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State Restrictions Block Philanthropist From Providing Free Health Care, No Questions Asked

By J. Edward Nelson


stan brock (

stan brock (

Similar to state regulations which largely contribute to health insurance premiums increasing beyond the means of millions of Americans to reasonably afford, state restrictions on out-of-state medical practitioners limit philanthropists such as Stan Brock in providing free health care to thousands of Americans.

Stan Brock is the founder of Remote Area Medical (RAM), a non-profit organization dedicated to providing free health, dental and eye care, primarily to people in remote areas of the United States and throughout the world.


Brock’s organization operates on a paltry annual budget of $250,000 and receives no federal subsidies.

Doctors, nurses, and a multitude of other professionals volunteer their services for RAM, traveling throughout the world, at their own expense. RAM is headquartered in Knoxville, TN, principally because it is the only state with a full blown “open borders” policy toward out-of-state medical volunteers.

In August 2009, RAM traveled to Inglewood, CA, providing health care services to over 6,000 people free of charge – no questions asked – at the LA Forum. The organization had to turn away thousands more because of California laws restricting out-of-state medical professionals from receiving temporary licenses, having to rely solely on local volunteers.

A great deal of donated medical equipment simply went unused at the event because of the lack of manpower.  “When you can’t bring in doctors from outside of the state, you just can’t recruit enough locally to be able to handle that kind of volume,” said Brock.

Ironically, state governments like California, currently suffocating under the weight of tremendous debt, should be boisterous advocates of RAM because it provides financial relief for state funded public health insurance programs.

RAM reportedly provided $1 million in free health care services to California residents at the LA Forum, which normally would have been apportioned to local hospital emergency rooms and government funded health care programs.  Each fed from the generous trough of Remote Area Medical for the duration of the eight day event.  

At the same time, state regulators “looked a gift horse in the mouth” by restricting the scope of RAM’s operations.

Candis Cohen, spokeswoman for the California Board of Medicine, justified the state’s position with the following statement to the press: “We don’t know how well someone may have been trained in Texas or Alaska or somewhere else … We have our own standards.  They’re quite high.”

David Freddoso, staff writer for the Washington Examiner, highlights the hypocrisy of Cohen’s statement in an op-ed titled, “These docs want to help,” in pointing out: “California doctors often train at the same medical schools as doctors in Texas, Alaska and elsewhere…out-of-state lawyers are easily admitted to other states’ bars on a temporary basis, despite drastic differences in states laws.  The human kidney, however, is identical in every state.”

Brock believes that dozens of organizations similar to RAM would materialize if state governments adopted more flexible regulatory policies. Some proponents of a stricker adherence to the Constitution by government, like judge Andrew Napalitano, contend that the framers of the Constitution never intended for government to have the authority to restrict commerce in this manner.

In his article which appeared in the Wallstreet Journal, “Health-Care Reform and the Constitution,” Napalitano says that the commonly held meaning for the term “regulate” when the Constitution was written in 1789 was “to keep regular.”  The Commerce Clause in the Constitution was meant to keep commerce between the states “regular,” preventing state imposed regulations favoring in-state businesses.

State laws restricting RAM’s interstate activities violate the Commerce Clause, and thus are unconstitutional, because they force the organization to utilize in-state medical professionals.  Any other organization performing similar activities but chartered in California would have a tremendous advantage over RAM.

The purpose of the Commerce Clause is to prevent this type of unequal footing for the protection of all businesses throughout the United States.

To paraphrase Judge Napalitano, in an era in which the federal government deems it necessary to regulate so many aspects of our lives, such as the air we breathe, the water we drink, the food we eat, and which drugs make their way into our medicine cabinets, it’s surprising that the federal government chooses not to take the regulation of health care practicioners out of the hands of state level politicians, and give that responsibility to Congress as the Commerce Clause designates.

Government regulation of the marketplace unrestrained by the Constitution, as in this particular instance, is subject to cause more problems than it solves:

  • organizations like RAM are restricted by law in the amount of free health care they can provide

  • choice is taken out of the marketplace and away from consumers

  • indigent consumers feel compelled to utilize hospital emergency rooms as “primary care providers”

  • abuse of hospitals in this manner diminishes their capacity to provide basic services in a timely manner

  • state and federal programs absorb larger portions of the escalating cost of health care with shrinking tax revenues

State regulations restricting medical professionals from practicing across state lines prevents the market – ie, the people which comprise the market – from deciding which available products or services are worth patronizing. Thousands chose to patronize the RAM event in Los Angeles but government restrictions allowed approximately half to receive service.

I wonder how many sick people who were turned away in Los Angeles wished that there were more Andrew Napalitano’s on the California state legislature.


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