by Donna Martinez
Former Senior Writer and Editor, John Locke Foundation
So many families are dealing with it. Someone close to you is troubled to the point that you’re worried about their future. Or your heart aches as you watch a friend spin out of control because of drug addiction. These problems are so widespread that it can appear hopeless.
But it’s not.
As caring individuals, we can step in to stop the cycle in our own families and circle of friends. But on the broader scale, public policymakers can play a critical role as well. Here in North Carolina, lawmakers don’t have hearts of stone, so they must not realize that an archaic state law is hurting people struggling with these difficult problems.
It’s called Certificate of Need. Essentially it’s permission slip state government requires of health care providers who want to open, expand, or offer a new type of service. CON is an artificial barrier that ties the hands of experts who want to better serve their communities. It puts government in charge of deciding what care is “needed” in which areas, not the people who see the problem firsthand.
We can truly help our neighbors if our CON law is repealed, and the John Locke Foundation is reaching out to state legislators and the public, urging action.
A new study published Jan. 26 by the John Locke Foundation details academic research that illustrates the impact of CON and the benefits of mitigating its negative effects on care and costs.
Author and researcher James Bailey of Providence College writes in “Certificate of Need In North Carolina: Cost, Access, Treatment” that North Carolina has the strictest CON laws in the Southeast and the third strictest in the United States. The laws remains in place despite evidence that CON’s flawed premise – to control rising costs through government restrictions – was proven wrong. Fifteen states have repealed CON since the federal requirement was dropped in the 1980s.
By repealing CON, access to care will grow and there will be downward pressure on costs.
How would repealing CON impact people with psychological issues?
By repealing North Carolina’s CON requirement for psychiatric hospitals, the state could expect to add three psychiatric hospitals, increasing capacity for care from 15 to 18. Bailey concludes that repealing this requirement would also benefit older North Carolinians, since 15 or 16 of the psychiatric hospitals would accept Medicare. Currently, only 12 of the 15 existing hospitals do so.
What about substance abuse care? Could repealing CON open doors to more care? Dr. Bailey studied that component of CON law as well.
Data from 2018 shows that 458 treatment facilities in North Carolina accept cash. Only 326 accept private insurance, and only 349 accept Medicaid. “Our estimates suggest that if CON were repealed, an additional six treatment facilities would accept private insurance and an additional 12 treatment facilities would accept Medicaid,” Bailey writes.
The research is clear: North Carolina’s antiquated Certificate-of-Need (CON) laws should be repealed or reformed to meet our growing state’s need for more access to affordable, convenient care to treat both physical and mental health.
Remember, there is hope for your family and friends who need professional help. Repealing CON is one way — a significant way — to help.