In this column I will provide my reasoning for seeking to repeal the draconian and “progressive” Certificate of Needs (CON) rules that was signed into law over four decades ago.
BACKGROUND: Democrat Jay Rockefeller signed the Democrat-sponsored bill into law in 1977. Back then we were told that the new Certificate of Need rules was designed to control health care costs and to prohibit redundant or unneeded medical services in communities.
Under the Rockefeller law, all health care providers in the state must ask permission to and seek approval from, the West Virginia Health Care Authority every time they desired to expand or diversify their services to better serve their local communities. In other words, under current law, local health care providers must seek the permission of a board of bureaucrats in Charleston before they can run their business the way they desire based on the local needs of the communities which they serve.
There are three primary reasons that I support the repeal of these bad CON rules:
First, I personally believe that all businesses, including health care providers, should have the freedom to compete in the marketplace free from outside interference. I sincerely believe that competition can drive down costs for the consumers over time, in this case for the patients and their respective health insurance agencies. Historically, when a local business knows that there is likely to be no competition in their community for their product or service, they tend to charge consumers what they want. With regards to healthcare, if such providers jack up their price for a unique service that they know is not being offered anywhere else in the community, the patient’s insurance company may initially absorb the brunt of the charges but could raise client premiums over time. This is not fair to the patients.
Second, if your elderly parent requires a unique procedure that the local provider in your community is not permitted by the Health Authority in Charleston to offer, they must now travel to other healthcare providers, oftentimes in another state and potentially hours away from their homes. Even if our local healthcare providers wanted to add a service, they must now oftentimes wait up to 18 months for approval to do so, if permitted at all. This is not how free-market capitalism is supposed to work. Repealing the Certificate of Needs requirements would set the conditions for our local hospitals to invest in new equipment, specialty physicians, and procedures that they are not currently permitted to do. This way, they are free to best prepare their facilities and services to handle healthcare situations faster instead of referring patients to other facilities out of state or making them wait for months or years for treatment.
The third reason that I desired to co-sponsor the repeal of this bad law, is that I am tired of West Virginia being last in most things. Not surprisingly, the first state to institute a CON law was New York in 1964. Many “progressive-leaning” states followed along with these restrictive laws, including West Virginia in 1977. Since then, most states have realized the errors of their ways and have already moved to repeal these requirements. Nearly half of the states that initially jumped aboard the CON train during the 1960s and 70s are now jumping back off in regret.
According to Christopher Koopman, a senior research fellow at George Mason University, West Virginia has the 6th most restrictive Certificate of Need rules in the nation. While most Marxists (aka “progressives”) seem to like the current law and loudly demonize those who seek positive change, I nevertheless believe CON rules to be the most restrictive and regressive rules currently impacting healthcare in West Virginia today.
Except for those who may potentially have special “gentleman’s agreements” in the future with those who sit upon the Health Authority Board, many in the industry agree that the CON rules must go. While they may be good for potentially fostering price-gouging monopolies, they are terrible for most of our state’s healthcare providers and especially for patients. I consider the bill I co-sponsored to be both a pro-business and pro-patient bill, one which is long overdue. Business competition is a hallmark of a free market system, and it is in this spirit that the repeal of the CON rules was brought about. Let the free market decide who may stay or go and who may expand services or roll them back. These decisions are best left to the free market to decide, not a handful of unelected bureaucrats in Charleston. My desire is that the repeal of CON rules in West Virginia will set the conditions for our healthcare industry to better provide much-needed services for our citizens at much lower costs.
Three bills designed to address the CON rules were introduced this year. One of which I co-sponsored, HB 2264, was passed out of the House of Delegates and is currently sitting in the Senate Health Committee. The Senate also has its own version, and it is also sitting idle in the Senate Judiciary Committee. On the surface, it appears as though the powers-that-be in the lobbyist world has been loud enough or there is not enough support in the State Senate to get the ball over the goal line at least this year.
Nevertheless, fingers are crossed! I am hoping to see movement on one of these two bills soon.
Todd Longanacre
Delegate, 42nd District, WV House
Todd.longanacre@wvhouse.gov
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