Congress passed the 1974 National Health Planning and Resources Development Act. Through it, States were to implement “Certificate-of-Need (CON)” requirements if designated federal program funding was to follow.

Washington D.C. and 36 other greedy states micromanage entry or expansion of healthcare facilities by CON programs. – no questions asked. (Isn’t federal blackmail great?)

Progressive Democrats enacted CON but never actually check on CONs success. They said, with government permissions (think control) it would theoretically:

• more readily provide new services or designated medical equipment;

• ensure adequate health resources;

• improved rural community care;

• better quality of care;

• provide for those without funds;

• develop walk-in surgery centers, and;

• restrain medical costs.

Not so! Thomas Stratman and Jacob Russ, George Mason Mercatus Center, and others, in multi-year studies find these regulations fail to increase access for the poor. CON, instead, limits services and facilities.

States with CON programs shortfalls demonstrate:

• 131 fewer beds per 100,000 persons;

• Fewer Hospitals overall;

• A reduction by 1-to-2 hospitals per 500,000 citizens in providing MRI service;

• 37 percent reduction in the number of hospitals offering CT scans;

• For example, citizens in Arkansas enjoy 6-12 fewer MRI capable hospitals and 15-21 fewer CT scan capable hospitals while Tennessee hospitals offer 8500 less hospital beds.

Much evidence from studies suggests CON regulations are actually causing higher healthcare prices and increased healthcare spending (Professor James Bailey, Creighton University).

CON programs vary state to state. They exhibit inconsistent metrics and management approaches. CON permits political influence over intelligent and competitively driven decisions on facility construction, equipment purchase. This can only invite manipulation, corruption, and abuse in patient services. Tax dollars are squandered through political manipulation of construction and rational spending.

Where were media checking into this condition while screaming for more ventilators, medical equipment and facilities? Understand the impact when two-thirds of states continue to restrict entry, expansion, and competition in healthcare through CON laws seems significant. Yet, it appears more important to spread fear than investigate Bureaucratic mismanagement!

Just like in “A Few Good Men"; Truth Please!

Gary Smith


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