Category: Regulations

American Indians Suffer from Lack of Property Rights

(p. A15) There are almost no private businesses or entrepreneurs on Indian reservations because there are no property rights. Reservation land is held in trust by the federal government and most is also owned communally by the tribe. It’s almost impossible for tribe members to get a mortgage, let alone borrow against their property to start a business. The Bureau of Indian Affairs regulates just about every aspect of commerce on reservations.
Instead of giving Indians more control over their own land–allowing them to develop natural resources or use land as collateral to start businesses–the federal government has offered them what you might call a loophole economy. Washington carves out a sector of the economy, giving tribes a regulatory or tax advantage over non-Indians. But within a few years the government takes it away, in many cases leaving Indian tribes as impoverished and more disheartened than they were before.
. . .
What American Indians need first is less regulation. There is a reason that Native Americans say BIA, the initials for the Bureau of Indian Affairs, really stands for “Bossing Indians Around.”

For the full commentary, see:
NAOMI SCHAEFER RILEY. “The Loophole Economy Is No Jackpot for Indians; Running casinos or selling tax-free cigarettes can’t substitute for what tribes truly need: property rights.” The Wall Street Journal (Thurs., July 28, 2016): A15.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date July 27, 2016.)

The above commentary by Riley is related to her book, which is:
Riley, Naomi Schaefer. The New Trail of Tears: How Washington Is Destroying American Indians. New York: Encounter Books, 2016.

Fragmented Health Care Causes Polypharmacy Harms

(p. D5) Dr. Caleb Alexander knows how easily older people can fall into so-called polypharmacy. Perhaps a patient, like most seniors, sees several specialists who write or renew prescriptions.
“A cardiologist puts someone on good, evidence-based medications for his heart,” said Dr. Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. “An endocrinologist does the same for his bones.”
. . .
“Pretty soon, you have an 82-year-old man who’s on 14 medications,” Dr. Alexander said, barely exaggerating.
Geriatricians and researchers have warned for years about the potential hazards of polypharmacy, usually defined as taking five or more drugs concurrently. Yet it continues to rise in all age groups, reaching disturbingly high levels among older adults.
. . .
Ultimately, the best way to reduce polypharmacy is to overhaul our fragmented approach to health care. “The system is not geared to look at a person as a whole, to see how the patterns fit together,” Dr. Steinman said.

For the full commentary, see:
Span, Paula. “THE NEW OLD AGE; An Ever-Mounting Pile of Pills.” The New York Times (Tues., APRIL 26, 2016): D5.
(Note: ellipses added.)
(Note: the online version of the commentary has the date APRIL 22, 2016, and has the title “THE NEW OLD AGE; The Dangers of ‘Polypharmacy,’ the Ever-Mounting Pile of Pills.”)

“To Understand Zoning, You Have to Have a Law Degree”

(p. 27) Not all buildings are worth keeping. In Midtown East, many nonconforming structures have low ceilings and columns that make them unappealing to new businesses. Some developers have gone so far as to demolish all but the bottom quarter of their buildings, and then build up from there, allowing them to retain the old zoning for their plots so as not to sacrifice a single square foot. The city is currently reconsidering a proposal that would allow these buildings to be rebuilt to their original size and possibly even larger.
It does not have to be this complicated. In honor of the code’s 100th anniversary, the Municipal Art Society of New York has called on City Hall to consider overhauling the code in a way that would make it intelligible to all.
“To understand zoning, you have to have a law degree, it’s so convoluted and so dense,” Mike Ernst, director of planning at the civic group, said. “The whole process of how buildings get built these days is so confusing and opaque to people. There really should be more transparency, so people can have an understanding of what the future holds for their city.”

For the full story, see:
“Reviled, Revered, and Still Challenging Russia to Evolve.” The New York Times, First Section (Sun., MAY 22, 2016): 27.
(Note: the online version of the story has the date MAY 20, 2016, and has the title “40 Percent of the Buildings in Manhattan Could Not Be Built Today.” It is substantially longer than the print version and includes three authors, while no authors were listed for the print version. The authors listed for the online version were: QUOCTRUNG BUI, MATT A.V. CHABAN and JEREMY WHITE.)

