JEFFREY SINGER: Removing state-based obstacles to affordable healthcare.
States can begin by repealing “Certificate of Need” (CON) laws. These are outdated and counterproductive laws which encourage cronyism, increase costs, and detract from the quality of health care. . . .
When a new provider petitions for a certificate, established providers are usually invited to testify against their would-be competitors. This means that some health care practices can openly challenge the right to exist of any practice that might hurt their bottom line. Indeed, hospital administrators openly admit that protection against competition thanks to CON laws has become an integral part of their business model.
Large hospitals and other medical incumbents have another advantage: They can afford the lengthy and expensive process while smaller, newer health care providers cannot. Getting state approval for a certificate of need can take years or even over a decade, including appeals and re-appeals. In a place like Washington state, the application fee alone can cost tens of thousands of dollars. All of this discourages new entrants who lack the legal and financial resources to run the certificate-of-need obstacle course.
“Permissionless innovation” made the Internet boom. Let’s try it elsewhere.