"Without regulations, licensing and codes, any Joe Blow can do brain surgery, build a house and, um, give you a haircut. You don't want things like that left up to the 'free market' now, do you?"
The absence of a state would not mean the absence of standards, and coercion is completely unnecessary. Private companies like Underwriter's Laboratories exist today to set standards, and private companies can and do test and accredit individuals to do various types of skilled work. When the state threatens harm to people who want to practice their skills without paying them for a license, it raises prices for everyone and in many cases isn't protecting anyone from anything at all. You wouldn't go to a back-alley surgeon even if it were legal, and the idea of needing government approval to cut hair or be an interior decorator is ludicrous.
A free society would have the benefit of trusted organizations to provide credentials where the market demands it (food inspection, medical practitioners, electrical devices, and so forth) but without the expensive monopolies a threat of state violence against "rogue" practitioners can create. (DBR)
Licensing of health care services gives us the illusion that we are protected against selfish others who would defraud us. Instead, our aggression boomerangs back to us, costing us our wealth, our health, and our very lives.
We've tolerated, even encouraged, the aggression of some licensing laws. We believe that they protect us from selfish others who would otherwise give us low-quality service, especially when a mistake can be deadly. The available evidence, however, suggests that our aggression in the form of licensing laws hurts us, rather than helps. Quality is most often compromised, not improved, by licensing laws.To understand how this happens, let's review what we know about the impact of licensing laws. Licensing always lowers the number of service providers by imposing extra requirements, such as citizenship, schooling, monetaty payments, or apprenticeship for those wishing to create wealth. In the previous chapter, we saw how licensing limited the number of taxi drivers and home child- care providers while increasing the prices charged by those still legally pennitted to create wealth in those professions. Studies show that whenever the number of service providers goes down, more people, especially the disadvantaged, either do without the service or do it themselves. For example, when the number of plumbers decreases because of licensing laws, retail sales of plumbing parts go up as people attempt to make their own repairs. Dental hygiene is poorer in states with the most restrictive licensing requirements for dentists, because fewer people can afford regular checkups. For the same reason, the incidence of blindness increases in areas with the most stringent licensing for optometrists. Accidental electrocutions go up when licensing requirements for electricians increase. Licensing laws intended to protect us can - and do - kill. - Mary Ruwart, Harming Our Health