Readers of the Locker Room know how our organization feels about certificate of need (CON) laws. These laws are anticompetitive, infringe on economic rights, and fail to hold down the rising cost of health care

However, several states, including North Carolina, still use a certificate of need regime to allocate their health care facilities. Kentucky is another state which requires a government permission slip to build or expand certain services. 

One town in Kentucky is feeling the pinch of how the certificate of need laws harm patients. MaryAnn Fletcher of WYMT reported:  

MAGOFFIN COUNTY, Ky. (WYMT) – In the moment of an emergency, many expect an ambulance to be on the way.

“The people of Magoffin County haven’t felt that way in nearly a year,” Matthew Wireman pointed out.

Wireman is the Judge-Executive of Magoffin County. He has worked to change the risky narrative.

“There’s a lot of worry out there because of the lack of service that we’ve had over the past six to eight months,” Wireman said.

He has filed for a Certificate of Need (CON) for an ambulance service. The process for the license is lengthy.

“The certificate of need asks or several different things. The actual application is about 19 pages long,” Wireman explained.

However, he does not have to do it alone.

1″One of the things you have to do in a certificate, is you have to obtain letters of support,” said Wireman.

From business owners to state representatives, many composed letters of concern.

“Because one of the problems that we’ve had is the length of time that it takes to get on scene,” Wireman pointed out.

Now, to help Mr. Wireman get his certificate of need application approved, 7th graders who fear for the lack of an ambulance service are helping to nudge the state to approve the application: 

One group of seventh-grade students at Herald Whitaker Middle School wanted to do their part.

Their teacher reached out to the Judge-Executive to ask for permission for her class to help.

“They all wrote a lot of very interesting things but there was a common theme,” recalled Wireman.

The class wrote about their worries about loved ones in need of medical care.

“That the ambulance wouldn’t get there on time if they had a heart attack or they cut themselves,” said Wireman.

The Judge-Executive told WYMT all the work is worth it, regardless of the outcome.

“If we’re not successful in a certificate of need, if nothing else, we’re pushing the current service to get better and to realize I’m not going to take my foot off the gas on this,” Wireman explained.

The next step will be a hearing which will be held either later this month or sometime next month.

We reached out to AMR Lifeguard and spokesman Mike Cohen said, “We continue to work hard to make our service even better. We just recently added some 20 EMT’s through our “Earn To Learn” program where we paid people to go through training….and paid for the training. Those folks are now working on ambulances and as we continue to increase manpower it will make our response time even better. It’s already very, very good the vast majority of the time.”

This shows how antithetical CON laws are to their supposed goal of adequately supplying a community with enough health care facilities and services. The people of Magoffin County obviously need this service. Yet these arcane CON laws are preventing private actors from obtaining crucial medical equipment and services. 

For states like Kentucky and North Carolina, this is the reality for those who want to enter the health care market. CON laws should be repealed across all 50 states and states should let private actors, rather than government bureaucrats, determine the proper supply of health care services in a given community.