North Carolina’s certificate-of-need law is an outdated law that dates back to the 1970s. It’s a failed economic policy from the feds that turns economics on its head when it comes to the supply of health and medical care. Locke’s Brian Balfour wrote about CON in North Carolina for

Most states enacted CON laws in response to a 1974 federal mandate, but Congress repealed that requirement in 1987, and 15 states subsequently repealed their laws. But not North Carolina. In a state known for its highly skilled workforce and world-class medical and research facilities, 23 categories of services are smothered by these rules. Everything from hospitals and nursing home facilities, to MRI machines and organ transplant services are subjected to government control.

This means North Carolina adds to its resume the dubious distinction of the third most restrictive CON laws in the country.

Now we have another real-world example of why North Carolina’s certificate-of-need law should be repealed, or at the very least, reformed.

UNC Health and the Duke University Health System are now in a battle for the coveted permission slip the state requires before a provider can build or expand care. Both want to provide more care in Durham County. Both hospitals want to build or add hospital beds and operating rooms. But stunningly, only one will be given the go-ahead by the state. That’s right. Both want to provide Durham County with more care, but only one will be “allowed” to help.

Have you ever heard of something so wrong-headed?

Locke’s Becki Gray has been talking about the anti-patient CON law for years. Just days ago she explained the insidious impact of CON law when she joined me on News Radio 680 WPTF. Listen:


The good news is that some members of the General Assembly understand the negative impact on patients and hospitals. This legislative session, more than half a dozen bills have been filed to address the problem, as Becki explains. LISTEN:


At the heart of this debate over certificate-of-need law is access to care. We need to expand access, particularly in the underserved rural areas of North Carolina. You can’t help people in need by keeping an artificial barrier to care in place. Becki talked about the need to give the providers the ability to develop a business plan that works in the marketplace. LISTEN:


Locke’s Brian Balfour put it this way:

People are moving to North Carolina in droves, seeking our quality of life and commitment to entrepreneurship and opportunity. My state is a leader and a beacon in many ways. Now it’s time we lead in the health care arena and ensure we’re prepared to meet the medical challenges of a post-pandemic world.

It’s time for North Carolina to expand access to quality, affordable care by joining the 15 other states that have already made the move. It’s time, in fact, for every to state to repeal their certificate-of-need laws.

Yes, it’s time. What’s happening in Durham County proves it.