The big CON That Caps Hospital Beds and Health Care Resources
Article from For Liberty by Norm Leahy.
One of the major worries about the COVID-19 outbreak is that local hospitals will be overwhelmed with patients, leading to shortages– and rationing – of beds and life-saving equipment.
There’s a way to begin fixing this – once the current emergency has passed: eliminating certificate of need laws.
The Mercatus Center’s Matthew Mitchel and Anne Philpot write:
…36 states and the District of Columbia have certificate-of-need (CON) laws, which require providers to apply for state permission before acquiring equipment or providing certain services to patients, such as drug rehabilitation centers, CT scans, or neo-natal intensive care units. By limiting the number of certificates awarded and by making the application process long and expensive, states have made care less accessible and more costly—even though CON statutes are supposed to do the opposite.
How would eliminating CON laws affect bed availability?
Bed space is of primary concern. The onslaught of cases in China and Italy has stretched space to the breaking point, leading to heart-wrenching health rationing. Even in the US, where the worst is yet to come, some hospitals have already set up outdoor tents to accommodate the influx of patients. At 2.8 hospital beds per 1,000 people, the US already has fewer beds than many other countries such as Italy (3.2 beds per 1,000), China (4.3 beds per 1,000), or South Korea (12.3 beds per 1,000).
And yet, the number of acute care hospital beds that a facility is allowed is limited by CON laws in 28 states. This means a hospital cannot expand existing units without enduring an often-lengthy CON approval process. Some states not only require a certificate-of-need for a new hospital bed but also require one to transfer a bed between facilities. It is also common for states to require a CON if a hospital makes any investment above a certain dollar threshold. These sorts of rules should be repealed to give hospitals maximum flexibility. Hospitals and their staffs—not state administrators—should decide how many beds are needed.
Libertarians have been arguing against CON laws for years. The standard pushback is that allowing the market to provide health care facilities at will would somehow hurt established providers.
The cartel mentality (coupled with plenty of lobbying) has kept an artificial lid on the number and variety of health care facilities available. Let’s hope it doesn’t exact a real human toll in the coming weeks.
And once the danger has passed…let’s bust the CON laws for good.
Image Credit: By Cellofellow (Gadsden_flag.svg) [CC0], via Wikimedia Commons
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