.Lawrence said...

Stefan, you don't know enough about apples. If you sold someone a "natural" apple, there would be a fatal dose of cyanide in it. They're only safe to eat because it's in the pips, and not much gets out unless you grind them and destructively distil them.

March 07, 2006 1:33 AM  
Anonymous Stefan said...

Ah, true P.M. Lawrence. I should have said "distilled and mixed into the apple" or something.

I think you're right about the sawdust example Kevin, but I'm not sure I'd be willing to attribute it to "implicit contract". Rather, I would say that the general meaning of the term "car" implies something like "having a working transmission, battery, etc" as opposed to being stuffed with sawdust. I think our disagreement is merely semantic however.

Mainly I was concerned with the example of someone who wants to buy experimental cancer treatment X even though there may be no evidence that it works. Currently the FDA prevents such transactions from taking place. In a free market people might not sell such drugs if there is always the implicit contract that "the drug will successfully cure your disease" attached to the sale of medicines. In that situation you could either not call it a "medicine" (perhaps sell it as a "chemical"), or else attach a warning label like "This may or may not kill you". The important point is that there has to be some way of absolving the seller of responsibility for misuse when customers want them to be absolved of it, as in the case with Lucy Wightman where the customers don't really care what kind of degree she has.

March 07, 2006 2:45 PM  
Anonymous Wild Pegasus said...

This whole situation is in the grey area where "fraud" and "unfair business practices" have to be sorted out. It's obviously stupid for someone to have to licence fingernail beauticians. For open heart surgery, I lean more toward the licencing side.

- Josh

March 09, 2006 12:34 PM  
Blogger Charles Johnson (Rad Geek) said...

Josh: For open heart surgery, I lean more toward the licencing side.

Licensing by whom?

If you just mean that you favor surgeons being credentialed by medical experts, there's already a system for that (the MD) without the further intervention of a licensing bureaucracy.

If you mean that you favor surgeons being licensed by the government over and above the community standards existing already in the medical field, then I don't know where the government (or for that matter privatized defense agencies) would get the knowledge, the virtue, or the right to impose licensing schemes above and beyond the voluntary forms of credentialing that exist within the medical community.

In either case, I think the case under question isn't even anywhere near a gray area. Ms. Wightman is a working counselor who does talk therapy for willing patients (not surgery or even the prescription of drugs). I don't think that there's even a prima facie plausible case for demanding a formalized licensing system here (certainly not imposing byzantine regulations about whether you can call your business "psychological" or merely "psychotherapeutic"!)

March 09, 2006 3:53 PM  
Blogger Kevin Carson said...

Josh,

As Rad Geek says, there are all sorts of private, voluntary certification systems in existence.

Several years back, The Freeman had a good article on the various voluntary systems for certifying kosher foods. Depending on the stringeny of the dietary laws under your sect of Judaism, you just look for the appropriate certification sticker on the food.

The best form of quality control is the free flow of information.

March 09, 2006 7:17 PM  
Anonymous Anonymous said...

This is quite the interesting commentary and refreshing as well! I agree that misrepresentation is a liability - this takes intention to achive. Free flow of information is utopia. Someday I will have this chance to "free flow" myself given that I am the subject here.

April 08, 2006 7:54 PM  

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