RALEIGH – I’m glad that Gov. Mike Easley vetoed the special incentives bill for the Goodyear plant in Fayetteville, a veto that the General Assembly proved incapable of overriding (though the final result may well be at best a marginal improvement). But despite my rediscovered good feelings towards the guv, I still don’t want him making critical decisions about my health care.
It’s nothing personal. No governor should have the power to decide what machines hospitals can buy and which services they can sell. Such a role is far, far removed from the core function of state government.
But at the current time in North Carolina, this is one of the powers of the governor. As Adam Linker reported in the August 31 Triangle Business Journal, Easley just overruled a decision from his own Division of Facility Services, which enforces the state’s counterproductive certificate-of-need law. It’s bad enough that the state continues the practice of attempting to impose a central plan on the health care market. It’s worse that the governor can selectively overrule elements of the plan with little notice or explanation.
Perhaps Easley was justified in concluding that, in the most recent case, the patients of Wake County and surrounding communities needed additional access to radiation-therapy devices for treating tumors. In the original State Medical Facilities Plan, regulators had not authorized any cancer center in the region to add a linear accelerator. Easley attached a memo to the 2007 plan stating that because the region was “growing rapidly,” the state should grant a CON to an existing cancer center in Wake, Franklin, or Harnett counties to add the machine, which could cost between $2.5 million and $4.5 million depending on what kind of accelerator regulators decide Easley meant to authorize. Unfortunately, none of the providers yet know exactly what the governor meant. One, Cancer Centers of North Carolina, has filed two separate applications just to hedge its bets.
Sound like a mess? It is. Incredibly, when Linker asked the Easley administration how often the governor had intervened to make special exceptions to the State Medical Facilities Plan, he was told that no one kept such records. Triangle Business Journal was able to determine that the governor had changed the plan on three prior occasions: adding a PET scanner in 2003, authorizing a new hospital in Harnett County in 2005, and indicating that Presbyterian Hospital Huntersville should not be closed as originally envisioned.
If the state is going to regulate what services medical providers can offer, this haphazard, ambiguous process is hardly the proper way to go about it. Whenever an elected official is granted the power to make arbitrary decisions involving millions of dollars of other people’s money, you can be sure those affected will take note. They’ll realize quickly the value of playing political ball. Want to know why government control over health care is so dangerous? Because of the very real possibility that a provider’s campaign contributions, not expertise or patient preference, will determine how medical dollars flow.
The right answer is to get North Carolina state government out of the health-care planning business. It costs patients time, money, and suffering. It subverts the powerful forces of competition that drive medical innovation and excellence.
As the General Assembly hasn’t shown much interest in free enterprise lately, however, perhaps the less-bad answer is all we can hope for: don’t let the governor or any other elected official attach a memo to a facilities plan that make special exceptions or allowances. That’s just asking for trouble.
Hood is president of the John Locke Foundation.