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Comment by h2zizzle | Hacker News Reader

Oh, well that's BS. Urgent care clinics have proliferated like crazy over the post decade or so. The supply to fill the vast majority of urgent medical needs which hospital ERs used to have to carry alone is there. But it's true that that supply often goes unused. Why? Because ERs HAVE to tend to and stabilize patients when they present; UCCs can turn you away if you can't demonstrate the ability to pay.

The problem is not restrictions on medical facility construction, it's inefficient use of what we already have.

In general, America has an issue with defaulting to "building new", as if we have an everlasting greenfield, rather than careful provisioning of the already overbuilt infrastructure base. Capitalists love being freed of prior obligations, with no regard for how they contribute to an even more unwieldy set of obligations in the future. Enough. You can't just do as you like. Help solve the actual problem.

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BS, eh?

https://www.health.ny.gov/facilities/cons/

That’s just New York, yeah? Does every state have similar regulations?

So, unless every state has a regulation, that regulation doesn't exist and has no effect?

Any other goal lines you want to redraw? Let's get that out of the way now instead of going back and forth.

(To answer: in my personal experience Illinois also has such a regulation.)

Slightly more than half have CoN laws and other states have a number of restrictions of facility construction that complicate building smaller clinics.

Yeah, that one actually fucked us over rurally. Local healthcare system wanted to put up a new greenfield hospital facility, was turned down for the CON by a challenge from another hospital 30 miles away. They wrenched demands out of the facility to get the CON approved with modifications that basically took away all of the “hospital” from it and basically made it “fancy block of specialist doctors” instead.

Rural/urban split. Many cities instead contend with local politicians who want to put a feather in their cap by giving concessions to developers to build new, expensive facilities (instead of, say, driving that money into actual healthcare or the rehab of existing facilities). What will happen is that the taxpayers will give millions to have a greenfield facility built, and around that time, the older local facility (likely to be servicing poorer residents or those without transportation access) will get shut down. Expanding building doesn't fix this dynamic, it makes it worse.

Yes, BS. Because, as I said, regulations have not stopped the establishment and proliferation of the urgent care clinics that would be intended to reduce the load for hospital emergency rooms. Such facilities do not need a CON if affiliated with an existing hospital or practice. They essentially function as extensions of local ERs for non-critical needs - or, they would, if they were forced to see patients regardless of demonstrated ability to pay, as ERs must. To fix that, you need MORE regulations, not fewer.

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