Terminology. In this report, the terms massage and massage therapists may apply to other kinds of bodywork and other bodyworkers depending on the context in which they are used. Regulation is state regulation, and requirements are the requirements of state regulation.
We thank those who have expressed their appreciation for the research we have been doing. We originally assumed our first reports on regulation would be all we would publish on that subject. However, we received so many requests for additional information that we continued researching and publishing. The same thing happened when we published our first reports on harm. That convinced us to continue because many people consider what we are doing important.
THE ISSUE IS FREEDOM
It is also gratifying that so many clearly recognize freedom as the core issue with which our research is concerned. This freedom is the right to do massage without having to pay a lot of money to comply with unnecessary requirements
The right to be left alone is indeed the beginning of all freedom. - U.S. Supreme Court Justice Louis Brandeis
People who want to make an honest living by doing massage, which is not harmful, should be left alone and not have to pay in order to do that.
An example of loss of freedom, and $$$$
Kevin Kunz reports a clear example of how regulation deprives reflexologists of freedom and income.1
"Reflexology' Kunz reports, "is now a felony in Florida. Practicing reflexology in Florida without a massage license is regarded as practicing medicine without a license... Reflexologists have ... been approached by agents of the Department of Health. They have been searching the phone books for reflexologists. (We were put out of business this way in New Mexico.)
"If you have a massage license, you do not need a definition or a scope of practice to do reflexology. In fact, you can really be anything you want - Rolfer, Feldenkrais, Trager, etc. And you really don't have to define a thing...
"It is a sad day when native healers are put out of business to satisfy the greed of the massage industry. What a scam. The consumer pays higher prices for lower standards of service. And one group gets a monopoly over an entire industry."
Reflexology does not harm people. Con- sequently, the simplest way for Florida to resolve this repressive situation is not to regulate reflexology, but to deregulate massage.
DOES PENNSYLVANIA SENATE BILL 1171 VIOLATE OUR FREEDOM?
Jack Thomas has pointed out, "A major question in the establishment of boards of massage therapy is whether the boards have jurisdiction over practitioners who are not massage therapists but who utilize various forms of touch, soft-tissue manipulation and movement."6
We raise a more basic question. DO STATES HAVE A LEGAL RIGHT TO REGULATE ANY BODYWORKERS? NONE OF THEM POSE A THREAT TO THE PUBLIC HEALTH, SAFETY, OR WELFARE.
Senate Bill 1171, which would regulate massage, is in the Senate Committee on Consumer Protection and Professional Licensure. However, there are serious questions about the legality of Senate Bill 1171.2 For example, does it violate:
1. constitutional protection of freedom of speech and freedom of the press?
2. constitutional prohibition of discri- mination and arbitrary governmental inter- ference?
3. laws which prohibit restraint of trade monopolies, and unfair trade practices?
THE ISSUE IS DEMOCRACY
In a democracy, people should have the right to do massage without regulation if they do not pose any threat to the health, safety, and welfare of the public.
The state has no obligation and no right to regulate a profession merely to give it status in the eyes of the public. It is the profession's responsibility to determine its acceptance and popularity with the public.
In a democracy, people who promote "licensure ... first and foremost to protect the public from harm" by massage should be required to reveal the specific kinds of harm from which they want to protect the public.
Legislators, whom promoters lobby to enact laws to protect the public from that harm, should require proponents of those laws to provide well-documented evidence that the alleged harm has actually occurred.3,4
Why I began doing research on state regulation of massage
I have been doing scientific research for more than half a century, and have always been concerned about the social responsibility of science. Although I retired in 1981, I continued doing research on problems that have important implications for our society.
I respect bodyworkers because the health care they provide is safe, effective, and satisfies the needs of many people. As a scientist with a social conscience, I feel a responsibility to help bodyworkers avoid being corporatized and monopolized.3,4
That is why I apply my expertise as a researcher to provide evidence that regulation is not needed to protect the public from being harmed by bodyworkers.
To expose exploitation. Since regulation is not needed to protect the public from harm or for other reasons, it unjustifiably exploits bodyworkers, most of whom are women. Voluntary title protection4 does not.
