What is it Good For?

By Jean Robinson
[Government Relations]

A new report, “Occupational Licensing: A Framework for Policymakers,” produced by several government agencies, including the US Department of Labor, outlines the growth of occupational licensing and regulation on the workforce over the past several decades, its costs and benefits, and its impacts on workers and work arrangements.

The growth of occupational licensing is easily recognizable, especially when you consider massage regulation. In 1959, seven states regulated massage therapy; today 45 states do. More than 25 percent of US workers now need licenses to do their jobs. The share of workers licensed at the state level has risen five-fold since the 1950s. Roughly two-thirds of this change comes from an increase in the number of professions that require a license.
The report also summarizes a problem we face in the massage profession, stating, “Licensing requirements vary substantially by state, creating barriers for workers moving across state lines and inefficiencies for businesses and the economy as a whole.” How long have we discussed the portability problems in the massage profession? What have we been able to do to address these problems? We have a long way to go—I think we can all agree on that.
Overall, the report recognizes that “when designed and implemented carefully, licensing can offer important health and safety protections to consumers, as well as benefits to workers.” However, it contends that, too often, policymakers do not weigh costs and benefits when making decisions about whether or how to regulate a profession through licensing. The report recommends several best practices to ensure that licensing protects consumers without placing unnecessary restrictions on employment, innovation, or access to important goods and services—a balance ABMP has been advocating for years.
Some best practices outlined in the report include:
• Limiting license requirements to those that address legitimate public health and safety concerns.
• Reducing the number of unnecessary or overly restrictive licenses.
• Harmonizing regulatory requirements state to state and creating compacts that recognize licenses from other states to increase the mobility of skilled workers.
• Allow practitioners to offer services to the full extent of their current competency.
ABMP could not agree more and will continue to strive for such commonsense approaches.

Rethinking Regulation

A similar report, “Rethinking Regulation,” from the UK Professional Standards Authority, calls for a “radical overhaul” of the UK health-care regulation system. The paper calls for a reassessment of the role of regulation in promoting safety and quality, followed by a redesign of the institutions and processes of regulation, also taking into account system regulators, product regulators, and the organizations that deliver care.

Read the full report at

Jean Robinson is ABMP’s director of government relations. Contact her at