Both patients and providers suffer from unnecessary costs, delays, and complexity in the healthcare system. Cumbersome state-level licensing requirements contribute to all these issues, because local regulations prevent competent practitioners from quickly moving and assisting wherever needs arise. Not only does this hindrance result in inconvenience for both sides, resulting practitioner shortages raise the risk of mistakes and mortality.
Federal control would further impinge on freedom and exacerbate the problem, hampering states from operating in the best way for their respective populations. Voluntary agreements between regions and license reciprocity, however, allow states to maintain their independence and standards while increasing efficiency.
This became common practice during the COVID-19 pandemic, but authorities tightened restrictions when the crisis waned. However, severe healthcare worker deficits remain. Making those adjustments permanent provides a permanent solution.
Cost Control
Healthcare prices, regardless of attempts to centrally plan them, depend on the same laws of economics that all service prices do. Practitioners will not pay exorbitant fees to operate in another state unless they receive compensation, and instead, they pass these costs to consumers.
Nursing school can cost as much as $160,000, and the required NCLEX exam fees can exceed $400. A nurse making $63,000 per year cannot afford to pay hundreds more to obtain a temporary license in another state to fill an urgent need. Consequently, all involved parties suffer.
Time
After paying all fees, a nurse might not receive a license for months. Even if the nurse finds this wait economically feasible, the patients in the region have to wait for necessary care.
During the COVID-19 pandemic, governors could not remove restrictions quickly enough to close the healthcare employee gap, and they should not have needed to do so. Willingly reinstating restrictions creates an unnecessary shortfall, which promises to become critical again during the next crisis.
Bureaucracy Bottlenecks
Paperwork requires time and money in administration as well as in the field. Roadblocks do not begin or end with patients and employees; they clutter administrative desks and calendars. Any impediments visible in the field are multiplied behind the scenes with every additional rule.
Administration accounts for as much as 30% of total healthcare costs, with a staggering $1 trillion total price tag. As much as half of this may be unnecessary, which is a dangerous level of inefficiency in a lifesaving industry.
Why Not?
The excuses for refusing interstate agreements typically involve professed worry about quality, but this logic proves exceptionally thin. Much of the testing and licensing is standardized across the country. The NCLEX, for example, is identical across all states, so any registered nurse is subjected to the same test.
States can also choose the parameters of all agreements. If one area is notorious for poor training, states can cross that region off their list of partners. Whether telehealth or in-person employees, workers can be subject to any standards the local agency wishes.
Looking closer at the stated reasons, an observer will see that avoidance of competition resides at their heart. The people who support regulatory protectionism worry they will lose control of the market if it is opened to all competent healthcare providers. But it is not the job of the government, patients, or fellow workers to keep current employees higher paid and less competitive. On the contrary, all concerned entities have the right to participate in the most robust market possible.