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Regulatory capture. In many states the industry successfully lobbied for licensing requirements on the (questionable) basis of it being necessary for public health.

While the basis for regulation makes sense on paper anyone who's done anything with a low margin service industry knows that whether good practices are followed in a particular workplace has almost nothing to do with education (everyone knows how to keep things clean) and everything to do with management (does management actually want these things done or does it consider them a waste of time).