We talk a lot about freedom in North Carolina. Freedom to choose the education opportunity that best fits your needs, freedom to spend your hard-earned money the way you want, freedom to pursue your dreams without burdensome regulations, freedom of ensured property rights.
In recent years, solid ideas and bold leadership have made North Carolina more free in many areas. It’s now time to restore health care freedom.
North Carolina has some of the most restrictive certificate-of-need laws in the country, driving up health care costs, limiting competition, and stifling innovation. By law, state bureaucrats (not health care providers, not the free market) determine the availability of new, updated, or expanded health care facilities and services.
Health care providers must get a permission slip from government to decide where, when, and how you’ll get your health care.
Introduced in 1974, federal CON laws were intended to increase access and lower costs. But by 1987 it had become clear that CON laws were not meeting their stated purpose, and the federal government repealed the mandate requiring state CON laws. North Carolina is one of 36 states that have kept them in place.
North Carolina has the nation’s fourth-most restrictive regulations. The average number of services, devices, and procedures regulated in a CON state are 14. North Carolina regulates 25.
The process for approval is long, complicated, and costly. As you’d expect, by limiting competition and choice, North Carolinians pay more and have less access to medical services.
Imagine the young couple having their first child at a local hospital. Unforeseen complications ensue. But because of CON laws, their hospital does not have a neonatal intensive-care unit. The baby and mother and child must be transported to the closest NICU unit — two hours away.
Or imagine a couple married for 50 years. The wife suffers a stroke and requires special long-term care. But because of CON laws, no facility near their home offers the needed care. Her husband must travel more than an hour each way to be with her and stay in a hotel room, incurring expenses far away from their home, family, and community.
Because of CON laws, we don’t have to imagine these scenarios. North Carolina families are living these stories and others every day. For knee replacements, rotator cuff repairs, life-saving screening tests, mental health services, dialysis — we’re paying more and are denied access every day.
CON laws are perverse. They lock out competition, discourage entrepreneurs, and stifle new ideas. Doctors and health care providers are kept from developing and investing in new technology, life-saving innovations, and life-changing procedures.
The loser is the patient, and the winner is an outdated, behemoth system that denies heath care freedom to every North Carolinian.
We don’t have to imagine what would happen if CON laws were repealed in North Carolina. In 2005, CON rules restricting colonoscopy centers were loosened. Since then, 56 new facilities have opened across the state.
These freestanding facilities charge 58 percent of the rate charged by hospitals. Every year, 50,000 Americans die from colon cancer. Forty percent of those deaths could be prevented with a colonoscopy.
Greater access and lower cost save lives. Imagine how much more health care could be delivered if all CON laws were repealed.
The John Locke Foundation’s first research on CON was published in 2005 — “Certificate Need Laws: Time for Repeal.” Since then we’ve written and reported extensively, partnered with national advocates, and worked with health care providers and legislators to repeal North Carolina’s CON laws.
Even so, health care costs have increased, access has been denied to many who needed services, and limits on competition have hindered innovative health care breakthroughs. It is way past time for CON repeal; it is time to restore health care freedom in North Carolina.
Go to RestoreHealthCareFreedom.com. Add your name to the thousands of North Carolinians who want to restore health care freedom. Because freedom matters.
Becki Gray (@BeckiGray) is vice president for outreach at the John Locke Foundation.