Many years ago, the Idaho Legislature required something called a “Certificate of Need” for each new hospital or hospital addition, medical facility or even new equipment. The Certificate of Need was ostensibly designed to prevent duplication of services when scarce medical dollars were being allocated.
The result, however, was to squelch competition for existing hospitals and medical facilities. A board was selected to review all proposed new facilities and decide whether there truly was a need. Of course, the board included individuals with serious conflicts of interest – they were vested in existing facilities which they hoped to protect from new competition. It was a political process, not based on true need. Fair trade was denied, and consumers of medical services suffered.
Fortunately, that law expired sometime in the early 1980’s. But now the Idaho Hospital Association is seeking to resurrect this very bad idea. Already St. Alphonsus Hospital in Boise has hosted a number of legislators at a lovely meal that included a course in “Certificate of Need” flambe’, so to speak. Lead “chef” was Jeremy Pisca, lobbyist (you remember – he helped bring us another great idea in Contractor Registration).
The argument now specifically addresses doctor-owned facilities, which existing hospitals see as threatening their bottom line. Even though surgical centers and other specialty facilities can offer much lower prices for patients, save money for private insurance, Medicaid and Medicare, and offer yet another health care choice, they are in the cross hairs.
Clearly, Certificates of Need are not about “need”, or patients, or saving money at all. They are about stamping out competition for existing hospitals who would like an exclusive corner on the health care market.
Keep an eye out for legislation bringing Certificates of Need back to the Idaho health care scene. A bill would likely be introduced in the Senate or House Health and Welfare Committee. Be prepared to contact legislators with your opinion on the subject.