“Doctors Often Do Not ‘Know’ What They Are Doing”

(p. A11) Into the “swift currents and roiling waters of modern medicine” plunges Dr. Steven Hatch, whose informative “Snowball in a Blizzard” adds an important perspective. Dr. Hatch believes that our health-care system can “champion patient autonomy” and facilitate “more humane treatment, less anxiety, and better care” by revealing to patients the “great unspoken secret of medicine.” What’s the secret? Simply stated, “doctors often do not ‘know’ what they are doing.” In Dr. Hatch’s view, despite spectacular advances in biomedical science, modern “doctors simply cannot provide the kind of confident predictions that are often expected of them.”
. . .
He begins where Donald Rumsfeld ended: There will always be “known knowns, known unknowns, and unknown unknowns” in medicine. Dr. Hatch illustrates this spectrum of uncertainty with engaging exposés of popular screening tests like mammograms (attempting to detect breast cancer is like “finding a snowball in a blizzard”); common drug treatments, like those used to lower serum cholesterol or blood-pressure levels (about which expert national guidelines seem to change almost yearly); and health-care coverage in the lay media (whose “breaking news” too often ignores the uncertainty of the news being broken). Throughout his book, Dr. Hatch’s message is “caveat emptor,” warning his readers to beware not only the pseudoscientists, flim-flammers, anti-vacciners and celebrity doctors but also the all-too-certain pronouncements of the medical establishment.

For the full review, see:
BRENDAN REILLY. “BOOKSHELF; Give It To Me Straight, Doc; Doctors can’t really be certain if any treatment will help a particular person. But patients are looking for prescriptions, not probabilities.” The Wall Street Journal (Tues., March 15, 2016): A11.
(Note: the ellipsis between paragraphs, and the first two in the final quoted paragraph, are added; the third ellipsis in the final paragraph is in the original.)
(Note: ellipsis added.)
(Note: the online version of the review has the date March 14, 2016.)

The book under review, is:
Hatch, Steven. Snowball in a Blizzard: A Physician’s Notes on Uncertainty in Medicine. New York: Basic Books, 2016.

“Draconian” Regulations Reduce Consumer Choice

(p. B1) The Consumer Financial Protection Bureau, the watchdog agency set up after the last financial crisis, is poised to adopt strict new national rules that will curtail payday lending.
. . .
(p. B6) A sweeping study of bans on payday lending, scheduled to be published soon in The Journal of Law and Economics, found similar patterns in other states. When short-term loans disappear, the need that drives demand for them does not; many customers simply shift to other expensive forms of credit like pawn shops, or pay late fees on overdue bills, the study’s authors concluded.
Mr. Munn, who works as a site geologist on oil wells, first borrowed from Advance America eight months ago when his car broke down. He had some money saved, but he needed a few hundred more to pay the $1,200 repair bill. Then his employer, reacting to falling oil prices, cut wages 30 percent. Mr. Munn became a regular at the loan shop.
He likes the store’s neighborhood vibe and friendly staff, and he views payday loans as a way to avoid debt traps he considers more insidious.
“I don’t like credit cards,” said Mr. Munn, who is wary of the high balances that they make it too easy to run up. “I could borrow from my I.R.A., but the penalties are huge.”
At Advance America, he said, “I come in here, pay back what I’ve taken, and get a little bit more for rent and bills. I keep the funds to an extent that I can pay back with the next check. I don’t want to get into more trouble or debt.”
. . .
The rules would radically reshape, and in some places eliminate, payday borrowing in the 36 states where lenders still operate, according to Richard P. Hackett, a former assistant director at the Consumer Financial Protection Bureau.
. . .
“It’s a draconian scenario,” said Jamie Fulmer, an Advance America spokesman.

For the full story, see:
STACY COWLEY. “To Curb Abuse, Loan Rules May Cut a Lifeline.” The New York Times (Sat., JULY 23, 2016): B1 & B6.
(Note: ellipses added.)
(Note: the online version of the story has the date JULY 22, 2016, and has the title “Payday Loan Limits May Cut Abuse but Leave Some Borrowers Looking.”)

