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YC Magazine, Libertarian Commentary, May 2011

Why Fort Mill is still waiting for a hospital

I noticed from ads in The Fort Mill Times that residents were asked to write the SC government in order to help bring their choice of hospital here. The hospitals that are competing for this privilege include Carolinas Medical Center, Piedmont Medical Center, and Presbyterian Healthcare. As a Libertarian, I find this premise of having to ask the government for something the market would have already provided to be absolutely ridiculous. This should be a choice for the hospitals and residents alone to make, not bureaucrats, but this is not a free market and hasn’t been for quite some time.

In Fort Mill we’ve been waiting for a hospital for seven years now, due to bureaucracy in the name of controlling health care costs through Certificate of Need applications, or CONs. The acronym of “CON” aptly describes the state law that says a hospital must go through a rigorous application process to be granted permission to open by the SC Department of Health and Environmental Control.

What happened in this case, according to The Charlotte Business Journal, is that SC regulators couldn’t correctly interpret the regulations that they are supposed to follow, and a state judge re-opened the process again after appeals by non-profits CMC and Presbyterian when a CON was granted to for-profit PMC in 2006. Sounds like it’s just as fun as the tax code. If our regulators can’t even understand the regulation, perhaps it’s time to scrap it.

Supporters of CONs claim that they help control and reduce the cost of health care by limiting duplication of services and making sure that we don’t have too many facilities with too much expensive equipment. However, businesses forced to compete with one another are quite adept at managing costs. If patients were in charge of controlling the cost of their own health care plan instead of the insurance company or the government, hospitals would cater a bit better to those they serve, and patients would be more cost-conscious.

In 1987, the Federal Government repealed the original CONs mandate Nixon signed into law because they determined it didn’t work. According to the National Conference of State Legislatures web site, “the Federal Trade Commission (FTC) and the Department of Justice both claimed that CON programs actually contribute to rising prices because they inhibit competitive markets that should be able to control the costs of care and guarantee quality and access to treatment and services.”

Not only are CONs not needed, we already have another government body which does this. According to a statement from the federal department of Housing and Urban Development, “HUD conducts the same analysis of need whether or not the state has a CON process.” So I ask, why do we need the CON process standing in our way? It seems to be just another layer of regulation that has done nothing but slow down construction of medical facilities at a time when our aging population has increasing needs.

And recently, we’ve made it a bit more costly for no other reason than political will. According to the SC Policy Council, under the “Worst of 2010,” the SC legislature overrode the governor’s veto and added a $100.00 fee to the hospital application process last year in addition to the onerous delays the CON policy has already caused. This fee only increases the cost of health care, further supporting the notion that CONs have the opposite effect of what they were written to do.

Like any business, hospitals will just pass on fees and administrative costs related to regulation to patients and government-approved insurance companies in the form of higher bills. Some may argue that $100.00 is not a lot of money for a hospital to pay, but it’s not fair to make patients pay extra because politicians are unwilling or unable to balance the budget and reign in spending.

That trip granny takes to the hospital could be five minutes long, not thirty. Mere minutes could mean life or death in some cases. Thanks to the over-regulation of health care, politicians are fixing prices, deciding where and when hospitals and doctor offices can be built, what kind of insurance you can have, and what those policies cover.

As a Libertarian, I believe that the only just transactions are voluntary ones. When the government meddles in business, it removes our right to choice in the marketplace and affects the quantity and quality of the products and services we buy. Instead of being able to vote with our dollars, and utilize our free speech regarding health care, everyone is forced to be at the mercy of politicians who rarely are held accountable for their actions. Government should only exist to protect our rights, not take them away. In this case, we’ve lost jobs that could have already been here, revenue that would have stayed in the county, and precious minutes with longer drives to further hospitals. Please ask your SC State representative to put an end to the CON policy.

Jen is Secretary/Treasurer of the York County Libertarian Party.

More information can be found at http://www.sclp.org and http://www.lp.org

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