I was interested in Diane Barnes recent post about restrictive licensure and the effect this has on the economically disadvantaged. My hope for the poor is that insuring their access to care will not relegate them to access to POOR care. I don't know what to think of the examples Diane gave about how strict liscensing standards made things worse for people. Dentists and hygienists do such invasive work which involves so much potential risk for both practicioner and patient in terms of infection.Don't we want very stringent licensure and the most meticulous practices? I'd rather have that assurance when I sit in the dentist's chair. I feel conflicted hearing stories about liscensing of electricians resulting in more do-it-yourself electrocutions. What's worse: that, or houses burning down from faulty wiring jobs done by unregulated electricians? I don't like lose-lose situations. There has to be a a better paradigm. My understanding of the intent behind taxpayer funds for WIC is that this money will identify and target income-eligible women who need help breastfeeding. A lot of that money is being spent on pumps in many states(a good example of throwing money rather than real support at a problem), and in some places the peer counselors appear to be in place in clinics and hospt. serving non-income eligible people -- replacing staff LCs.Why would hospt. pay when the govt pays a stipend to a peer counselor for doing what the hospt. perceives as the same work? I would hope that great clarity be used to conserve those WIC funds to serve the target population. This is an important mandate which should not be diluted or diverted. One hopes that this funding carefully trains the best assistants to advocate for these moms who are not insured and cannot pay out-of-pocket. Additionally, all professionals have an obligation, in my opinion, to do a decent amount of pro bono work, even those of us not on any kind of salary. Ione raises some interesting points when she describes how the extra money and effort required to keep up certification actually making this a better way than liscensure to assure quality practicioners. I think we should keep those requirements too. But as Ione points out, she cannot afford to focus on LC work and must depend on the services for which she can be liscensed in order to make a living. That is my point. Because LCs are not liscensed, it is difficult to focus on that specialty and make a living. I am probably in a good position to know that as I have no interest in nursing or midwifery and am solely obsessed with refining my specialty in human lactation.I could go to a 2 yr nursing program and become an RN. Then what? Go to work in a hospt as a staff nurse who may or may not get to continue to focus on my passion? My income is totally dependant on breastfeeding work. Lactation may have a chance as a subspecialty in which people can economically survive if it is liscensed. Why continue to crank out certified people who have to spend so much to get and obtain the certs. and have them be unemployable except as staff nurses or the odd WIC staff counselor? The salary doesn't change, no one with any real power pays any attention to what they say, and they are afraid half the time to tell the truth about the standing protocols for fear of losing their jobs. This is not the woman-to-woman empowerment and the recognition of our skills and our science that we've fought and sacrificed for. Protectionism is an issue in all trades, and is not new. It is the concept which spawns the idea of paying your dues and of apprenticing. It fosters the concept that by the time you arrive you really can represent your craft well. It seeks to insure that after arriving, a person is able to make an honest living which supports a family. It is the concept behind franchaising. Most companies (pump companies notwithstanding) refuse to open up franchaises across the street from each other for obvious reasons. For some reason we have taken the view as a profession that we should get as many LCs cert. as possible and perhaps that is not smart. Some are clearly not ready to well-represent the field. The general public has no way of knowing who has a clue and who doesn't. This won't nec. change because of liscensure. The liscensure is for US. The certification process being tightened is for the consumer. Both are valid issues to pursue. Barbara Wilson-Clay, BS, IBCLC Private Practice, Austin, Texas Owner, Lactnews On-Line Conference Page http://moontower.com/bwc/lactnews.html