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Jane M. Orient, M.D.

While Americans are preoccupied with the political theater of the Presidential race, special interest groups toil to pass legislation that could radically transform your medical care. One example is the Interstate Medical Licensure Compact, which has passed in 11 states. Pennsylvania has joined a number of others in proposing it.

The proposal promises to provide “remote communities with access to high-quality care through telemedicine” and “address a shortage of medical personnel in underserved rural and urban regions,” according to an article in the Pennsylvania Business Daily.

Americans need to remember three things about proposed legislation:

  • Its real purpose is likely to be very different from the stated one, and the result may be the opposite of the one that is promised.
  • Especially when the same law is surfacing simultaneously in a number of states, some vested interest wants to make money from it. A lot of money—getting laws passed can be very expensive.
  • There may be no way back, as the law empowers and funds interest groups that will oppose repeal.

So what does the Compact do to bring telemedicine to underserved areas? By itself, nothing. It’s about a bypass to state control of licensure, not about providing care. If telemedicine were the real object, the way to expedite it would be to define the location of medical care as the location of the doctor, not the patient. The doctor would need a license in only one state. Compact proponents oppose a telemedicine bill in Congress that would do just that.

Some physicians already hold a license in several states—they just apply to each state. Under the Compact, they would apply to a private interstate commission, which would have its own rules, possibly overriding rules of the states, and which would have no public accountability. This would add costs, not eliminate them. It could also allow doctors to evade state laws meant to protect patients. For example, a carpetbagger abortionist could fly in to do late-term abortions forbidden by the state, under his Compact license. More

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