Often in politics, it is easier to define a problem than it is to solve it.
Remember Barack Obama’s eloquent speech about the need to unite America beyond red states Vs blue states? When Obama left office, America was more politically polarized than before.
Who could forget Al Gore’s theatrics as he talked about the need to save the planet? I doubt a Gore-run administration would be able to control the country’s borders, let alone control global sea levels or the climate.
Remember how during last year’s gubernatorial race here in Mississippi, Brandon Presley, the Democrat candidate, waxed lyrically about the fate of rural hospitals? Hosing federal funds around is unlikely to change the fact that hospitals that are underused will remain underused.
Politicians can certainly make problems worse. Obama, I would argue, exacerbated America’s divisions. Gore & co have advocated for an energy policy that does nothing to control the climate, but has made people poorer. Subsidising an underused health service is unlikely to make it magically sustainable.
Occasionally, however, politicians have it in their gift to do something that really would improve things.
In a report we published this week, we show that there is a solution to Mississippi’s healthcare crisis staring us in the face: our leaders could abolish the anticompetitive laws that intentionally limit the number of healthcare providers in our state. This would improve access to healthcare and lower costs for everyone.
For years, if a healthcare provider wants to offer new services or expand existing services in 19 key areas of health care, they are required by law to get a permit. These Soviet-style permits, known as Certificates of Need (CON), are also required for a provider wanting to spend more than $1.5 million on new medical equipment, relocate services from one part of the state to another, or change ownership.
Unlike other sensible licensing requirements, CON requirements are not designed primarily to assess a provider’s qualifications, safety record, or fitness. They are about central planning to decide if each new applicant’s services are “needed” by the community. I believe that it should be up to patients and practioners to decide what is needed, not government bureaucrats.
CON laws in Mississippi limit the provision of long term care, despite demographic change that has seen the number of elderly people needing care increase dramatically. Ambulatory services, key diagnostic services, psychiatric services and many other services are all limited by CON laws.
If the case for change is so overwhelming, why has it not already been done? In any market, when there are restrictions imposed to keep out the competition, there will be various vested interests that lobby for their retention. So, too, with CON laws.
Defenders of CON restrictions suggest that CON repeal would be risky and dangerous. They like to imply that any reform would reduce access and quality would suffer.
Such concerns are unfounded. Over 100 million Americans—nearly a third of the population—live in states without CON laws in health care. Four in ten Americans live in states with limited CON regimes that apply to only one or two services, such as ambulance services or nursing homes.
If our lawmakers are serious about improving healthcare in Mississippi, I hope they read our report, which sets out not only what needs to be done, but provides a roadmap explaining how to do it.
High flying rhetoric won’t improve our state. Getting down to work and removing CON laws will.
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