by Brian Balfour
Senior Vice President of Research, John Locke Foundation
The good news for Buncombe County: three medical care providers are planning on investing in new medical care facilities, increasing access for patients. The bad news: they must first obtain permission from a state government board.
Certificate of Need (CON) laws require healthcare providers to undergo a time-consuming and expensive application process with the CON board in the hopes of being approved to go ahead with their investments in new or expanded medical care facilities and equipment.
North Carolina is one of 35 states with CON laws on their books, and research has shown that CON laws are associated with a lower supply of medical care and higher healthcare costs. North Carolina has one of the most restrictive sets of CON restrictions in the country.
In this recent case in Buncombe County, three different healthcare providers have applied for numerous medical care facilities and equipment, including but not limited to: 67 new acute care beds, an additional operating room, MRI, CT and X-ray equipment, an emergency room with 35 bays, a new $254 million building on Smoky Park Highway, and a $125 million expansion to the Mission Hospital in Asheville.
Buncombe is among the 91 North Carolina counties to be considered as having a primary care, dental, and mental/ behavior health shortage.
The announced investments in new medical care facilities and equipment should be welcome news – but sadly the new hospital beds, diagnostic equipment, etc. is contingent on the approval of a government board that may include representatives from the potential investors’ competition. This provides an incentive for the expanded services to be denied so as to protect against competition.
Such an archaic obstruction to investing in expanded medical care facilities would be unthinkable in a free society. This is yet another reminder why North Carolina should eliminate all of its CON laws.
Disappointingly, the N.C. Court of Appeals this week dismissed a New Bern eye surgeon’s challenge to the state’s CON restrictions.
Moreover, the Medicaid expansion bill recently approved by the Senate and now sitting in the House includes some provisions that would partially repeal or relax some CON restrictions. These provisions should be advanced in separate legislation, and not held hostage to the Medicaid expansion debate – because expansion remains a bad deal for North Carolina.