If I had to pick one book that has shaped my political philosophy, it would have to be Milton Friedman’s Capitalism and Freedom. It was a wakeup call, of sorts. All of his ideas made sense to me and were written from a radical perspective that I had never even thought of.

Many of the things he recommended seemed radical at the time but have now become accepted or at least respectable ideas: school vouchers, flexible exchange rates for currency, negative income tax instead of traditional welfare state measures, and a flat tax. However, I found it most difficult to grasp his recommendation to end the mandatory licensing of doctors. I still feel fairly uneasy about such a proposition and more importantly I think it is the least politically feasible of all his views.

If you want to think about the benefits of doctor licensure in consequentialist terms, consider these points:

  • Do the licenses really completely protect consumers against medical malpractice (not really).
  • Do the licenses potentially raise overall medical costs (yes, because there is a much smaller supply of doctors, they charge more)
  • Are the requirements necessary to be certified set at the right level (potentially, but look how many years one has to go to medical school to get a license).
  • Does the fact that a doctor has a license make you more trustworthy of that doctor (yes, I am going to assume).
  • If there are no licenses, will people acting as doctors do a worse job because they can (maybe, but probably not. Think of other professions that don’t have licenses).

I remember reading a story a while ago that said the Florida attorney general tried taking the Florida Bar Exam and failed. The attorney general wouldn’t have been able to be a lawyer in Florida. This example shows that while occupational licensing may have the (supposed) intention of protecting the consumer, it can really just act as an effective cartel for those already in the profession. The cartel will limit the supply of those in the industry and effectively raise their wages. I think we can see this in the fact that some places require babysitters to have a license.

I am definitely not convinced completely that we don’t need licenses for doctors. If anything, I think we should have an “optional” licensing system. For example, doctors can be given a gold star if they have certain qualifications (which would make people more confident going to them) but doctors without those qualifications cannot be legally excluded from working. For instance, I could treat you with “alternative” medicines if you really trust me to do so. This seems more plausible. I know Carson supports the ending of licensing for doctors so maybe he’ll have something to say about it.

The following is a short video of Friedman speaking to the Mayo Clinic about the idea:

Video courtesy of Will Wilkinson.