Jordan Johnson: Some key points to consider about The Tenth Amendment

Jordan Johnson, Founder and Principal at Bridge Oncology, shared on LinkedIn:

“As healthcare moves forward post-COVID, should healthcare professionals, including physicians, fall under state or federal licensure?
The Tenth Amendment ‘police power’ has protected state boards and licensure, but does it still fit?
Does state oversight further a standard of health safety and federal welfare consistently?

Here are some key points to consider:

• Purpose of Licensure: What does licensure really achieve? Is it primarily tied to reimbursement (Medicaid/Medicare)? Quality? Safety?
• Should we or do consider the ‘private accreditations’ JC, NCQA, etc.
• Control of Prescribing Practices: States control prescribing practices while the federal government controls medications, presenting clear challenges.
• Federal Authority: The federal government’s authority currently lies in its spending power and programs.
• Disciplinary Grounds: Statutory and common grounds for discipline vary from state to state, leading to inconsistencies.
• Burden of Proof: The burden of proof varies, with ‘preponderance of evidence’ versus ‘clear and convincing evidence’ standards supporting medical board decisions.
• Access to Information: Has the availability of information and access to data beyond state lines created the need for a federal standard of care?
• Value-Based Care: Can value-based care be consistent at the state level?
  Drug Approval and Licensure: Drugs are approved by the FDA (federal) and prescriptive licensure is granted by the DEA (federal).
• State Revenue: Is state licensure more about revenue? For example, California received $62 million in physician application and renewal fees two years ago.
• Telehealth: Telehealth has resulted in a wide variety of inconsistent state standards and state compacts. Understanding telehealth as interstate commerce is crucial.
• Evidence-Based Decisions: Do state medical boards base decisions on data and evidence-based approaches, and if so, why isn’t there more consistency? Would federal oversight correct this?

Thoughts or perspective on whether federal licensure could create a more consistent and effective healthcare system.”

Source: Jordan Johnson/LinkedIn