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Atrium, Novant fight over CON

It’s hard not to laugh while reading the following excerpt from an article on CON laws from the Charlotte Observer

Atrium Health and Novant Health agreed on one thing at a public hearing on Monday — Mecklenburg County needs more acute care beds and operating rooms.

The state agrees. The state will approve six new operating rooms and 76 new acute care beds in Mecklenburg County requested in 2019, according to the 2019 State Medical Facilities Plan.

But Novant and Atrium have submitted a combined eight applications for 7 new operating rooms and 96 new acute care beds in the county.

Both systems gave arguments to the North Carolina Department of Health and Human Services in a public hearing Monday, and heard from roughly 20 members of the public. In a months-long process, the state will decide which of the applications to approve.

Atrium has requested six new operating rooms and 76 acute care beds, and Novant has requested 1 operating room and 20 new acute care beds.

Now try replacing Atrium with Pizza Hut and Novant with Dominos and acute care beds with pizza ovens and re-read the passage. This is the way the state regulates the amount of health care facilities and beds in the state under the certificate of need laws (CON). An incredible amount of time and resources are wasted on a law that almost one-third of states don’t have. 

CON laws were implemented to eliminate unnecessary duplication of health care facilities, ensure an adequate supply of health care facilities, and keep health care cost inflation in check. Well, we know from decades of research that CON laws don’t do anything to keep prices down. If anything, they raise them

But most importantly, the CON process does not ensure an adequate supply of health care facilities and beds because the government cannot possibly have the knowledge of the private actors on the ground. The CON process hinders private actors from making the best decisions possible for the population they serve. This is illustrated in an example used in the Charlotte Observer article: 

Charlotte resident Shawn Flynn said he knows firsthand how important acute care beds can be. In October 2018, his 6-year-old son began getting sick.

Flynn’s son was limping when a specialist told them to go to a Novant Health hospital. But there wasn’t an available bed at Novant for five hours — when his son could no longer walk.

“I actually had to carry him into the hospital,” he said.

Delays in finding a bed meant a delay in an ultrasound that found a cancerous growth in his son’s pancreas and liver. “We lost a day in the fight because of that,” Flynn said.

Months later, his son is now cancer-free. He came to the public hearing to support Novant’s proposal for more acute care beds.

Had North Carolina not used CON laws, would there be enough beds for the Flynn family? It’s possible. But the CON laws certainly played a role in limiting the number of beds in Charlotte for which the Flynn family could use. North Carolinians are paying more in health care costs and have less access than they otherwise would in the absence of CON laws. It is long past time for North Carolina to repeal the state’s CON laws.

Jordan Roberts / Health Policy Analyst

Jordan joined the Locke Foundation in the summer of 2018 as Health Care Policy Analyst. He analyzes state and national health policy issues with an eye toward removing governm...

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