The Charleston County Medical Society has been battling to repeal the Certificate of Need (aptly named CON) Law which has been a big issue in SC for quite some time. This law limits the number of healthcare facilities, the type of facilities, and the types of service provided based on the state’s approval. The hospital systems have fought it for years. It is complicated but protects those with certificates while limiting the building of healthcare facilities and services provided.
How are COVID-19 and Certificates of Need related? This pandemic highlighted the need for ordinary health care centers, birthing centers, independent surgical centers, facilities for heart attack care, etc. But there were no alternatives to hospitals. Why? Because a CON law is restricting the supply of these!
Now is a great opportunity to make the temporarily lifted CON, put in place by the Governor’s Executive Order, to be made permanent. South Carolina’s Certificate of Need Law is the ninth most restrictive law in the U.S. “The catch is that anybody who has a Certificate of Need can contest a new application.” Why would a hospital want an orthopedic center nearby? They wouldn’t and would contest it to keep orthopedic surgery in-house. It’s like Lowes stopping Home Depot from opening next door.
Who is suffering in the interim-the public who had no access to more cost-effective, efficient centers with possibly higher quality services? Consequently, the big systems are being protected, encouraging monopolies. The trend in health care centers across the country is mergers, resulting in fewer and larger entities. Rural patients have to go to urban areas to have their needs met.
The current system denies patients the option of a perhaps smaller, higher quality, more efficient venue close to home. This is why Lowes and Home Depot are next to each other – because the public and the companies benefit from the competition.