Certificate-of-Need Regulations Protect Incumbents and Hurt Consumers

(p. A11) An important but overlooked debate is unfolding in several states: When governments restrict market forces in health care, who benefits? Legislative majorities in 36 states believe that consumers benefit, because restrictions help control health-care costs. But new research confirms what should be common sense: Preventing qualified health-care providers from freely plying their trade results in less access to care.
Most states enforce market restrictions through certificate-of-need programs, which mandate a lengthy, expensive application process before a health-care provider can open or expand a facility. The story goes: If hospitals or physicians could choose what services to provide, competition for patients would force providers to overinvest in equipment such as MRI machines–and the cost could be passed on to patients through higher medical bills.
. . .
These restrictions have largely failed to reduce costs, but they certainly reduce services. A 2011 study in the Journal of Health Care Finance found that certificate-of-need laws resulted in 48% fewer hospitals and 12% fewer hospital beds.

For the full commentary, see:
THOMAS STRATMANN and MATTHEW BAKER. “Certifiably Needless Health-Care Meddling.” The Wall Street Journal (Tues., Jan. 12, 2016): A11.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date Jan. 11, 2016.)

The “new research” mentioned by Stratman in the passage quoted above, is:
Stratmann, Thomas, and Matthew C. Baker. “Are Certificate-of-Need Laws Barriers to Entry?: How They Affect Access to MRI, CT, and Pet Scans.” Mercatus Working Paper, Jan. 2016.

Denmark Drones Saving Lives

(p. B1) Mr. McLinden is a member of a group of middle-aged emergency workers taking part in a trial to jump-start the use of unmanned aircraft by Europe’s emergency services. The goal is to give the region a head start over the United States and elsewhere in using drones to tackle real-world emergencies.
The “drone school” builds on Europe’s worldwide lead in giving public groups and companies relatively free rein to experiment with unmanned aircraft. If everything goes as planned, the project’s backers hope government agencies in Europe and farther afield can piggyback on the experiences, helping to transform drones from recreational toys to lifesaving tools.
“For us, this technology is a game-changer,” said Mr. McLinden, who traveled to Copenhagen (p. B4) for a three-day training course with two colleagues from the Mid and West Wales Fire and Rescue Service. They will start offering 24/7 drone support — allowing colleagues, for example, to monitor accidents from 300 feet above — across central Wales later this month.
“Drones aren’t going to replace what we do,” Mr. McLinden added. “But anything that we can do to give our crews an advantage, that’s great.”
. . .
In a somewhat stuffy classroom at a disused fire station in Copenhagen, Thomas Sylvest gave advice to Mr. McLinden and others from his two years of flying. As Denmark’s first, and so far only, emergency service drone pilot, Mr. Sylvest has responded to things as varied as missing person cases and fires, often receiving calls late at night.
Mr. Sylvest, a fast-talking 50-year-old, offered tips on how best to share videos streamed directly from drones to commanders on the ground. During a recent fire in downtown Copenhagen, Mr. Sylvest said, he was able to beam high-definition images from high above, allowing his bosses to judge if a building’s walls would collapse (they did not). And when the police called him out last year after a man was reported missing, he flew his drone along a stretch of train tracks to guide colleagues on where best to look. (The man was found.)

For the full story, see:
MARK SCOTT. “Emergency Workers Turn to Drones to Save Lives.” The New York Times (Mon., JUNE 20, 2016): B1 & B4.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date JUNE 19, 2016, and has the title “Europe’s Emergency Workers Turn to Drones to Save Lives.”)

Crony Credentialism Is Regulatory Barrier to Telemedicine

(p. A11) Telemedicine has made exciting advances in recent years. Remote access to experts lets patients in stroke, neonatal and intensive-care units get better treatment at a lower cost than ever before. In rural communities, the technology improves timely access to care and reduces expensive medevac trips. Remote-monitoring technology lets patients with chronic conditions live at home rather than in an assisted-living facility.
Yet while telemedicine can connect a patient in rural Idaho with top specialists in New York, it often runs into a brick wall at state lines. Instead of welcoming the benefits of telemedicine, state governments and entrenched interests use licensing laws to make it difficult for out-of-state experts to offer remote care.
. . .
Using its power under the Commerce Clause of the Constitution, Congress could pass legislation to define where a physician practices medicine to be the location of the physician, rather than the location of the patient, as states currently do. Physicians would need only one license, that of their home state, and would work under its particular rules and regulations.
This would allow licensed physicians to treat patients in all 50 states. It would greatly expand access to quality medical care by freeing millions of patients to seek services from specialists around the country without the immense travel costs involved.

For the full commentary, see:

SHIRLEY SVORNY. “Telemedicine Runs Into Crony Doctoring; State medical-licensing barriers protect local MDs and deny patients access to remote-care physicians.” The Wall Street Journal (Sat., July 23, 2016): A11.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date JUNE 22, 2016.)

