by Mitch Kokai
Senior Political Analyst, John Locke Foundation
Mark Flatten offers National Review Online readers another reason to support reform of state certificate-of-need restrictions.
The dearth of mental-health-treatment options that exists in many places around the country is driven by the greed, or at least the economic selfishness, of established medical providers who are able to prevent competitors from moving in on their turf, regardless of how dire the shortage. To do so, they use what are called Certificate-of-Need (CON) laws, which generally require would-be providers of health-related services to get approval from a state regulatory board before building or expanding a facility or service.
Indeed, my new Goldwater Institute report finds that the primary beneficiaries of the CON laws currently on the books in 38 states are existing providers of health services, who use them to block or delay construction of new facilities by would-be competitors. From Iowa to Oregon to Tennessee and beyond, private companies are being prevented from building new mental-health facilities financed entirely by their own money. Even though these facilities are clearly very much needed, in more than two-thirds of states existing providers and state bureaucrats turn a cold shoulder and a blind eye to that need so that they may preserve their own power.
The consequences are tragic. People in severe mental-health meltdowns are held in emergency rooms for days without receiving care. Sheriff’s deputies routinely drive for hours to transport dangerous mental patients to distant facilities that have just one available bed. Pregnant women seeking to shake their opioid addictions are forced to drive for hours every day to receive treatment in the nearest methadone clinic. Yet existing medical providers routinely oppose competitors’ applications for a certificate of need, typically arguing that the shortage of inpatient beds is not a problem, or that if it is a problem, they are the ones to fix it.