To protect the integrity of bodywork. The integrity of the bodywork professions is violated if they are unjustly accused of being harmful - particularly if special interests use the allegation of harm to corporatize, monopolize, and exploit the practitioners.
To protect the identity and sanctity of spiritual massage healing. Even though there is no convincing evidence that secular massage therapy harms people, the corporatizers and monopolizers of secular massage therapy may try to expand their regulatory dragnet to include spiritual massage healing.
To do that, they may allege that spiritual massage healing - like secular massage therapy - is harmful and should therefore also be regulated.
The reality is quite different
1. Spiritual massage healing, like secular massage therapy, is not harmful. There is con- siderable evidence that neither one is injurious.
2. The First Amendment of the Constitution of the United States and many state constitutions prohibit government from interfering with the practice of one's religion. Spiritual massage healing, like other kinds of spiritual healing, is the practice of one's religion.
3. The fact that state medical practice acts exempt spiritual healing is convincing evidence that it is not harmful. If it were, it would not be exempt.
State medical practice acts determine the requirements with which all doctors must comply in order to practice medicine. Doctors who may sincerely believe they are guided by and working with God in treating patients are not exempt because conventional medicine is harmful. It is the fourth major cause of death in the United States.
Some medications which doctors prescribe have serious adverse side effects and have been the direct cause of many deaths.
IT'S NOT ABOUT HARM.
IT'S ABOUT $$$$
We became interested in finding out whether massage harms people when the Pennsylvania Licensure Coalition announced that:
"Licensure is first and foremost to protect the public from harm... We [the Coalition] are working to create a bill which protects the public from harm... "State licensing will ... create educational requirements for that public protection."
I received this information after I had been teaching and doing massage for several years. During that time, I had never heard of anyone being injured by massage. I therefore wrote to the officers of the Coalition and asked for information about the harm from which the Coalition wanted to protect the public. They did not reply to that letter and several others.3,4 Common sense then led me to conclude:
1. The Coalition has no well-documented evidence that massage therapists have harmed people. This is understandable because massage is safe. In fact, more people are struck by lightning than are injured by massage. More people are bitten by dogs than are injured by massage.
The decreasing cost of insurance for massage therapists also reveals the safety of massage. I have been told that $65.00, which was the wholesale price of $1,000,000 of insurance in 1984, is now the wholesale price of $2,000,000 of insurance. While the price of many things has increased significantly since 1984, the cost of insurance for massage therapists has decreased by 50%. The same wholesale price of $65.00 buys twice as much coverage today as it did in 1984.
2. Pennsylvania does not need licensure to protect the public from nonexistent harm, or for any other reason.
In a democracy, people need to do something about a scare tactic4 involving nonexistent harm. It is important to find out why the scare tactic is used, and then expose it.
Our constitutional protection of freedom of speech and freedom of the press enables us to do that.
Our sense of social responsibility obliges us to do that.
FOLLOW THE MONEY TRAIL
The massage industry consists of regulation, national certification, continuing education, insurance, etc., for which massage therapists have to pay fees annually or biannually. The industry is a GIANT $$$$-GENERATING MACHINE. State regulation is the engine which keeps the machine going. The fees massage therapists pay fuels the engine.
To understand what is happening to bodyworkers, we have to follow the money trail. Or, as the French say, Chercher l'argent. The money trail leads to the massage industry. This industry has industrialized the bodywork professions.
The changes, which that industrialization has brought about, constitute what I call the industrial revolution of bodywork. This revolution has corporatized and monopolized bodywork in order to exploit bodyworkers. The following two economic areas of massage illuminate what has been happening and why.
HOW MUCH MONEY DO BODYWORKERS EARN?
Our research on regulation required us to follow the money trail because regulation is the first step in industrializing bodywork. There are an estimated 175,00 to 200,000 bodyworkers in more than 90 different modalities in the U.S.5 The median annual income is about $35,000.5 Assuming the median income is equal or close to the average income, the gross annual income of all bodyworkers is in the vicinity of 6.1 to 7.0 BILLION DOLLARS!
HOW MUCH MONEY DO BODYWORKERS PAY?
