Patients deserve better access to both life-saving and life-preserving health care treatments. Which means that physicians, hospitals, and other health care facilities should be able to invest in their communities to address unmet patient demand for kidney dialysis units, cost-effective surgery centers, neonatal intensive care units (NICUs), nursing homes, and much, much, more. Unfortunately, providers in North Carolina and 35 other states can’t embark on any plans to expand patient care unless the state has determined for itself that there is a “need.” And even if the state does grant a certificate of need (CON) to a winning applicant, competitors can step in to delay any capital projects from moving forward.
This morning’s op-ed in the Wall Street Journal explains:
In Cartersville, Ga., two highly regarded obstetricians, Hugo Ribot and Malcolm Barfield, hoped to add a second room to their one-room surgery center. But the plan hit a snag. They needed to obtain a “certificate of need” from Georgia’s Department of Community Health. Three large hospitals in the area—which provide similar services at far higher cost—blocked their application. Dr. Ribot and Dr. Barfield are now suing the state for restraint of trade.
The CON regulatory process was originally designed for state health planners to slow the growth of rising health care costs by preventing an over-investment of underused facilities and ensuring equitable distribution of health care resources across the state. However, decades-old data show that CON law has not contained health care costs. Nor does the law preserve health care in rural areas. According to the Mercatus Center, CON states have 30 percent fewer rural hospitals and 13 percent fewer rural ambulatory surgery centers compared to states without CON laws. As mentioned in the Wall Street Journal and numerous other publications, this regulation has instead evolved into a protectionist policy for established providers. Who wouldn’t leverage a law to their advantage that stalls competition?
Because of CON, patients continue to pay higher out-of-pocket costs for certain treatments, or are forced to travel longer distances to fulfill their health care needs.
The good news, however, is that North Carolina’s CON law could very well be nearing its end. The Senate’s budget proposal calls for a complete phase-out of the 25 services and facilities that are limited by the Department of Health and Human Services by 2025. You can read up on more of the details here.
