Michigan’s Licensing Laws Prevent Poor from Accessing Health Care

It seems like a no-brainer: If licensed medical professionals want to provide free treatment to low-income families, they should be able to. But Michigan’s complicated regulatory apparatus gets in the way of doctors, nurses and dentists trying to help those in need. 

We recently volunteered with Remote Area Medical at a clinic in Florida and witnessed firsthand how important these free services are. RAM is a nonprofit that provides free medical, dental and vision services to underserved areas and people of limited means. They get doctors, dentists, opticians, nurses, translators and other volunteers to donate their time and skills to work at the clinics. The service is provided entirely free to patients — no questions asked.

People arrived the day before the clinic opened and spent the night in the parking lot. By 3 a.m., there was a line leading up to the door, filled with people like Jamie Ogline. The 30-year-old mother of two was trying to fit in a visit to this free clinic around her work schedule.

“This is saving me and my kids,” Ogline said. “I heard about [the RAM clinic] and I just couldn’t believe it because it’s all free and it doesn’t matter if you have insurance.”

RAM provides basic health checkups, new glasses and fresh fruit and vegetables. But about 90 percent of what its volunteers do is dental and vision work. Many of the people seeking this free care haven’t seen a medical professional in a decade or more.

While neither of us is a medical professional, we were able to help with crowd control and by moving supplies. But why did we have to go all the way to Florida to find professionals to help? Because in many states it is illegal for them to provide care without jumping over high regulatory hurdles. This includes Michigan, where even if a person is licensed by another state, providing free dental, vision and medical services is a felony, with only a few exceptions.

The CEO of the company, Jeff Eastman, told us they have talked for years about setting up in Michigan. 

“We would love to do a clinic in Detroit,” Eastman said. “But it’s a big struggle.”

The city fits the profile of a place where RAM typically offers clinics: It has a large low-income population and there’s a desperate need for care. At the clinic in Florida, there were doctors from Canada, Chicago and Buffalo. Many of these same people would make the shorter drive to Motown — but Michigan’s licensing laws are strict and those out-of-state professionals would violate the law and risk prosecution were they to help there. Relying only on local providers means RAM has a tough time finding enough medical volunteers, so, unfortunately, Detroiters will have to wait.

It’s no surprise that RAM clinics are concentrated in states like Illinois, West Virginia and Tennessee, where licensing laws make it easier to operate. 

Stan Brock, who founded RAM over 30 years ago, points to Tennessee as a model. In 1997, the Volunteer State lived up to its nickname by allowing out-of-state medical providers to work there as long as their license was verified by the nonprofit they were working with. Today, half the volunteers at the Tennessee clinics come from outside the state. 

“They pay their own way,” Brock said. “They get nothing from us or the government.”

At the end of the day, the location of the state agency that certifies health care professionals doesn’t matter to people like Lisa Alaya, whose life had been threatened by a tooth infection. Her mother, Donna Souza, told us a doctor had warned that the infection could turn into sepsis that would ultimately kill her because she was still recovering from heart valve replacement surgery.

“You guys are going to save my daughter’s life,” Souza said.

How many people in Michigan and around the country have similar stories? And how many lives could be saved or improved with nothing more from the government than letting licensed doctors from other states offer free care to those who need it the most?