Massage school fees. Massage school tuition varies greatly depending on geographical location, the number of hours of courses, and other factors. Assuming an average, across-the-board, tuition of $6,000, the 20,000 to 25,000 massage therapists pay $120,000,000 to $150,000,000 annually.
Some massage schools have additional income because they offer workshops for continuing ducation credit and to prepare graduates for the national certification examination.
If there are 200,000 massage therapists who are now practicing and have paid an average of $4,000 tuition, massage schools have grossed approximately $800,000,000. THIS IS MORE THAN THREE QUARTERS OF A BILLION DOLLARS.
State fees. The 21 states which regulate massage presently collect fees amounting to almost $3,000,000 annually.4 Sooner or later, all "massage therapists [will] discover that the cost of regulation in their state comes out of their own profits, in the form of application fees, licensing fees, testing fees, fees for duplicate certificates, and fines."6
National Certification. By February, 1996, massage therapists had paid approximately $3,000,000 for national certification.7 The fee has increased since then.
Insurance, continuing education, etc. We have no data on these payments.
Dropouts. An estimated 20,000 to 25,000 new body- workers enter the field annually.5 I have been told that approximately one-third of them have dropped out one year after graduation. They are no longer doing bodywork. About one-third of the survivors have dropped out three years after graduation. Assuming an average school tuition fee of $6,000 and disregarding other fees, the dropouts have probably invested more than $150,000,000.
The machine will continuing generating $$$$ because only about 15% of adults in the United States have so far experienced massage.8
Unfortunately, definitive information on the macroeconomics of massage has been published. Consequently, massage therapists, from whom the money flows, do not know how much money they are all paying annually TO KEEP THE BIG $$$$-GENERATING MACHINE WELL-OILED.
Without regulation, the income of the entire industry would be considerably less. It would be illuminating to have hard data on the fees and total income of massage therapists in states which do and do not regulate massage.
REGULATION IS "THE ROOT OF ALL EVIL"
The results of that evil are the loss of freedom to do massage without having to pay a lot of money year after year to comply with unnecessary requirements; and the millions of dollars massage therapists have to pay annually.
Many massage therapists do not want regulation simply because: (a) They don't believe it's worth the money they have to pay. And (b) Regulation creates special interest groups with monopoly control.
IT'S MASSAGE THERAPISTS WHO NEED PROTECTION
They need to be protected from regulation which restricts their freedom and requires them to pay considerable money annually to comply with unjustifiable requirements.
THE "NAY" SAYERS
Some people have told us they are opposed to regulation but believe: "It's inevitable." They also say, "You can't win. So, why fight it?"
People with that defeatist attitude help make regulation inevitable because they don't actively oppose it.
We are motivated by Pete Seeger and many others who, in the face of adversity, decided they would rather try to do something constructive and fail, than not try at all.
It is not enough for a wise man to study nature and truth; he should dare state truth for the benefit of the few who are willing and able to think. As for the rest, who are voluntarily slaves of prejudice, they can no more attain truth than frogs can fly. - Julien Offray de la Mettrie
1. Kunz, K. <firstname.lastname@example.org> Reflex- ology now a felony in Florida. Feb. 27, 1998. <http://www,reflexology-research.com>
2. Schatz, A. Does Senate Bill 1171 violate laws that protect freedom of speech and freedom of the press, prohibit discrimination and arbitrary governmental interference, and prohibit restraint of trade, monopolies, and unfair trade practices? Massage Law Newsletter. 4(2):1-3, 1998.
3. Schatz, A., and Brewster, M. The cor- poratization of massage. An economic perspective. Massage Law Newsletter. 2(2):1-10. 1997.
4. Schatz, A. Follow the money trail to find out why scare tactics tell us massage is harmful. JSB. Special Issue 4. pp. 1-14. 1997.
5. A career in Massage & Bodywork. Associated Bodywork & Massage Professionals. Touch Therapy Directory. pp. 2-5. 1997.
6. Thomas, J. The way boards work. Massage Magazine. pp. 103-105. May/June. 1998.
7. Schatz, A. Some thoughts and questions about the $3,000,000 National Certification examination. One man's point of view. SMMN. 2(1):1-5. 1996.
8. Successful Business Handbook. Associated Bodywork & Massage Professionals. pp. 2-3. 1997.