system
Given the following post, respond as if you're commenting on Reddit:
human
CMV: The US should have federal licensing for health care professionals (MD/NP/PA/RN/RT/Pharm)

Health  care providers are required to be licensed in every individual state  they practice in (exception: "compact" states mean that if you live in a  compact state, you can practice in every other compact state for  nursing)

I'm an NP, and it costs  \~400-500 to maintain my license every two years where I currently am. I  have practiced in two other states as well, but have let those licenses  lapse because of the cost of maintaining.  For doctors, it is even more.  (Plus we both have specialty board licensures to maintain)

Obtaining a new or reactivating an inactive license takes anywhere from 2-6 months.

The requirements for each state are nearly identical. You are required to have

* the requisite degree
   * Entire sealed college transcript is also needed, which is a pain in the ass
* the requisite testing board being passed
* Money
* Proof of identity
* Fingerprints (for background check)

This  process can be held up for many reasons.  For example, in TX, my  license took longer because my "pathophysiology across the lifespan" class was taken earlier than my other nursing courses and they missed it  on my transcript and in CA it was held up because they thought I didn't  have microbiology, because they didn't notice it at the bottom on the other side of my transcript. (granted, my transcripts were more confusing than many, as I graduated from the same school undergrad and  grad, but my undergrad was a different subject and had a lot of transfer credits)

Some states will have  specific classes needed for "continuing education" (usually a narc  prescribing class for NPs) and a few like OH have additional supervision requirements when you are new to the state, no matter how long you have been practicing. (OH requires an externship of 500 hours for  prescribing, even if you have 20+ years experience in another state).  And at least for NPs, depending on your specialty, that extra CE has  nothing to do with any part of your specialty, and costs $200+. 

The  practice laws do not vary greatly from state to state, they are more subtle differences, and more  importantly, it is up to the individual provider to be aware of the laws  in the state they practice in.  The tests we take are standard across  the nation.  There is no difference in the NCLEX in OH vs TX vs ND.  My  specialty certification is also nationally based.

The problems with the current system are:

* Expense needed to maintain multiple state licenses
* Easier for people who have lost their license to switch states to potentially continue giving dangerous care
* Inconsistent discipline/treatment of nurses with addiction
* Difficulties in moving to another state and starting work quickly
   * This is especially problematic in situations where getting health care providers to where they are needed could be vital
* Sheer  frustration factor - I have a special calendar with all my licenses,  expirations and reminders. I still use it for licenses/certifications  that are just for the one state I'm licensed in, but it used to have  three state licenses, my national certification, my BLS/NRP, and other  annual requirements.
* Duplication of bureaucracy creating more cost and less efficiency
* Difficulties if you live on a state border, potentially requiring two licenses
* Difficulties potentially with telemedicine that might cross state borders

Potential complaints about national licenses:

* State nursing boards would lose power/staff/jobs
   * They could be at least partially converted to local branches of federal offices
* States rights?
   * I mean, I guess.  But if we are one country, the license requirements are the same, it's a hard sell
* The change would be complicated
   * But, jobs, right?

I  honestly cannot think of any reason why having state-based licensure  for medical professionals would be better than a national system.  So,  change my view!
gpt
Because different states have different views on infractions, and there does not currently exist a federal body to govern sanctions and exclusions. 

And before you say they should do that instead, creating such a federal body would be outside of the scope of the Constitution and would never achieve Congressional approval, let alone judicial review.

Also, while the requirements for each state may be “nearly identical”, they are not ACTUALLY identical (for example nor every state requires fingerprinting). 

Each state has its right to set its own standards, and again unless you centralized those standards they are not equivalents.

You already provided the best and existing method to address this - the compacts and reciprocity agreements.