Obama and Koch Brothers Agree Occupational Licensing Restricts Opportunity

GranatelliGraceCanineMassageTherapist2016-07-11.jpg“Grace Granatelli, a certified canine massage therapist. In 2013, Arizona’s Veterinary Medical Examining Board demanded that she close up shop for medically treating animals without a veterinary degree.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. B1) SCOTTSDALE, Ariz. — “I usually start behind the neck,” Grace Granatelli said from her plump brown sofa. “There’s two pressure points back behind the ears that help relax them a little bit.” In her lap, she held the head of Sketch, her mixed beagle rat terrier, as her fingers traced small circles through his fur.

Ms. Granatelli, whose passion for dogs can be glimpsed in the oil portrait of her deceased pets and the bronzed casts of their paws, started an animal massage business during the recession after taking several courses and workshops. Her primary form of advertising was her car, with its “K9 RUBS” license plate and her website, Pawsitive Touch, stenciled onto her rear window.
But in 2013, Arizona’s Veterinary Medical Examining Board sent her a cease-and-desist order, demanding that she close up shop for medically treating animals without a veterinary degree. If not, the board warned, every Swedish doggy massage she completed could cost her a $1,000 fine.
To comply with the ruling and obtain a license, Ms. Granatelli would have to spend about $250,000 over four years at an accredited veterinary school. None require courses in massage technique; many don’t even offer one.
. . .
(p. B5) The Obama administration and the conservative political network financed by the Koch brothers don’t agree on much, but the belief that the zeal among states for licensing all sorts of occupations has spiraled out of control is one of them. In recent months, they have collaborated with an array of like-minded organizations and political leaders in a bid to roll back licensing rules.
. . .
. . . the current mishmash of requirements is too often “inconsistent, inefficient, and arbitrary,” a White House report concluded last year. Many of them, the report said, have little purpose other than to protect those already in the field from further competition.
. . .
Only rarely are licensing requirements removed. Last month, though, Arizona agreed to curb them for yoga teachers, geologists, citrus fruit packers and cremationists.
But dozens more professions escaped the ax. “Arizona is perceived as a low-regulatory state, but this was the most difficult bill we worked on this session,” said Daniel Scarpinato, a spokesman for the Republican governor, Douglas Ducey.
Licensing boards are generally dominated by members of the regulated profession. And in Arizona, more than two dozen of the boards are allowed to keep 90 percent of their fees, turning over a mere 10 percent of the revenue to the state.
“They use that money to hire contract lobbyists and P.R. people,” Mr. Scarpinato said. “This is really a dark corner of state government.”
They are often joined in their campaign by lobbyists from industry trade associations and for-profit colleges, which sell the required training courses.

For the full story, see:
PATRICIA COHEN. “Horse Rub? Where’s Your License?” The New York Times (Sat., JUNE 18, 2016): B1 & B5.
(Note: ellipses added.)
(Note: the online version of the story has the date JUNE 17, 2016, and has the title “Moving to Arizona Soon? You Might Need a License.”)

The White House report mentioned above, is:
The White House. “Occupational Licensing: A Framework for Policy Makers.” July 2015.

World Health Organization Praises Coffee, Reversing 1991 Warning

(p. A9) An influential panel of experts convened by the World Health Organization concluded on Wednesday [JUNE 15, 2016] that regularly drinking coffee could protect against at least two types of cancer, a decision that followed decades of research pointing to the beverage’s many health benefits. The panel also said there was a lack of evidence that it might cause other types of cancer.
The announcement marked a rare reversal for the panel, which had previously described coffee as “possibly carcinogenic” in 1991 and linked it to bladder cancer. But since then a large body of research has portrayed coffee as a surprising elixir, finding lower rates of heart disease, Type 2 diabetes, neurological disorders and several cancers in those who drink it regularly.

For the full story, see:
ANAHAD O’CONNOR. “Coffee May Protect Against Cancer, W.H.O. Concludes, in Reversal of a 1991 Study.” The New York Times (Thurs., JUNE 16, 2016): A9.
(Note: bracketed date added.)
(Note: the online version of the commentary has the date JUNE 15, 2016, and has the title “Coffee May Protect Against Cancer, W.H.O. Concludes.”)