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May 12, 2020 10 tweets 5 min read Read on X
NEW REPORT from @Robert_t_Orr: Health care occupational licensing in the U.S. is more pervasive, burdensome, and restrictive than in Europe. The consequences are being felt across our country. #OccupationalLicensing #Health niskanencenter.org/u-s-health-car…
First, more entry and mid-level workers must be licensed in the U.S. For example, while most European countries license physical therapists, they don’t require physical therapy aides and assistants to have licenses. The U.S. does. Image
Licensing is also more burdensome and expensive for individual health care professionals in the U.S. Compare the requirements for an advanced practice nurse in the U.S. versus one in Sweden. Image
An advanced practice nurse may expect to pay well over $15,000 in licensure-related fees. A nurse in Sweden will pay approximately $86.
Health professionals who move must undergo an additional round of licensure and must provide additional documentation from each board they were previously licensed under (with additional fees assessed by both the new and previous boards).
Moving to a position in another state requires paying fees, filling out extensive paperwork, and possibly meeting numerous other burdensome requirements, including exams or an interview with the state board.
In the best of times, cross-state licensing requirements put individuals and our economy at a disadvantage. In the middle of a pandemic, that means that hard-hit areas won’t get the help they need. Image
In response to COVID-19, some states temporarily lifted or streamlined licensing requirements. That states were comfortable with this makes one wonder how necessary the requirements were in the first place. niskanencenter.org/states-are-tem…
In conclusion, licensing reform in the U.S. could go a long way toward improving the lives of health care workers, lowering the cost of our health care system, and making sure that qualified professionals can practice where they are needed most.

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More from @NiskanenCenter

May 9
New apartment buildings in U.S. all look really similar to each other.

One reason: U.S. regulations dictate an oddly-specific layout that's hostile to families and limits light/ventilation.

THREAD:
Image
Image
In most U.S. cities, building code requires multiple exit stairways accessible from each apartment for buildings over 3 stories tall.

It's all done in the name of fire safety. But the restrictions don't really advance fire safety.
Enter the double-loaded corridor layout.

Long, windowless corridors slice through the middle of deep floor plates.

Non-corner units only have windows on one side, opposite the entry door—favoring studios and one-bedroom layouts. Image
Read 8 tweets
Feb 20
.@heritage publishes regular iterations of its “Mandate for Leadership” with an agenda for the next Republican administration. The prior Trump admin implemented nearly 64% of its recommendations in its 1st year.

Here’s what’s in the 2025 edition: niskanencenter.org/project-2025-u…
First, the Mandate would effectively close many avenues of legal immigration by:
❌Halting H2 visa programs
❌Closing the H-1B visa program to most recent grads
❌Leveraging entire visa categories as collateral in foreign policy negotiations
It would sabotage U.S. humanitarian relief by:
❌Repealing all TPS designations, stripping almost 700,000 of legal protection + work authorization.
❌Forbidding use of DHS staff time on DACA, Uniting for Ukraine, etc.
❌Prohibiting refugee vetting, ending refugee resettlement.
Read 14 tweets
Apr 6, 2023
NEW PAPER: Manufactured housing is an affordable option in rural areas where land prices are low. They even promise to ease the housing crunch in coastal cities where land prices are high!

But, as always, housing discrimination is getting in the way. niskanencenter.org/manufactured-h…
To clarify, we’re not talking about vacation trailers, or 1970’s-era mobile homes. Modern manufactured homes have strict standards for structural integrity and safety. They often look like homes built on-site, but they were assembled in a factory, like a car or an airplane.
Benefits of manufactured homes include: (1) They’re safer and more efficient to make, their materials don’t have to be exposed to the elements until the house is fully assembled, and (3) they can help improve quality of housing while driving costs down.
Read 12 tweets
Apr 4, 2023
Critics of Welcome Corps (the new U.S. private refugee sponsorship program) have been complaining loudly that it's vulnerable to fraud.

We’ve looked into 3 of the main concerns and have found that all but one are completely unsubstantiated. 1/ niskanencenter.org/is-there-any-t…
CONCERN 1: “The vetting process for refugees is being expedited and is therefore less thorough.”

FACT: Privately sponsored applicants must still go through the same USRAP pipeline as everyone else and have often been waiting years to travel. 2/
CONCERN 2: “The quality of protections meant to ensure sponsors are well-vetted aren’t good enough.”

FACT: Extensive safeguards have been built into the private sponsor group application process to screen for potential bad actors. 3/ Image
Read 6 tweets
Feb 28, 2023
THREAD: Why do housing supply restrictions persist? Conventional wisdom says it's because incumbents are defending their property values.

The reality is way more complicated. That's an opportunity for YIMBYs.

Introducing our agenda for abundant housing: niskanencenter.org/an-agenda-for-… Image
Before we enact any reform, we have to understand the political economy of our system: whom it empowers, whom it enriches, etc.

Answering these questions will rally opinion shapers around reform, protect reforms against backlash, and help avoid unintended consequences.
Here's how the conventional wisdom explains the political economy of housing: single-family homes and large lot sizes restrict the availability of housing to buyers who will pay at least as much in local taxes as they consume in public services, such as schools.
Read 13 tweets
Feb 24, 2023
THREAD: The cost of building public transit is out of control. We can do something about that:

Stop relying on outside consultants to do the work of government agencies. slate.com/business/2023/…
In the name of cutting costs, we’ve hollowed out government agencies, asking full-time employees to handle impossible tasks.

The result? Chaos. And lots of wasted taxpayer dollars. (After all, government contractors arguably cost even more money).
.@alon_levy produced a report for us outlining some solutions:

(1) The federal government should require that state/local transportation agencies demonstrate they already have the capacity to oversee big infrastructure projects before releasing funds. niskanencenter.org/report-so-you-…
Read 9 tweets

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