In order to open a new hospital in most jurisdictions, by law you need the permission of other local hospitals [0]. That's like being required to get the permission from Google to start a new search engine.
[0] https://www.ftc.gov/system/files/documents/public_statements...
[0] https://www.beckershospitalreview.com/finance/the-12m-patien...
See premiums rising and all of a sudden, "We need to consider letting this person die a noble death."
It's like a paradigm shifting, without a clutch.
just like tax laws, medical laws and implementation are done to favor specific groups to the detriment of others unfortunately
This is like, the main way to make insurance affordable.
Edit: The media only publishes the most extreme examples so I wasn't left with many options.
That doesn't really have much of an effect these days, though, because if anything, we already have an excess of hospitals in most areas where this would come into effect.
That's why hospitals have been hemorrhaging money, and so many have either gone broke and closed up entirely or been consolidated into larger hospital systems. The independent hospital is a dying breed, and it's been dying for a very long time.
In other words, there just simply isn't really any appreciable desire to open hospitals in those regions. The Certificate of Need isn't the limiting factor; their ability to break even on their operating expenses is.
Just a few days ago: http://www.newsobserver.com/news/business/article188329569.h...
"More likely, CON has affected the intensity and speed with which hospitals pursue particular construction activities. For example, the absence of CON in Indianapolis is likely an important factor in its rapid build-up of new full-service hospitals and specialty facilities. In Seattle, where CON is present, multiple hospital organizations are seeking to build new facilities in population-growth areas, but they must await review and final approval. CON requirements in this community could explain why Seattle hospitals expressed greater interest in better management of their existing capacity in the face of growing demand, because they cannot move quickly to build more capacity."
Anecdotally, there has been a 10 year long fight near where I live over opening a hospital with CON laws being at the center of state supreme court litigation[1]
As someone who works in healthcare and understands the economics of the system your perception cannot be further from reality.
[0]https://www.healthaffairs.org/doi/full/10.1377/hlthaff.25.3.... [1] http://www.charlotteobserver.com/news/local/article126222794...
As someone who's also worked in healthcare and also has an actual degree in economics, I stand by my point. In general, the CoN requirement doesn't have much of an end impact on prices for patients.
However, I will not fall back on my credentials since I prefer evidence instead of grandstanding.
Here are a few links that I think could help change your mind.
https://www.mercatus.org/system/files/mercatus-mitchell-con-... http://www.econtalk.org/archives/2012/11/cochrane_on_hea.htm... http://www.econtalk.org/archives/2017/10/michael_munger_4.ht...
I've excerpted the following quote from the first link as I think it summarizes my viewpoint quite well.
"A review of 19 peer-reviewed academic studies finds that CON laws have worked largely as economic theory predicts and that they have failed to achieve their stated goal of cost reduction. The overwhelming weight of evidence suggests that CON laws are associated with both higher per unit costs and higher total expenditures. The evidence is mixed on whether CON laws have increased the efficiency of particular hospitals by channeling more patients through fewer facilities, and there is no evidence that CON decreased overall investment as its proponents had hoped. The weight of evidence suggests that CON regulations persist because they protect politically potent special interests from competition"
From physicians to pharma companies, everyone is focused on leverage and ensuring they control the supply in their vertical.
Everyone pretends like the next round of drugs will make us so much healthier/live longer/etc. But we could have 0 innovation in medical/pharma technology in the next 20 years and if we instead focused on innovating in efficiency, expanding supply of docs and healthcare workers, and building a sustainable system, we would all be better off for it.
The next new procedure or pharmaceutical can’t do jack shit when most people that need them can’t get them in a timely and affordable manner.
Raise the bars for what you contribute to, folks!
http://www.cbs46.com/story/34481437/local-hospital-says-its-...